Bavaria calls on doctors to reason

Bavaria calls doctors to reason: The exit from the cash register system would have far-reaching consequences for doctors and patients.

The announcement by the Bavarian General Practitioners' Association to leave the statutory health insurance system is now also prompting the state government to call on doctors to reason. In large-scale newspaper advertisements, Bavaria warns of the exit from the till and the resulting consequences for general practitioners and patients. Physicians should carefully consider whether such a step does not have financial disadvantages. After an exit from the health care system, family doctors could only treat private patients.

The dispute between the family doctor association and the general local health insurance AOK in Bavaria has escalated in the past week. After the Bavarian Association of General Practitioners announced the exit from the health insurance system, the health insurance company in turn reacted by immediately terminating the family doctor contracts. However, the medical association continues to maintain its position to issue the box office approval at the beginning of the year in protest. In the coming week, the family doctor association wants to ask its members about this.

Bavaria's state government warns general practitioners against leaving the country
A few days before the vote on the exit, the Bavarian state government also intervened in the conflict. In state-of-the-art advertisements in the daily press, the state government has asked general practitioners to refrain from leaving the company. The step of further escalation endangers patients and general practitioners, as stated in the advertisements that have appeared in several newspapers. "Consider the consequences of an exit! Because: Whoever gets out is outside!" The Bavarian Association of General Practitioners wants to call on its members next Wednesday to vote on the exit. The association, chaired by Dr. Wolfgang Hoppenthaller maintains the system exit despite the termination of the contracts. In addition, other family doctors' associations have shown solidarity with their Bavarian colleagues and agreed to support them. For example, the General Practitioners 'Association in Baden-Württemberg called on its doctors in the neighboring regions of Bavaria to show solidarity with their colleagues' decision. One would not make up for a possible deficit in the supply, as it was said.

The top supervision of the health insurance companies, the Federal Insurance Office (BVA), also issued a clear warning. “Organizing a collective exit is not only illegal. It is a tangible, rough breach of the general practitioner contract that the Bavarian general practitioners have concluded, ”said Maximilian Gassner, BVA chairman.

In addition to the AOK, other health insurers have now announced that the contracts will be terminated without notice, provided that the medical profession does not give in. "This can lead to the termination of the contract and claims for damages," Gassner warned. "One can only hope that Dr. Hoppenthaller does not prevail, "said the BVA boss.

Medical Association wants to force health insurance companies to extensive negotiations
If a majority of the general practitioners vote in favor of the exit, this step would have far-reaching consequences. Many thousands of doctors would suddenly leave the cash register system. In order not to endanger the care of the patients, the billing of the fees would have to be done by another body. The medical association then wants to do this on its own. For the medical director Dr. Hoppenthaller are the current social laws a means to keep the doctors as slaves to the health insurance. The association sees the care of patients in danger, as the lower increase in fees means that especially young doctors would shy away from opening surgeries. “We want more time for patients again. In connection with this, we demand planning security for ourselves and our employees by ensuring the long-term sovereignty of the general practitioner and negotiating with the health insurance companies at eye level. "

Once out of the cash register system, re-entry becomes extremely difficult
But the Ministry of Health sees the possibilities of re-entry as very difficult. Because contracts with the health insurers of the outgoing family doctors are prohibited by law. In addition, an exit from the cash register system would cause a year-long ban. From this point on, the general practitioners could only treat private patients or insured patients on a private bill. "Those who get out can only treat private patients with it." But the family doctor association relies on a majority of its members. If a large number of doctors actually decided to hand over their statutory health insurance approval, new negotiations would have to be held. Then where should the patients be treated? It is precisely this factor that Bavaria's General Practitioners Association relies on. The health insurance companies would actually be forced to start new negotiations, whether they like it or not. But the situation is difficult. If this means of protest first goes to school, other associations could come up with the idea to imitate their Bavarian colleagues. The health insurance companies would be almost helplessly exposed to this situation.

This situation, which was forcibly created, also angered the Bavarian Minister of Health Markus Söder (CSU). He reminded the medical community of their responsibility towards the patients. The Minister said to the Passauer Neue Presse (PNP): "Doctors have a professional ethic. It is about caring for the sick, and not just about fee disputes." Söder therefore tries moral arguments. Every family doctor should talk to his partner and his bank about whether such a step makes economic sense. "Every family doctor who gets out of the till system is outside and endangers his own existence." (sb)

Read on this topic:
Family doctors association insists on system change
AOK Bayern terminates family doctor contracts without notice
PKV and doctors argue about fees
AOK boss: problem with medical oversupply
Dispute between AOK and family doctors escalates

Image: Gerd Altmann /

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