Law on medical care is being revised

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The law on medical care is to be revised in 2011: health insurance companies are demanding limited licenses instead of previous medical approvals.

With his initiative to revise the hospital sector, Jens Spahn, health expert at the CDU, brought the discussion about the problems of medical care back to life last week. In the coming year 2011, the Federal Minister of Health Philipp Rösler (FDP) not only wants to submit to the cabinet a proposal for nursing reform but also a new care law for the treatment of patients in the hospital or at the doctor for decision.

After initial skepticism, the Federal Minister of Health welcomed Jens Spahn's suggestion in relation to the reform of medical care to guarantee double-bed patients in clinics in the future, too good approach. ”But such demands are difficult to implement at the federal level, because the individual federal states are responsible for the clinics. However, it is questionable whether they will come along with the looming higher costs for proposals such as the twin room arrangement. Therefore, in the run-up to the draft law, the Federal Minister of Health wants to work out in cooperation with the federal states and associations of doctors, health insurance companies and clinics what an appropriate health care law could look like.

Association of Statutory Health Insurance Funds calls for revision of the system of medical approvals The head of the umbrella association of statutory health insurance funds (GKV umbrella association), Doris Pfeiffer, spoke up regarding the plans of the Federal Minister of Health and emphasized that she was looking forward to the negotiations with great confidence: "I am glad that we are now talking about patient care and no longer just about more money for doctors and hospitals, "Pfeiffer told the news agency dpa. In particular, the rigid system of medical admissions needs to be urgently revised as part of the new health care law the chairman of the health insurance association. "A main problem is the legal guarantee for every practice owner that his practice can be resold even in a completely oversupplied region," explained Doris Pfeiffer.

Time-limited licenses instead of the previous approvals The head of the GKV umbrella association is addressing a topic that is critical for most doctors, because the resale of established practices has so far been an important aspect in the medical insurance of old age. Over the years there has been a maladministration in the distribution of medical practices, so that there is currently an overhang of 25,000 doctors in the areas with over-provision, but in certain regions with a shortage of doctors, it is estimated that only 800 doctors are missing, said Pfeiffer. In total, the number of general practitioners and doctors working in clinics in Germany is around 140,000 each, higher than ever before, according to the head of the GKV umbrella association. "Obviously we have a distribution problem and not a quantity problem," emphasized Pfeiffer. According to their statements, it would be perfectly appropriate in the sparsely populated areas if incentives for home visits could be set, but these supplements should only be granted if, in return, discounts are made in areas that are not provided with medical care.

Aligning medical care to actual needs "I think it would be fatal to simply spend more money on underserved regions," warned Doris Pfeiffer. The problems of the medical in rural areas can not be solved by a new burden on the contributors, said the chair of the health insurance association. Rather, it is about aligning medical care with actual needs, i.e. also building up capacities in underserved regions and reducing them in oversupplied regions, explained Pfeiffer. One of the suggestions of the National Association of Statutory Health Insurance Funds for the implementation of the goals are time-limited licenses instead of the previous unlimited medical approvals. A proposal that has so far received little support from doctors. On the other hand, the proposal meets with open ears in the ranks of politics. Johannes Singhammer, health politician at the CSU, also said that he considered the current system of medical admissions to be too rigid, as this sometimes has the character of a life decision - the motto is: once a country doctor, always a country doctor.

Physicians should be able to choose more flexibly In the future, more mobility should be possible to encourage physicians to open a practice in underserved, rural regions in the short term and thus to remedy the shortage of doctors in the country, explained Johannes Singhammer. The long-term commitment of doctors to a specific doctor's office is rather disadvantageous, because "it would be easier for them to move to an unattractive region if they could also realign themselves after a few years," said the CSU health politician. However, Singhammer believes that market forces could counteract the rural shortage of doctors anyway. Easier access to work, the attractive environment, the high quality of living and family-friendly conditions will in future increasingly attract physicians from the metropolitan areas to the rural regions, so the health politician hopes. However, Singhammer warned of cutbacks in remuneration, because money is not everything, but a good income is an important factor in choosing a location. On average, the German taxpayer spends around 300,000 euros for training students to become medical doctors, but 2,500 out of 10,000 graduates go abroad, primarily because of their income, Singhammer explained. Therefore, the development of medical fees should not lag behind the income of doctors in Scandinavia or in Great Britain, emphasized the CSU health politician.

Cooperation between general practitioners, specialists and hospitals
In addition to the introduction of licenses instead of the previous approvals, the GKV umbrella association has brought up the loosening of the too rigid boundary between general practitioners and clinics when treating patients. Often, patients in a clinic would only be treated for hours or a day, which should stimulate thinking about the function of the hospitals, said the head of the GKV umbrella association. Doris Pfeiffer explained that the purpose of comprehensive care with pulmonary specialists or surgical ophthalmologists should also be questioned. In the future, it will depend much more on the good cooperation between general practitioners, specialists and hospitals, although negotiations at this point could also be extremely difficult, emphasized the head of the health insurance association. “It is obvious that we have to drill a thick board here,” says Pfeiffer. Politicians, health insurers, medical and clinic associations agree on one point, however: The supply law must be urgently addressed in the coming year to ensure long-term medical care. (fp)

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