FDP demands self-payment obligation in the event of a shortage of doctors



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FDP health politician demands that patients pay for themselves if there is a shortage of doctors

09.01.2011
There is a real shortage of doctors in numerous, especially rural, regions. In order to address the shortage of doctors, the FDP in such regions demands that patients pay a general self-payment for each visit to the doctor. In the FDP's view, there could be something to counter the shortage of doctors, since the obligation to pay self-pay could encourage doctors to go to areas where there is a shortage of doctors.

Self-payment obligation against lack of doctors
In order to cope with the ever more rapidly increasing shortage of doctors, insured members of the FDP should pay the doctor's fees themselves in some regions and submit the treatment costs to their health insurance company. The FDP member of the Bundestag Lars Lindemann on Friday suggested to the dpa news agency in Berlin that patients should pay for themselves. Doctors could thus earn more money in such areas. The attractiveness of opening a practice in a problem region would increase. The upper limits of the statutory health insurance companies do not apply due to the self-payment obligation, which means that doctors could demand higher treatment costs from the health insured. "I think that's reasonable for the insured," said the FDP politician, who is also a member of the Federal Government's Health Committee. "The patients then get 100 percent of the costs back from their health insurance."

The concept of reimbursement is not a new model. For a long time, the FDP has repeatedly brought the cost reimbursement model into the health debate. According to Lindemann, the reimbursement of costs for all statutory health insurers should become compulsory in regions with a low number of doctors. In other regions, the previous model of the benefit in kind is to be retained "in principle". In regions with a lower density of doctors, it would become more attractive for doctors to open a practice. "For example, we have gotten used to the fact that a substantial portion of the medical services are not paid for. If this makes the operation of a medical practice no longer attractive, it is not surprising that this also produces undersupply in the area," said Lindemann on his own website.

Doctors for patient reimbursement
Some medical representatives favor the reimbursement model. On the one hand, they would be able to bill fees to the patient in a timely manner and would no longer have to agree with the health insurance companies whether the treatment costs would be borne. Because the bills are paid either way, even if the health insurance does not reimburse the patient. In case of doubt, patients would then have to pay the treatment costs themselves if the health insurers refuse to reimburse the costs.

FDP disagrees about future regulations
But there is no agreement within the FDP on this controversial point. The deputy FDP parliamentary group leader and health spokeswoman for the party, Ulrike Flach, rated Lindemann's proposal as "individual opinion". The FDP politician is against it: "I want to stimulate a debate," said Lindemann. The self-payment obligation project could first be implemented in model regions to see whether it would be successful. Lindemann also criticized the demands of the medical associations to reform the need planning in the event of a lack of doctors. Demand planning regulates, among other things, the distribution of doctors across individual areas of Germany. Even a revised need planning does not increase the attractiveness for doctors to go to problem areas, says Lindemann.

Health insurance companies criticize self-payment obligations for patients
The criticism of the health insurance company Barmer GEK was clear. Its chairman Brigit Fischer suspects a clientele-oriented policy behind the proposal. "The proposal of the FDP is absurd, wrong and guided by clientele interests," Fischer told the dpa. "Private health insurance shows that reimbursement is not a suitable means of increasing the quality of care." The sufferers would be the patients, because they would have to open up new income opportunities for doctors with greater effort.

Negotiations with doctors and clinics planned
The Federal Minister of Health Philipp Rösler (FDP) will soon meet to negotiate with representatives of clinics, health insurers and doctors to advise on the law on doctors and clinics. The consultations should also deal with the rapidly increasing shortage of doctors in numerous regions. According to a current evaluation by the Association of Statutory Health Insurance Physicians (KV), 234 general practitioners and 47 specialists are missing in Thuringia alone. During the debate about setting the course for health care reform, Rösler also advocated the prepayment model when visiting a doctor. Under pressure from the CSU, the FDP had to abandon this concept. Because consumer advocates also spoke in this context of building a "three-class medicine". The debate is now kindled by the FDP through the back door. (sb)

Also read:
Doctors advocate reimbursement
Rösler plans to pay in advance when visiting the doctor
CSU criticism of reimbursement: Rösler defends itself

Image: Michael Grabscheit / pixelio.de

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