Freiburg - With view to the federal election in September, the President of the German Medical Association (), Frank Ulrich Montgomery, warned against the introduction of citizens' insurance scheme, as advocated by the SPD. A unified insurance for all citizens is “the turbo-charger of real two-class medicine”, said Montgomery at the opening of the 120th German Medical Congress today in Freiburg.
“It causes and promotes injustice instead of preventing it, Said Montgomery. If it did, there would immediately be huge market for additional health services and additional insurance. “Anyone who thinks that uniform insurance is more just than our current system is confusing equality at low level with justice,” warned the BÄK President.
Differences in comfort, but no differences in quality
In the German health care system, there are differences in comfort between statutory and private health insurance due to the different fee levels. On the other hand, there are no quality differences in medical treatment depending on the insurance status. The German healthcare system is still one of the best in the world, said Montgomery. In an international comparison, it has the lowest access thresholds for all services.
Montgomery used the presence of Federal Health Minister Hermann Gröhe (CDU) to once again point out the election test stones that the BÄK recently presented. The main points are the preservation of the free choice of doctor as well as the medical freelance. This means that not only doctors in their own practice, but also employed doctors, act medically and professionally independently of instructions from third parties.
For medical expertise in the G-BA
The BÄK is also committed to effective medical self-administration. This is decisive factor in ensuring the quality and professionalism of the medical profession and at the same time best suited to include medical expertise in the further development of the health care system.
In this context, Montgomery sharply criticized that Regina Klakow-Franck, the only doctor among the three impartial members of the Federal Joint Committee (G-BA), to be exchanged for the lawyer and former FDP member of the Bundestag Lars Lindemann at the end of her term.
Interview with Frank Ulrich Montgomery, President of the German Medical Association
"Further training is professional practice"
In addition to the rapid implementation of the reform of medical studies, other health policy demands of the BÄK also include change in the financing of further training positions in outpatient care. Montgomery emphasized that continuing education is job from day one and, unlike studying, is not an education. “That is why at least the same collective bargaining conditions must apply to outpatient training as in hospitals, and the financing of outpatient medical training must be regulated by law as remuneration for medical services.”
Montgomery emphatically called for an end to the investment backlog in hospitals, which now amounts to 27 to 30 billion euros. At the same time he criticized the increasing economization of the health system. The competition was - despite all the promises to be made about the quality competition - almost exclusively based on price. In the clinics, the ability to generate economic results was more important than medical performance. There is risk that the medical indication will be optimized for economic reasons.
But what is efficient for business economists does not have to be efficient for patients. Frank Ulrich Montgomery
Under the conditions of health system financed by solidarity, the most economical use of the limited financial resources possible is not only an economic but also professional ethical imperative.
"But what is efficient for business administrators doesn't have to be efficient for patients," said Montgomery. If the indication for diagnosis and therapy is optimized for economic reasons, there will be fundamental disruptions in the relationship of trust between doctor and patient.
Doctors should not be made vicarious agents for economic optimization strategies. Frank Ulrich Montgomery
“Doctors must not be turned into vicarious agents for economic optimization strategies”, warned the BÄK President. The health care system needs competition regime that recognizes possible collateral effects on the insured and everyone involved in the care in good time.
Minimum staffing levels for doctors, too
The downside of medical companies that are trimmed for economic success is not enough Staff, too long working hours, poor organization, overcrowded emergency rooms and too much bureaucracy. It is therefore to be welcomed that the federal government is taking countermeasures and is planning lower staffing levels for care. However, that alone is not enough. Lower limits are necessary for the entire staff, including the medical service.
In the dispute about emergency care between hospitals and general practitioners, Montgomery offered the BÄK as an intermediary. It is conceivable to convene round table at the BÄK, at which doctors from clinics and practices, the German Hospital Association and the cost bearers could develop joint solution. The fact that more and more patients are making use of the emergency rooms in hospitals, although they could just as easily be cared for by resident doctor, was also topic at the general assembly of the Marburger Bund, which took place in the run-up to the German Doctors' Conference in Freiburg.
The goal of the medical profession is also modern and continuously evolving fee schedule for doctors (GOÄ), which preserves its double protective function: to protect the patient from excessive financial demands and the doctor from ruinous undercutting competition, stressed Montgomery. He called on the future federal government to implement the almost completed new GOÄ on the basis of the joint proposal by BÄK, the Association of Private Health Insurance (PKV) and the aid providers.