Are there too many doctors in Germany?
AOK boss: "Problem with medical oversupply". According to the chairman of the health insurance association, there is no shortage of doctors in Germany, but rather the problem of an uneven regional distribution.
Unlike the Federal Minister of Health Philipp Rösler (FDP), who recently predicted a shortage of doctors for Germany, Herbert Reichelt, head of the AOK health insurance company, cannot recognize such a deficiency, but rather sees a distribution problem as the cause of possible undersupply. "We have a problem with medical oversupply," is the provocative thesis of the chairman of the AOK federal association.
As the AOK chief explained in an interview with the daily newspaper “Die Welt”, cities tend to be over-supplied with doctors, while in rural areas there is in fact a corresponding shortage of doctors. Reichelt explained that there are many more doctors, especially in large cities and their surrounding areas, than are necessary for medical care. For example, there are "more than a third of general practitioners too many in Freiburg or Munich (...)", the AOK boss told Die Die Welt and the specialist added: "So we have a distribution problem" and no general lack of doctors. Herbert Reichelt believes that the shortage of doctors in the country can only be remedied "if at the same time you reduce the oversupply in cities". In the cities, the money is spent on the oversupply that would actually be needed to supply the rural population, said the chairman of the AOK federal association. "As long as doctors can continue to settle in over-supplied areas, hardly anyone goes to the countryside voluntarily," Reichelt concludes. According to the AOK chief, the shortage of doctors in the country should also be countered by reducing the number of practice admissions in the city. The goal must be to reduce the number of practices in the over-served areas in the long term and, in return, to build capacities in the under-served areas.
Herbert Reichelt also explained in an interview with "Die Welt" that the numbers of the National Association of Statutory Health Insurance Physicians, which come to the conclusion that 3,600 doctors are needed nationwide, were very generously calculated. Because "so many doctors are needed", according to Reichelt, "to reach the border to oversupply everywhere in Germany". "This cannot be the yardstick," emphasized the AOK boss. In order to achieve the redistribution of existing medical capacities that Reichelt is considering, the AOK chief believes that medical practices in cities should be closed. H. the number of practice admissions will be reduced. For example, medical practices that should be sold for reasons of age could instead be closed. Since the practice sale to successors is considered an essential component of the pension scheme for resident doctors, he can "imagine that doctors who stop in over-served areas for reasons of age will receive a kind of severance payment for their practice," Reichelt explained.
The AOK boss emphasized that this would reduce the number of medical practices in the cities while at the same time ensuring the pension provision for those affected. According to Herbert Reichelt, the severance payment could be financed from the existing fee volume. This would reduce the number of medical practices in the cities and speed up the settlement of doctors in rural areas, Reichelt continued. However, other models such as the use of specially trained “community sisters” and the greater involvement of hospitals to expand medical care in rural areas are also conceivable, according to the AOK chief. “In general, the planning of medical care has to be changed. It has to be geared more towards the medical needs of the population, ”emphasized Herbert Reichelt.
Herbert Reichelt also spoke to Die Die Welt about the care reform planned for the coming year by the CDU, CSU and FDP. The AOK chief was excited about the proposals for the sustainable financing of long-term care insurance, since the Christian-liberal federal government has already announced that part of the supply will be covered by capital. Long-term care insurance is not in acute financial distress, "but the financial reserves will probably only last until spring 2014," said Reichelt. Afterwards there will have to be a moderate increase in the premium, the AOK boss continues. In his view, there are doubts about the proposals on capital coverage, since the financial crisis behind us has put the potential benefits of a funded system into question. With regard to future premium increases, Reichelt indicated: "As the number of people in need of care increases, premium increases are therefore inevitable in the long run". While the CDU / CSU and FDP also want to discuss as part of the care reform whether the employer's share of the contributions should be frozen, Reichelt sees clear advantages in the current parity contribution model. "Employer participation strengthens the system," said the AOK boss. (fp)
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