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Health insurance companies are demanding the granting of limited health insurance approvals in order to counter the shortage of doctors in rural areas and social hotspots.
The health insurance companies criticize the too high density of doctors in the cities, while patient representatives and medical associations speak of a veritable shortage of doctors in the country. Both arguments actually reflect the German reality. While a doctor's office advertises patients on almost every corner in the big cities, rural residents often have to travel long distances to get medical treatment. In order to tackle the unequal distribution, health insurance companies are proposing a systematic redistribution: If resident doctors give up their doctor's office, the approval should also expire. According to the health insurance funds, newcomers should no longer be given the opportunity to inherit a cash register approval from their predecessor.
Inheritance of health insurance approvals should be prevented. For decades, medical practitioners have had a special privilege. Anyone who retires himself or is otherwise professionally oriented can pass on or sell his statutory health insurance license to a colleague who will move up. If it were up to the will of the statutory health insurers, it should soon be over. If you give up your doctor's office, you should also lose your health insurance license. The aim of this change is to reduce the number of practices in the cities and to increase the supply in the country.
Reduced fees in cities with a high density of doctors Whoever wants to settle as a doctor in a larger city with a high density of services should, according to the wishes of the umbrella association of health insurers, reduce the fees together. Both measures are intended to encourage medical professionals to settle in underserved areas. A real undersupply exists especially in rural areas and social hotspots.
Attempts to date have been unsuccessful. The deputy chairman of the Federal Association of Health Insurance Funds, Johann-Magnus von Stackelberg, justified the targeted cuts to the Berliner Zeitung. After all, all attempts by the federal government have so far not been successful. "Any efforts by the black-and-yellow coalition to attract more country doctors will be totally ineffective if the problem of over-supply is not addressed," the vice-chief told the newspaper. If the federal government does not include the proposed changes in the new pension law, the changes in law will inevitably lead to higher costs. If the costs in the healthcare system increase, the higher expenses have to be passed on to the insured in the form of higher health insurance contributions.
Not a shortage but a surplus of doctors
Contrary to the statements by the FDP, there can be no question of a shortage of doctors. There is only a regional distribution problem. "We have over 25,000 resident doctors too many in over-served areas and only 800 under-resident in under-served regions." Therefore, the cuts in medical fees should also make over-served areas unattractive for doctors. The run on the cities has to be curbed, "otherwise we will never win over doctors for rural care," von Stackelberg continued.
Changes should affect newcomers
However, the new regulations should only apply to physicians who have received health insurance approval following a change in the legal situation. Doctors who are already licensed should not be affected by this. "We don't want to expropriate anyone," said Florian Lanz, spokesman for the health insurance association.
On the part of the FDP there is only rejection for such ideas. The medical doctor and Federal Minister of Health Philipp Rösler strictly refuses to "make doctors in urban areas" worse off ". In a coalition-internal compromise, it was only possible to negotiate that the Association of Statutory Health Insurance Physicians would be able to buy back approvals more easily in the future. From 1993 to 2009 the number of doctors rose from 104,600 to 137,400. There can therefore be no question of a shortage of doctors. (sb)
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Image: Thommy Weiss / pixelio.de