More costs for those with statutory health insurance: If you don't want to wait, you have to pay

dpa/afp | According to Andreas Gassen, head of statutory health insurance, those with statutory health insurance must be prepared to pay for treatments out of their own pockets due to fee cuts - in order to avoid longer waiting times. “Nobody can expect that the practices will simply carry on as before in view of the cuts,” Gassen told the editorial network Germany. “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).

“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,” he said. This is the only way to finance the costs of additional cases beyond the budget. “The practices do not have an infinite performance obligation,” Gassen made it clear and warned: “If specialist groups lose 25 percent of their sales, which is sometimes the case, that is a cut that threatens their existence.”

The federal government's savings program for statutory health insurance (GKV) provides for extensive cost-cutting measures. According to Gassen, the three billion euro fee cuts will particularly affect the areas of ENT, orthopedics, cardiology, radiology and rheumatology. There will be fewer appointments, especially here. “If the budget is used up, patients will have to accept that they may not be able to get an appointment at their preferred practice until the next quarter,” he said.

Criticism of Gassen's statements 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," explained 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."