Freedom was often discussed in the Frankfurt Paulskirche so also at the opening of the 118th German Medical Congress. The tenor: The medical profession wants to fight for its freelance work and at the same time take responsibility for the system.
Mutual appreciation is not matter of course in the health system. Anyone who remembers the time of Federal Health Minister Ulla Schmidt (SPD) knows that. There are also numerous differences of opinion with Health Minister Hermann Gröhe (CDU). Today, however, the interaction between the medical profession and politics is often no longer conflict, but rather togetherness. "I know what great achievements doctors in Germany, both in hospitals and in outpatient care, provide every day," emphasized Gröhe on May 12 at the opening of the 118th German Doctors' Day in the Paulskirche in Frankfurt am Main. He especially thanked the doctors in West Africa who, using their own health, helped to fight the Ebola epidemic.
Prof. Dr. med. Frank Ulrich Montgomery, President of the German Medical Association, thanked Gröhe beforehand “for the atmosphere of discussion in which we can always openly address all problems”. Unfortunately, however, not all problems can always be completely resolved in the interests of the medical profession. Montgomery criticized two regulations from the planned Statutory Health Insurance Supply Strengthening Act in particular: the compulsory purchase of medical practices in supposedly oversupplied areas by the statutory health insurance associations and the appointment service centers to be set up by the KVs.
"What is that supposed to mean Whole? ”
In the current legislative process, the medical profession has succeeded in raising the oversupply limit from an initial 110 percent to 140 percent - the KVs are to buy vacant doctor's seats in the future if the oversupply in district is above 140 percent. Nevertheless, the whole process "in principle represents an attack on the freelance", criticized Montgomery. “Worse still: The whole thing happens under the supposed motivation to improve the supply in underserved areas. But by buying away doctor's practice in supposedly oversupplied areas, not single practice is founded in undersupplied areas. ”The philosophy is simply not right here.
Freedom was often discussed in the Frankfurt Paulskirche so also at the opening of the 118th German Medical Congress. The tenor: The medical profession wants to fight for its freelance work and at the same time take responsibility for the system.
Mutual appreciation is not matter of course in the health system. Anyone who remembers the time of Federal Health Minister Ulla Schmidt (SPD) knows that. There are also numerous differences of opinion with Health Minister Hermann Gröhe (CDU). Today, however, the interaction between the medical profession and politics is often no longer conflict, but rather togetherness. "I know what great achievements doctors in Germany, both in hospitals and in outpatient care, provide every day," emphasized Gröhe on May 12 at the opening of the 118th German Doctors' Day in the Paulskirche in Frankfurt am Main. He especially thanked the doctors in West Africa who, using their own health, helped to fight the Ebola epidemic.
Prof. Dr. med. Frank Ulrich Montgomery, President of the German Medical Association, thanked Gröhe beforehand “for the atmosphere of discussion in which we can always openly address all problems”. Unfortunately, however, not all problems can always be completely resolved in the interests of the medical profession. Montgomery criticized two regulations from the planned Statutory Health Insurance Supply Strengthening Act in particular: the compulsory purchase of medical practices in supposedly oversupplied areas by the statutory health insurance associations and the appointment service centers to be set up by the KVs.
"What is that supposed to mean Whole? ”
In the current legislative process, the medical profession has succeeded in raising the oversupply limit from an initial 110 percent to 140 percent - the KVs are to buy vacant doctor's seats in the future if the oversupply in district is above 140 percent. Nevertheless, the whole process "in principle represents an attack on the freelance", criticized Montgomery. “Worse still: The whole thing happens under the supposed motivation to improve the supply in underserved areas. But by buying away doctor's practice in supposedly oversupplied areas, not single practice is founded in undersupplied areas. ”The philosophy is simply not right here.Instead of going the smart way and setting sensible incentives, bureaucratic procedures are used to restrict freelance work.
Gröhe defended the ruling. It is not about forced purchase of doctor's seats, he said. Instead, decisions are made on each individual case in the admissions committees, half of which are doctors. "The benchmark is the on-site supply situation," emphasized Gröhe.
Montgomery also criticized the planned appointment service points, with which the KVen patients are supposed to get specialist appointment within four weeks. "What sense does it make to dismantle practice locations when our patients' alleged appointment problems call politics on the scene at the same time?" He asked, and at the same time doubted that patients would have any difficulty getting appointments with specialist. "An international comparative study - which was also published on the website of the Ministry of Health - came to the conclusion that only in France and New Zealand you can get an appointment with family doctor as quickly as in Germany," said Montgomery.
And appointments with specialist are only faster for patients in the USA and Switzerland - there, however, only with private co-payments by the patient. "But what's the point then?" Asked Montgomery to the applause of the 900 or so guests. This regulation is simply humbug, it does not benefit anyone and is “a purely populist move”.
Dishonest second opinion plan
The government's plans for second opinion procedures are also poorly designed. For certain planned interventions, doctors should inform their patients ten days before the intervention about their right to second opinion. The medical profession generally welcomes obtaining second opinions, emphasized Montgomery. "But I doubt whether mandatory ten-day period between clarification and intervention makes sense."
He also accused the legislature of not having the quality of care at all with this regulation , but rather that he wants to “reduce services that are supposedly too often”. Instead of setting reasonable economic framework conditions without false economic incentives, however, he tries to solve an economic problem by burdening the patient-doctor relationship.
Gröhe defended the ruling. It is not about forced purchase of doctor's seats, he said. Instead, decisions are made on each individual case in the admissions committees, half of which are doctors. "The benchmark is the on-site supply situation," emphasized Gröhe.
Montgomery also criticized the planned appointment service points, with which the KVen patients are supposed to get specialist appointment within four weeks. "What sense does it make to dismantle practice locations when our patients' alleged appointment problems call politics on the scene at the same time?" He asked, and at the same time doubted that patients would have any difficulty getting appointments with specialist. "An international comparative study - which was also published on the website of the Ministry of Health - came to the conclusion that only in France and New Zealand you can get an appointment with family doctor as quickly as in Germany," said Montgomery.
And appointments with specialist are only faster for patients in the USA and Switzerland - there, however, only with private co-payments by the patient. "But what's the point then?" Asked Montgomery to the applause of the 900 or so guests. This regulation is simply humbug, it does not benefit anyone and is “a purely populist move”.
Dishonest second opinion plan
The government's plans for second opinion procedures are also poorly designed. For certain planned interventions, doctors should inform their patients ten days before the intervention about their right to second opinion. The medical profession generally welcomes obtaining second opinions, emphasized Montgomery. "But I doubt whether mandatory ten-day period between clarification and intervention makes sense."
He also accused the legislature of not having the quality of care at all with this regulation , but rather that he wants to “reduce services that are supposedly too often”. Instead of setting reasonable economic framework conditions without false economic incentives, however, he tries to solve an economic problem by burdening the patient-doctor relationship.
Do not loosen confidentiality
The importance of the patient-doctor relationship was also emphasized by the President of the host State Medical Association of Hesse, Dr. med. Gottfried von Knoblauch zu Hatzbach: "The medical art lies not only in the operation or in the highly technical diagnostics, but also in the weighing of the available possibilities, in the trusting conversation with the patient, in the affection and care." refusal may be issued to relax medical confidentiality. After the Germanwings plane crashed in the French Alps, voices were raised because the co-pilot who crashed the plane had received psychological treatment. "Confidentiality is sine qua non for trusting patient-doctor relationship," emphasized von Knoblauch zu Hatzbach.
In addition to the Health Care Strengthening Act, numerous other political projects are currently in the legislative process. Much is worthy of criticism from medical point of view, for example the planned collective bargaining unit law, with which in future only the collective agreement of the union that has the majority in company will apply. “This law is intended to force hospital doctors back under the knot of large hospital-wide union. We have only just escaped this yoke through the actions of the years 2001 to 2007 ”, emphasized Montgomery, who, as the former chairman of the Marburg Association, had led these actions himself. "We will definitely not go under this foreign rule again."
The BÄK president also expressed criticism of the hospital structure law. “Take look at what it looks like in many hospitals now. Nursing staff and doctors are completely overloaded. Old buildings make modern hygiene difficult, if not almost impossible. No new hygiene laws help, ”said Montgomery to the applause of the guests. This is due to the fact that the federal states have not adequately financed their hospitals for years. Meanwhile, shortfall of 30 billion euros has accumulated.
In the draft bill on hospital reform, all that can be read about investment financing is that the federal states will spend at least as much money annually on the Provide investment finance for hospitals, as they did in 2012-2014. "This is where the countries prevailed," said Montgomery.
Do not loosen confidentiality
The importance of the patient-doctor relationship was also emphasized by the President of the host State Medical Association of Hesse, Dr. med. Gottfried von Knoblauch zu Hatzbach: "The medical art lies not only in the operation or in the highly technical diagnostics, but also in the weighing of the available possibilities, in the trusting conversation with the patient, in the affection and care." refusal may be issued to relax medical confidentiality. After the Germanwings plane crashed in the French Alps, voices were raised because the co-pilot who crashed the plane had received psychological treatment. "Confidentiality is sine qua non for trusting patient-doctor relationship," emphasized von Knoblauch zu Hatzbach.
In addition to the Health Care Strengthening Act, numerous other political projects are currently in the legislative process. Much is worthy of criticism from medical point of view, for example the planned collective bargaining unit law, with which in future only the collective agreement of the union that has the majority in company will apply. “This law is intended to force hospital doctors back under the knot of large hospital-wide union. We have only just escaped this yoke through the actions of the years 2001 to 2007 ”, emphasized Montgomery, who, as the former chairman of the Marburg Association, had led these actions himself. "We will definitely not go under this foreign rule again."
The BÄK president also expressed criticism of the hospital structure law. “Take look at what it looks like in many hospitals now. Nursing staff and doctors are completely overloaded. Old buildings make modern hygiene difficult, if not almost impossible. No new hygiene laws help, ”said Montgomery to the applause of the guests. This is due to the fact that the federal states have not adequately financed their hospitals for years. Meanwhile, shortfall of 30 billion euros has accumulated.
In the draft bill on hospital reform, all that can be read about investment financing is that the federal states will spend at least as much money annually on the Provide investment finance for hospitals, as they did in 2012-2014. "This is where the countries prevailed," said Montgomery.
Gröhe emphasized that it would make sense to leave hospital planning and investment cost financing in one hand with the federal states. And after all, the federal states have committed themselves to paying the investment costs in the key points of the reform. He emphasized that the federal government wanted to pay surcharges for certain hospitals in the future. In addition, clammy municipalities could also finance their houses from the total of 3.5 billion euros that the federal government will also transfer to them.
Montgomery also warned that German norms and social standards would not apply within the framework of the TTIP free trade agreement transatlantic are likely to be undermined or even thwarted. “Our social security is protected from European harmonization by the Lisbon Treaty: and it has to stay that way!” He emphasized. In addition, “we do not want any international arbitration boards where lawyers who are not democratically legitimized can negotiate what social protection standards or investments in hospital chains or medical care centers could look like by way of transatlantic compromise”. Gröhe agreed that there will be no lowering of social standards within the framework of TTIP and that investor protection will be based on the rule of law and be transparent.
GOÄ: "It looks good!"
Doctors and politicians were of the same opinion with regard to the amendment to the official fee schedule for doctors (GOÄ). “In an admittedly arduous process, we negotiated new GOÄ with the PKV association,” explained Montgomery. "We are now so far that we have been able to make jointly agreed proposal to the ministry that includes 400 total services and 160 additional services, which cover around 80 percent of the volume of the GOÄ."
This is huge step forward, if you consider that there was complete standstill in the GOÄ for 20 years before the joint negotiations. "It looks good," said Montgomery. “We can do this in shared responsibility as an expression of free self-administration!” Gröhe signaled his willingness to cooperate: “We now have talks with the aid and the coalition. But my position is clear: What was achieved in the last legislative period with the dentists' fee schedule must now finally also be achieved with the GOÄ.
Gröhe emphasized that it would make sense to leave hospital planning and investment cost financing in one hand with the federal states. And after all, the federal states have committed themselves to paying the investment costs in the key points of the reform. He emphasized that the federal government wanted to pay surcharges for certain hospitals in the future. In addition, clammy municipalities could also finance their houses from the total of 3.5 billion euros that the federal government will also transfer to them.
Montgomery also warned that German norms and social standards would not apply within the framework of the TTIP free trade agreement transatlantic are likely to be undermined or even thwarted. “Our social security is protected from European harmonization by the Lisbon Treaty: and it has to stay that way!” He emphasized. In addition, “we do not want any international arbitration boards where lawyers who are not democratically legitimized can negotiate what social protection standards or investments in hospital chains or medical care centers could look like by way of transatlantic compromise”. Gröhe agreed that there will be no lowering of social standards within the framework of TTIP and that investor protection will be based on the rule of law and be transparent.
GOÄ: "It looks good!"
Doctors and politicians were of the same opinion with regard to the amendment to the official fee schedule for doctors (GOÄ). “In an admittedly arduous process, we negotiated new GOÄ with the PKV association,” explained Montgomery. "We are now so far that we have been able to make jointly agreed proposal to the ministry that includes 400 total services and 160 additional services, which cover around 80 percent of the volume of the GOÄ."
This is huge step forward, if you consider that there was complete standstill in the GOÄ for 20 years before the joint negotiations. "It looks good," said Montgomery. “We can do this in shared responsibility as an expression of free self-administration!” Gröhe signaled his willingness to cooperate: “We now have talks with the aid and the coalition. But my position is clear: What was achieved in the last legislative period with the dentists' fee schedule must now finally also be achieved with the GOÄ.“
In conclusion, Montgomery expressly thanked the members of the German Bundestag“ for the quality and intellectuality ”of the debate that had been going on up to now about the ban on commercial euthanasia organizations. “But I would like to especially thank you for drafting hospice and palliative care law,” continued Montgomery. “I find it remarkable that you are taking this important initiative before the debate on assisted suicide legislation continues. With this you prove your seriousness and you show medicine at the end of your life really necessary and well-deserved reference for its daily work. "
Falk Osterloh
@ Current reports, videos from the opening speeches and the opening event: www./aerztetag2015
Ärztetag sets impulses
The Hessian Health Minister Stefan Grüttner (CDU) emphasized in his welcoming address that the Politicians closely followed and observed the resolutions of the German Medical Association. As an example, he cited the debate at the last Doctors' Day in Düsseldorf about pain medicine. The German Bundestag then dealt with this topic, and the Conference of Health Ministers will also deal with it and try to “implement your justified demands in care”.
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