120th German Doctors 'Day: Montgomery speaks out against citizens' insurance

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.

"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.

Video

Interview with Hermann Gröhe, Federal Minister of Health

Gröhe wants the GOÄ to be implemented quickly

An amendment to the GOÄ is overdue, said Federal Health Minister Gröhe before the German Medical Congress. He had already emphasized this in the same place last year. A more appropriate description and evaluation of medical services is in the interest of everyone, including aid. If doctors, the private health insurance association and subsidies presented concept, he would do everything to ensure that it was implemented quickly, affirmed Gröhe.

The minister attended the opening ceremony also responded to the criticism of the BÄK president of the citizen insurance. "We do not need any slogans of envy that are owed to the election campaign," said Gröhe. A compulsory merger of statutory and private health insurance will not solve any of the challenges facing the German health care system. “In the end, nothing would get better, just lot worse,” he agreed with Montgomery's judgment. Similar to him, Gröhe also praised the efficiency of the health system, which traditionally combines high performance and solidarity. "This is perceived as model around the world," he said.

Promoting "team performance"

Looking back at the past legislative period, the minister was satisfied with the numerous legislative procedures that he was completing could. "The main idea was that we had to promote the best possible team performance," said Gröhe.

It is one of the images that he always tries to promote better networking between those involved in the medical care of patients. In this context, Gröhe also praised the project applications with which institutions had applied for funding from the innovation fund. In the years 2016 to 2019, 300 million euros are available annually to promote new forms of care and health services research.

It is now matter of building bridges instead of walls between the sectors, said the minister. The goal is patient-oriented further development of the health system. It is true that responsible use of the means of solidarity health insurance is essential. The minister, however, rejected the primacy of the economy. “The focus is always on the patient,” emphasized Gröhe. When he hears that critically ill child is being referred to as “cost runaway”, “I am outraged,” he said President of the host, Ulrich Clever, praised the solidarity in the German health system. He shared with those present the good fortune to be cared for in the event of illness or injury regardless of origin, income or ideology, he said in front of the 1,000 invited guests of the German Medical Congress.

Clever also pointed out that there was use the German Medical Association worldwide for doctors who are hindered in the exercise of their profession or who, despite massive reprisals, stand up for their medical autonomy and their medical-ethical self-image. The German Medical Association invited the Turkish forensic doctor and President of the Turkish Human Rights Foundation, Şebnem Fincancı, to Freiburg on behalf of these colleagues. At the opening of the plenary in the afternoon, she addressed the 250 delegates of the German Medical Association.

Fincanci, who has been actively campaigning for democracy and human rights since she was student, is currently answerable to court. She was arrested together with two journalists in June 2016 because she had taken part in solidarity campaign for the newspaper Özgur Gündem, which is considered to be pro-Kurdish and critical of the government.