The dispute over the GOÄ was the focus of the novella Opening of the 119th German Medical Congress. At the same time, there was reminder of the great progress in patient care, which was only possible in cooperation.
The amendment to the fee schedule for doctors (GOÄ) has been one of the major internal medical disputes in recent months. The German Medical Association (BÄK) and in particular BÄK President Prof. Dr. med. Frank Ulrich Montgomery was accused by various medical associations of not having conducted the negotiations with the Association of Private Health Insurance (PKV) and the aid in sufficiently transparent manner and of not having achieved any negotiation result so far. The speech by Montgomery at the opening of the 119th German Medical Congress in Hamburg was therefore eagerly awaited.
In the BÄK president admitted mistakes in the GOÄ amendment to the Laeiszhalle. "We all - and I expressly include myself here - underestimated the complexity of this process," he said. “We should have taken care of the details and their interactions with the basic structure earlier and more intensively. I personally have to deal with the accusation that we only accompanied the process for too long instead of intervening. ”
GOÄ: Criticism of the debate style
After discussion process lasting several years and an informative special doctors' day the BÄK board of directors found at its meeting in March that there had been "very significant incongruities" between the intermediate status of an assessed specification of the new GOÄ and the ideas and expectations of the board. “Colleagues, what else could we have done other than unanimously rejecting this interim result because of the obvious incongruities?” He asked the audience.
There is definitely reason for criticism, said Montgomery. Regarding the style of the debate, however, “one would like to call out to some: Don't you have it size smaller too?” In terms of content, Montgomery also disagreed with some of the criticisms made: “Just an inflation adjustment without adjusting the GOÄ legends of 30, yes up to 70 percent Demanding is easy to say and quickly finds supporters. But let's not overlook the fact that around 40 percent of the GOÄ bills are subsidies from the federal and state governments. So you will be reimbursed directly from their households.
The dispute over the GOÄ was the focus of the novella Opening of the 119th German Medical Congress. At the same time, there was reminder of the great progress in patient care, which was only possible in cooperation.
The amendment to the fee schedule for doctors (GOÄ) has been one of the major internal medical disputes in recent months. The German Medical Association (BÄK) and in particular BÄK President Prof. Dr. med. Frank Ulrich Montgomery was accused by various medical associations of not having conducted the negotiations with the Association of Private Health Insurance (PKV) and the aid in sufficiently transparent manner and of not having achieved any negotiation result so far. The speech by Montgomery at the opening of the 119th German Medical Congress in Hamburg was therefore eagerly awaited.
In the BÄK president admitted mistakes in the GOÄ amendment to the Laeiszhalle. "We all - and I expressly include myself here - underestimated the complexity of this process," he said. “We should have taken care of the details and their interactions with the basic structure earlier and more intensively. I personally have to deal with the accusation that we only accompanied the process for too long instead of intervening. ”
GOÄ: Criticism of the debate style
After discussion process lasting several years and an informative special doctors' day the BÄK board of directors found at its meeting in March that there had been "very significant incongruities" between the intermediate status of an assessed specification of the new GOÄ and the ideas and expectations of the board. “Colleagues, what else could we have done other than unanimously rejecting this interim result because of the obvious incongruities?” He asked the audience.
There is definitely reason for criticism, said Montgomery. Regarding the style of the debate, however, “one would like to call out to some: Don't you have it size smaller too?” In terms of content, Montgomery also disagreed with some of the criticisms made: “Just an inflation adjustment without adjusting the GOÄ legends of 30, yes up to 70 percent Demanding is easy to say and quickly finds supporters. But let's not overlook the fact that around 40 percent of the GOÄ bills are subsidies from the federal and state governments. So you will be reimbursed directly from their households."Without the approval of the Federal Council, without taking into account the state budgets and the financial reserves under the debt brake that will take effect from 2020, it will not work.
" What is possible is modernized, legally secure, adaptable and future-oriented new GOÄ, that too the Federal Council can agree, ”said Montgomery. “And for them - and only for them - there is an offer of 5.8 percent more in the room. All other options would forego this plus - you have to know that and then take responsibility. “
In his speech, Federal Minister of Health Hermann Gröhe (CDU) doubted that all critics of the GOÄ amendment were really interested in the matter. "I advocate that unnecessary, publicly fought arguments or expressions of mistrust in their own negotiators do not make business easier for those who do not like the whole GOÄ debate," he said to the applause of the audience. At the same time, he repeated his statement, which he had given at the opening ceremonies of the two previous doctors' days: "I think revision of the GOÄ is overdue." It is not only about additional financial claims, but also about the fact that the analog bills are finally better and also Systematics capable of further development follow.
GOÄ amendment remains the goal
Gröhe does not see the overall goal of renewed GOÄ in jeopardy due to the current developments. "Now lead the course you set at the Special Doctors' Day in January and on the board of the German Medical Association in such way that you are putting us under pressure," said the Minister. He still wants to amend the GOÄ on the basis of joint proposal by the medical profession, private health insurance and aid. The delegates of the Doctors' Day began their discussion and debate on the GOÄ following the opening on Tuesday afternoon and want to continue it on Wednesday - after this edition went to press.
Gröhe expressly committed to self-administration in the German health system. "My clear commitment to self-administration is based on the conviction that it is far better suited to making patient-related decisions at the medical level than purely private system, one run by health insurance companies or politicians," said Gröhe, which received much applause . “I don't want any medical or state medicine, I want strong self-administration."Without the approval of the Federal Council, without taking into account the state budgets and the financial reserves under the debt brake that will take effect from 2020, it will not work.
" What is possible is modernized, legally secure, adaptable and future-oriented new GOÄ, that too the Federal Council can agree, ”said Montgomery. “And for them - and only for them - there is an offer of 5.8 percent more in the room. All other options would forego this plus - you have to know that and then take responsibility. “
In his speech, Federal Minister of Health Hermann Gröhe (CDU) doubted that all critics of the GOÄ amendment were really interested in the matter. "I advocate that unnecessary, publicly fought arguments or expressions of mistrust in their own negotiators do not make business easier for those who do not like the whole GOÄ debate," he said to the applause of the audience. At the same time, he repeated his statement, which he had given at the opening ceremonies of the two previous doctors' days: "I think revision of the GOÄ is overdue." It is not only about additional financial claims, but also about the fact that the analog bills are finally better and also Systematics capable of further development follow.
GOÄ amendment remains the goal
Gröhe does not see the overall goal of renewed GOÄ in jeopardy due to the current developments. "Now lead the course you set at the Special Doctors' Day in January and on the board of the German Medical Association in such way that you are putting us under pressure," said the Minister. He still wants to amend the GOÄ on the basis of joint proposal by the medical profession, private health insurance and aid. The delegates of the Doctors' Day began their discussion and debate on the GOÄ following the opening on Tuesday afternoon and want to continue it on Wednesday - after this edition went to press.
Gröhe expressly committed to self-administration in the German health system. "My clear commitment to self-administration is based on the conviction that it is far better suited to making patient-related decisions at the medical level than purely private system, one run by health insurance companies or politicians," said Gröhe, which received much applause . “I don't want any medical or state medicine, I want strong self-administration.“
Thanks to refugee helpers
In this context, the minister emphasized the importance of teamwork for the quality of the system. In the German health care system, top performance was achieved in many positions. In the end, it's about making the best possible team performance out of it.
In particular, Gröhe thanked the doctors who helped care for the refugees. "I would also like to thank all the doctors who are not so much in focus: the members of the public health services, the volunteers, civil protection, the medical services of the Bundeswehr and many more," said the minister. In addition, many doctors made sure in their daily work that the people who had just come to Germany receive good care after their entry.
Previously, Montgomery had already praised the work of the doctors in the refugee crisis: “As the situation In many initial reception centers was at best tense, often even chaotic, they campaigned in an unprecedented wave of helpfulness for people seeking protection. ”What they had achieved was medical in the best sense of the word. They deserve thanks, recognition and respect.
The mayor of Hamburg, Olaf Scholz (SPD), spoke of the good experiences the city had made with the introduction of health card for refugees. "The card works well in two ways: It is simple and unbureaucratic and at the same time saves costs and is more efficient than when employees in local authorities make decisions about whether the expenses for medical treatment were correct or not." Scholz advocated the introduction of the health card for Refugees all over Germany.
Montgomery and Gröhe emphasized the good cooperation between the medical profession and health policy, for example in preventing organized euthanasia or maintaining medical confidentiality, about which discussion after the crash of German wing Aircraft had appeared in March 2015. As third positive example, Montgomery cited the anti-corruption law. “We have demanded that there should be no lex specialis for doctors. We have demanded that not only the allegedly bribed, but also the bribers feel the rigors of the law. And we wanted provisions that socially wanted cooperations cannot provide an opportunity to investigate hyperactive prosecutors, "said Montgomery. “Ultimately, we wanted clear rules that you can understand and understand without additional law studies. We got all that.“
Thanks to refugee helpers
In this context, the minister emphasized the importance of teamwork for the quality of the system. In the German health care system, top performance was achieved in many positions. In the end, it's about making the best possible team performance out of it.
In particular, Gröhe thanked the doctors who helped care for the refugees. "I would also like to thank all the doctors who are not so much in focus: the members of the public health services, the volunteers, civil protection, the medical services of the Bundeswehr and many more," said the minister. In addition, many doctors made sure in their daily work that the people who had just come to Germany receive good care after their entry.
Previously, Montgomery had already praised the work of the doctors in the refugee crisis: “As the situation In many initial reception centers was at best tense, often even chaotic, they campaigned in an unprecedented wave of helpfulness for people seeking protection. ”What they had achieved was medical in the best sense of the word. They deserve thanks, recognition and respect.
The mayor of Hamburg, Olaf Scholz (SPD), spoke of the good experiences the city had made with the introduction of health card for refugees. "The card works well in two ways: It is simple and unbureaucratic and at the same time saves costs and is more efficient than when employees in local authorities make decisions about whether the expenses for medical treatment were correct or not." Scholz advocated the introduction of the health card for Refugees all over Germany.
Montgomery and Gröhe emphasized the good cooperation between the medical profession and health policy, for example in preventing organized euthanasia or maintaining medical confidentiality, about which discussion after the crash of German wing Aircraft had appeared in March 2015. As third positive example, Montgomery cited the anti-corruption law. “We have demanded that there should be no lex specialis for doctors. We have demanded that not only the allegedly bribed, but also the bribers feel the rigors of the law. And we wanted provisions that socially wanted cooperations cannot provide an opportunity to investigate hyperactive prosecutors, "said Montgomery. “Ultimately, we wanted clear rules that you can understand and understand without additional law studies. We got all that.“With these and many other topics it has been shown that it is worthwhile if the medical profession persists in legislative projects and repeatedly brings their point of view into the parliamentary deliberations.
Studies: "Time is running out"
Politicians and doctors are not of the same opinion everywhere. “A master plan for medical studies 2020 is addressed in the coalition agreement, which is still pending. The German medical profession has identified number of points that need to be changed. In the selection process, we call for greater weighting of psychosocial skills. We not only need doctors who can transplant hearts, but also people who are wholeheartedly involved, "said Montgomery to the applause of the audience. “We have to introduce young students to family medicine early enough during their studies and finally set up chairs for general medicine in all faculties. Time is of the essence, Minister, because anyone who changes their training has to wait around 15 years for the results to reach the patient's care. ”But nobody could wait that long. Gröhe explained that not only the Ministry of Health is responsible here, but also the Ministry of Research and Finance. He emphasized, however, that work was being carried out at full speed to implement this coalition project as well.
Montgomery also warned that great care must be taken in the TTIP negotiations "that our proven standards are not negotiable" . He stressed that standards of professional practice or training as doctor should not be the subject of barter deals in the negotiations. Gröhe replied that the European Union did not have mandate to negotiate public health and the licensing of doctors. In addition, foreign companies that want to provide services in Germany would have to meet the legal framework conditions that apply here.
The German Medical Association met for the last time in Hamburg 25 years ago. In his speech, Gröhe recalled everything that had happened in the German healthcare system and in how many areas patient care had been improved. “That could only be achieved with an impressive team performance, to which the medical profession and politics contributed,” said Gröhe.“With these and many other topics it has been shown that it is worthwhile if the medical profession persists in legislative projects and repeatedly brings their point of view into the parliamentary deliberations.
Studies: "Time is running out"
Politicians and doctors are not of the same opinion everywhere. “A master plan for medical studies 2020 is addressed in the coalition agreement, which is still pending. The German medical profession has identified number of points that need to be changed. In the selection process, we call for greater weighting of psychosocial skills. We not only need doctors who can transplant hearts, but also people who are wholeheartedly involved, "said Montgomery to the applause of the audience. “We have to introduce young students to family medicine early enough during their studies and finally set up chairs for general medicine in all faculties. Time is of the essence, Minister, because anyone who changes their training has to wait around 15 years for the results to reach the patient's care. ”But nobody could wait that long. Gröhe explained that not only the Ministry of Health is responsible here, but also the Ministry of Research and Finance. He emphasized, however, that work was being carried out at full speed to implement this coalition project as well.
Montgomery also warned that great care must be taken in the TTIP negotiations "that our proven standards are not negotiable" . He stressed that standards of professional practice or training as doctor should not be the subject of barter deals in the negotiations. Gröhe replied that the European Union did not have mandate to negotiate public health and the licensing of doctors. In addition, foreign companies that want to provide services in Germany would have to meet the legal framework conditions that apply here.
The German Medical Association met for the last time in Hamburg 25 years ago. In his speech, Gröhe recalled everything that had happened in the German healthcare system and in how many areas patient care had been improved. “That could only be achieved with an impressive team performance, to which the medical profession and politics contributed,” said Gröhe.
Falk Osterloh
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