Monday, December 4, 2006
Nationwide protests against the health reform
For the first time in West German history, all health professionals have united in opposition to the planned health reforms. Doctors, pharmacists, hospital staff and over 40 organizations and health care organizations participated in a day of protest under the motto ...
patient in need - the reform hurts all.
egg-motif to the action of
the Federal Medical Council,
organized the physicians' Federation,
the German Hospital Association
and the hospital doctors association Marburger Federation
took part nationwide more than 100,000 health care workers: a third of all
Doctors' offices were closed (40,000 physicians), also a third of all hospitals provided their patients only in emergencies and after all was over half of all hospitals are information sessions. Many pharmacies were closed or made an emergency service only. In pedestrian zones and at Christmas markets studied physicians and hospital staff to talk to the citizens. There were information stalls and demonstrations.
The President of the Federal Medical Joerg-Dietrich Hoppe warned the road to a state medicine. The reform would lead to closure of many clinics and hospitals, long waiting times of patients would be Episode. The health care threatens to be turned back on. And capital income would be used to finance healthcare, because the unilateral wage-related funding was no longer sufficient.
opponents: Jörg-Dietrich Hoppe and Ulla Schmidt (SPD)
Hoppe, has already this October in detail the possible consequences of proposed health care reform:
interview with the world "(20.10.2006) with the
Federal Medical Association President Prof. Dr. Jörg-Dietrich Hoppe ...
The World: Professor Hoppe, doctors make front against the health care reform. Is it not just about grandfathering?
Hoppe: No, we want to inform people about the fact that this reform leads to a system change in health: away from the supply to the medical necessity and to allocate medical * . So far the system is characterized relatively liberal. There are freedom, free choice of doctor and therapy freedom. The reform we are taking a big step toward national health care.
The World: What new rules do you mean specifically?
Hoppe: So far, the decision about the scope of the statutory health insurance for the self administration of health insurance and doctors. The Federal Joint Committee to determine which treatments and medications can be prescribed on a cash cost. In future, the responsibility lies with the de facto Ministry of Health. The established community-based health system is centralized and transferred to a bureaucratic state medicine. The state has mainly the costs in the eye and not the health care needs. To date, it is granted, what is necessary, effective and economical. In the state ruled by allocating the necessary medicine to the financier bears will be adjusted. Under such conditions, the patient is then only the owner of a diagnosis and is supplied in Schedule F.
The World: The performance of panel doctors are evaluated from 2009 € and no longer fluctuating from quarter to quarter points. In addition, the budget will be abolished. This meets the important demands of the government doctors.
Hoppe: Although the bill is that the budgets are hereby repealed. In fact, however, they remain intact. It remains in the chronic under-funding. For the introduction of the new fee structure should be cost neutral. Any doctor can only certain amount of power to euro pricing bill. This is followed by Abstaffelung. The bottom line for the physician changes nothing. It is therefore open to the defendant misconception that insured patients are at the end of the quarter for certain services no doctor and have to wait until the next quarter. Today we talk of budget holidays, when doctors close their offices temporarily, in future they will make lot of holidays.
The World: So be better treated private patients in the future?
Hoppe: In qualitative terms, are private patients were never treated better than insured patients. But who is privately insured, must not take into account waiting times, because this system without a budget manages. However, for private patients who are insured in the proposed base rate, subject to the same restrictions as for all patients.
The World: The hospital sector is to save 500 million. What impact will it?
Hoppe: The hospitals are already in a precarious financial position. Reason, the rate increases, law-related cost increases as the increased VAT from 2007 and higher energy costs. The savings will review the policy to achieve a market shakeout, hospitals are to close or merge. The thinning of the hospital sector for the comprehensive care of patients significant Consequences. We are sliding slowly but surely in the waiting list medicine. The new budget constraints, the cost pressure is further increased. Previously patients were discharged only when they were cured. For older singles, this is important. But this achievement is further eroded.
The World: Convert or with corrections to the reform?
Hoppe: The danger is great that the train has left. Nevertheless, we hope that Members will be unsafe if they understand first what they served the Ministry of Health. However, should the grand coalition for political reasons such difficulty to pull the brake. Especially the Union will not admit that it has negotiated badly. Obviously you want to run through the project now just quickly and without much debate. Such a situation would have in a highly sensitive area such as health care may never happen.
The World: How do exert pressure on the doctors, the policy?
Hoppe: First, there will be an extraordinary 'Conference next week where we will warn of the consequences of the reform. In addition, we plan information activities in the waiting rooms. We will have to tell the patient, who is responsible for the loss of quality in medicine. The associations will ensure that is fully informed. should
Conversation with Jörg-Dietrich Hoppe led Dorothea Siems
*
The health reform, the benefit assessment of drugs in a cost-benefit analysis be expanded. This point is particularly bad and has been perceived in the Öffentlchkeit enough. Stood so far at least in theory and according to the Hippocratic Oath of doctors on the patients, it is now the life of the patient are weighed against money. Welch inhuman consequences it can have, one was recently seen a message from the UK: There rejected the National Institute for Health and Clinical Excellence (NICE) for the reimbursement of the two innoativen and effective cancer drug Avastin (Roche) and Erbitux (Merck KG) from their high prices. Scale were the costs that are necessary for an additional years in good quality of life (the benefits) to win. If these costs exceed the equivalent of 44,000 euros per year of life, a refund is not recommended (Source: internally, 30.8.2006). In Germany, evaluated the Institute for Quality and Efficiency in Health Care (IQWiG) the benefit and in future the cost of medicines.
The pharmacists also expect serious Impact of health reform on patient care and relate in particular to the planned changes to the fixed prices for prescription Medikamente.Die previous fixed prices should be replaced by the maximum prices that can be maintained. This gives the possibility of health insurance with drug manufacturers to agree to more favorable prices than before. To enhance competition, get the pharmacies can "voluntarily" to the legal drug co-payments to refrain entirely or in part, as these are part of the price of prescription Azneimittel. That would have life-threatening consequences for many pharmacies, since the legal Co-payments in the same order as the trade margins on prescription drugs are. The prescription drugs produce in the average pharmacy is still two thirds of sales and also in some of the profits. Suddenly, many pharmacies would no longer viable. The nationwide supply of medicines and of course many jobs would be jeopardized. Longer term, the prices of non-prescription medicines, which have declined since its release in 2004 for customers happily clearly pick up again. The number of providers would be compared to the demand side (the pharmacy customers) reduce significantly the resignation of many pharmacies, which tends to effect price-raising by the then less competition.
should also be saved in 2007 another 500 million euros. Health insurance companies and pharmacies are obliged to price negotiations in order to achieve this goal. The pharmacies are to negotiate with the pharmaceutical companies extra discounts that they should disclose to the public health insurance. Find the pharmacies in the pharmaceutical industry not listen, they must pay a mandatory discount of an equivalent amount to the health insurance.
Federal Health Minister Ulla Schmidt (SPD), criticized the protests were unnecessary and each group of health professionals protest only for their own interests. The patients were taken by the protests "hostage". Their spokesman said, watch the ministry "a jealous" about the fact that the reform was fully implemented. The government will not experience any permanent resistance.
The associations of health announced the other hand, continue the protests even after the possible entry into force of the reform law to do.
Jens Christian Heuer (own report)
Sources: Reuters Germany, Financial Times Germany Internet edition, Press Release of the Federal Medical Council and Ministry of Health)
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