Health care reform: Insurance companies and doctors argue: Do patients have to wait longer?

KBV boss Andreas Gassen told the “Bild” newspaper that the government had canceled more than 50 million outpatient appointments through cuts. The “shortage of appointments” will be further exacerbated by a new reporting requirement. If a fixed appointment contingent is blocked in this way, it will no longer be available to patients. There can only be more appointments with more money.

The umbrella association of statutory health insurance (GKV) responded that some were trying to “enforce fee demands on the backs of patients”. Spokesman Florian Lanz said: “No one canceled any doctor’s appointments; rather, the fee bonus for making appointments faster was withdrawn because there were no faster doctor’s appointments.” Elsner, whose association represents health insurance companies such as TK, Barmer and DAK-Gesundheit, also said: “The claim that the deletion of the so-called TSVG regulations would result in tens of millions of appointments for insured people being eliminated is particularly absurd.”

With the Appointment Service and Care Act (TSVG/2019), doctors were granted additional remuneration in certain cases when appointments were made. Despite the corresponding billions in additional expenditure, it was “not achieved” to reduce waiting times, as the Federal Audit Office found in February. The government's cash savings package, the Statutory Health Insurance Contribution Rate Stabilization Act, which came into force in July, now partially abolishes these remuneration regulations. According to the KBV, the loss of the so-called TSVG remuneration means a loss in fees of around 1.64 billion euros per year for practices.

“Not a single appointment is canceled just because an extra surcharge is no longer paid for something that is a matter of course,” said Elsner. The vdek boss referred to the 57.3 billion euros that the GKV is already spending on medical care this year. “It is long overdue for the legislature to end such false incentives and double financing - because the timely care for the insured is already paid for in full through the regular, annually increasing total remuneration.”

Gassen, on the other hand, had criticized politicians for first cutting the remuneration for additional appointments and then tightening the reporting requirement. After a new regulation passed by the Bundestag last week, contracted doctors will in future be more strongly obliged to report appointments to the appointment service centers.

The board of the German Foundation for Patient Protection, Eugen Brysch, criticized: “The statutory health insurance lobby wants to torpedo outpatient care for the almost 75 million people with statutory health insurance through a pseudo-shortage.” The government's plans to cut statutory health insurance should be fought on the backs of patients. Brysch told the German Press Agency that the government's plans would already be fleecing those with statutory health insurance the most. As examples, he cited rising medication co-payments, falling fixed subsidies for dentures and limited non-contributory co-insurance for spouses.