Outrage over push for specialist appointments: Klingbeil against additional costs for statutory health insurance patients

dpa | Pay yourself to see a specialist so that you can get an appointment more quickly if you have statutory health insurance? Andreas Gassen, head of statutory health insurance physicians, designed this scenario in view of the fee cuts - and thus attracted sharp criticism. “I assume that there will be offers for private consultations, so every appointment will be reimbursed,” said the head of the National Association of Statutory Health Insurance Physicians (KBV) to the Germany editorial network.

“People with statutory insurance who choose this option will then be treated like a private patient outside of statutory insurance, but will have to pay the costs out of their own pocket as self-payers,” explained Gassen. “Nobody can expect practices to just carry on as before in the face of the cuts.”

If specialist groups sometimes lose 25 percent of their sales, that would be a threat to their existence. Gassen spoke of fee cuts amounting to three billion euros. The areas of ENT, orthopedics, cardiology, radiology and rheumatology are particularly affected.

The initiative received a red card from politicians. Vice Chancellor and SPD leader Lars Klingbeil made it clear on the sidelines of an event in Potsdam that “such a proposal cannot be made with us.” Statutory health insurance patients should not have to incur additional costs. He referred to the appointment guarantee agreed by the coalition for specialists who should receive statutory health insurance patients.

The health policy spokesman for the Green parliamentary group, Janosch Dahmen, told the German Press Agency that the model threatens to create a new payment barrier: "If you pay yourself, you can sometimes get it within a few hours. If you rely on your health insurance, you have to wait." A development towards “paywall medicine” is highly problematic from a medical and socio-political point of view. “I strongly warn against the fact that a new three-class care system will be established in Germany alongside the existing two-class medicine.”

Sharp criticism also came from the umbrella association of statutory health insurance companies. "Here, people with statutory health insurance who need a doctor are being held hostage so that doctors can increase their fees. This is scandalous behavior," said the deputy chairwoman of the GKV board, Stefanie Stoff-Ahnis. The National Association of Statutory Health Insurance Physicians has the legal task of enabling the care of the sick, not making it more difficult. "Doctors in private practice receive an average of over 200,000 euros per year from their medical practices. There is no indication that this will change in the coming year."

The Social Association of Germany (SoVD) rated the initiative as “highly lacking in solidarity and socially unfair”. It would particularly affect people with low incomes and chronically ill people who are dependent on reliable medical care, said SoVD board chairwoman Michaela Engelmeier. “Those who have little money would avoid necessary visits to the doctor more often, while those with higher incomes could easily pay for their doctor’s visit.”

The board of the German Foundation for Patient Protection, Eugen Brysch, emphasized that the associations of statutory health insurance physicians have a legal mandate to ensure safety. The medical association must be measured by this. "Instead, the chief lobbyist refers to private payments. So supply becomes a question of wallet." The burden must be distributed more fairly. "Many practices do a lot and take on more patients. This effort has to be worth it," said Brysch. He called on Health Minister Carsten Linnemann (CDU) to create clear legal requirements.