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Medical president criticizes Kassen abuse of power

Medical president criticizes Kassen abuse of power

Do health insurers abuse their power in fee negotiations with the medical profession?

The President of the German Medical Association, Prof. Frank Ulrich Montgomery, has accused the health insurance companies of abuse of power in the current dispute with the medical profession about future remuneration. Montgomery explained to the "Stuttgarter Zeitung" that the power of the umbrella organization of statutory health insurers (GKV umbrella association) "has been extremely strengthened by the legislation of the past few years", but that this "has increasingly lost the relevance to reality for patient care" "and to a pure bureaucracy body.

The substantial surpluses of health insurance companies in 2011 and in the first half of 2012 act like water on the mills of criticism by the President of the German Medical Association. Here, "more and more money is hoarded instead of being used to care for patients or to reimburse contributors," complained Montgomery. "The association behaves like a lobbyist association par excellence, no trace of public service obligations," said the statement in the current announcement of the German Medical Association and to let psychotherapists feel. Although no practices will be closed, next week, for example, "informal health insurance queries will no longer be answered in writing," said KBV boss Andreas Köhler in a recent press release.

Health insurance companies scratch the dignity of doctors For the medical profession, reports of record surpluses of 21.8 billion euros from the statutory health insurance companies are an additional argument in the context of the current dispute over fees. The doctors' negotiators had asked for the remuneration to be raised by around 3.5 billion euros, not least to compensate for the significant increase in operating costs and inflation since 2008. The GKV umbrella association, on the other hand, had initially started the negotiations with a proposal for a reduced remuneration on the basis of a specially prepared expert opinion and had finally agreed to increase the medical fees by a total of 270 million or 0.9 percent. The physician president Frank Ulrich Montgomery criticized this procedure sharply: "With three zero rounds for the doctors with a ten percent minus offer to go into the negotiations and in the end only 0.92 percent plus offer, although ten percent increase in costs is demonstrable, that scratches the dignity of the negotiating partner - the doctors. ”Due to the questionable procedure of the health insurance companies, the situation in the current fee dispute is heated up similarly to the 2005 hospital strike.

Power of the National Association of Statutory Health Insurance Funds limit? In the opinion of the President of the German Medical Association, the power of the National Association of Statutory Health Insurance Funds should be significantly restricted due to its behavior. The GKV umbrella association feels like a savings bank and completely forget that doctors have to treat patients. How else is it to be explained that the cash office officials, who are not all earning badly, are hoarding more and more money instead of using it to care for patients or to reimburse contributors. According to Frank Ulrich Montgomery, it should be urgently questioned whether “it is it is wise to have the doctors negotiate with just one umbrella organization for all health insurance companies. ”In his opinion, it would be wiser, as in the past, to allow more differentiations. "We negotiated with replacement and local health insurance companies in competition - that's why it was more about patient care," explained Montgomery. The behavior of the National Association of Statutory Health Insurance Funds illustrates "how dangerous monopolies are when they exercise power irresponsibly."

The National Association of Statutory Health Insurance Physicians is planning a policy of needlestick stitches. The National Statutory Health Insurance Association has now announced what actions its "policy of needlestick stitches" against health insurance companies should begin with next week. In the approximately 100,000 practices of the resident doctors and psychotherapists, "a wide potpourri of staggered actions" are available, of which targeted measures are implemented every week, according to the KBV. Initially, the plan was to stop responding to informal till requests in writing. Every day, 145 health insurance companies shower doctors' offices with informal inquiries of this kind, such as whether a rehabilitation measure has been carried out or insured persons are still on sick leave, reports the KBV. In order to convey to the health insurance employees "how long doctors generally work, they have to limit their inquiries and requests to talk either to before 8 a.m. or after 8 p.m.", explained the KBV. The rest of the day the doctors would need to take care of their patients.

Voting on strikes and practice closings The resident doctors and physiotherapists also want to refuse to stamp the bonus booklets as of Monday. The planned "measures hit the biggest cause of bureaucracy in the practices, namely the health insurance companies. As a result, the doctors actually have more time for their patients, ”explained KBV boss Köhler. "The health insurance companies will feel our pinpricks", but the actions will not be at the patient's expense, Köhler continues. In addition, the National Association of Statutory Health Insurance Physicians decided to bring an action before the Berlin-Brandenburg Social Court against the current proposal to increase the fee. In the middle of next week, the independent medical associations also called for a vote on strikes and closings.

Surpluses of the health insurance companies cause for criticism The significant surpluses of 12.8 billion euros in the health insurance funds and nine million euros in reserves in the health fund do not exactly strengthen the bargaining positions. Politicians have already been accused of hoarding money. The Federal Minister of Health Daniel Bahr (FDP) spoke several times that particularly well-off health insurance companies should reimburse the surpluses to their members in the form of premiums or at least use them for significant improvements in performance. However, the health insurance companies apparently prefer to keep their money together, which, based on past experience, cannot really be resented. Up until three years ago, the discussion was really only about the deficits of the health insurers and possible bankruptcies. It is therefore understandable that health insurance companies initially use the current surpluses to create financial cushions. However, you should not overexert your hand, because ultimately the well-being of the patient must be the focus. (fp)

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