Statutory health insurance doctors suggest self-pay appointments for statutory health insurance patients

Many practicing doctors are annoyed by the federal government's planned cost-cutting measures. Many practices are currently displaying notices in which doctors make their position clear: If politicians cut back on remuneration, it would be more difficult for many statutory health insurance patients to get appointments in the future, according to the tenor. What is rarely mentioned there, however, is why politicians are taking these measures: to slow down the sharp increase in health insurance contributions with which insured people finance the health system from their wages and salaries.

According to statutory health insurance physicians, those with statutory health insurance will have to pay for treatments out of their own pockets in the future due to the agreed fee cuts in order to avoid longer waiting times. He assumes "that there will be offers in private consultations, because every appointment will be reimbursed," said the chairman of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, to the editorial network Germany.

This is the only way to finance the costs of additional cases beyond the budget. “Nobody can expect that the practices will simply carry on as before in view of the cuts,” said Gassen. The practices have “no infinite performance obligation,” explained the head of statutory health insurance physicians 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 the KBV, the outpatient sector is particularly badly affected.

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. The budget will then be available again.

Gassen appeared willing to compromise on the question of the extent to which doctors will have to report available appointments in the future. “It would be conceivable to agree with the health insurance companies a quota for really urgent medical appointments,” he said, but set one condition: “But the following must apply: whoever orders, pays. If we guarantee appointments, the health insurance companies must guarantee reimbursement in return - regardless of whether the patient comes or not," he warned. »Nobody can expect self-employed practices to keep appointments free so that they can end up twiddling their thumbs.«

The fact that statutory health insurance patients are often less likely to get appointments than self-payers and private patients is a source of constant anger in Germany. Read a SPIEGEL cover story here about how that could be changed: Everyone talks about justice, but no one addresses the biggest problem.