Health insurance chief demands abolition of practice fees

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The head of the Techniker Krankenkasse considers the practice fee to be unnecessary

More and more decision makers are calling for the abolition of the practice fee. For the first time, a head of a statutory health insurance company is now demanding that the quarterly fee for a doctor's visit be canceled. A study had already determined that the practice fees missed the original goal of minimizing unnecessary medical consultations. The chairman of the board of the Techniker Krankenkasse Jens Baas also relies on this examination: "The practice fee does not prevent unnecessary visits to the doctor."

A nuisance for sick people and doctors As the first fund manager, the chairman of the Techniker Krankenkasse, Jens Baas, demands that the statutory practice fee be abolished entirely. Until now, only health politicians, patient representatives and the medical profession had asked for the cancellation. “Health insurance companies and health funds are currently in a very good financial position. There is no reason to pointlessly reach into the patient's pocket, ”the TK boss told“ Bild am Sonntag ”. In addition, the practice fee cannot prevent unnecessary visits to the doctor or control patient flows. Rather, the quarterly fee is "simply a nuisance for the sick and doctors".

Since the health care reform in 2004, every adult health insurance patient has to pay 10 euros per quarter for the first visit to a family doctor, dentist or specialist. The umbrella organization of statutory health insurance (GKV) pleads for the practice fees to be retained. After all, the fee flushes around two billion euros a year into the coffers. According to Baas, this source of income would be dispensable for the health insurance companies. The abolition would not only relieve the burden on insured persons, but also doctors, as they would have to do much less bureaucratic tasks. Another positive effect could be effective: "The pointless issuing of transfers in stock would finally be over."

Baas has only been in the position of cashier for a short time. In June of this year, his predecessor, Norbert Klusen, in an interview with the “Frankfurter Allgemeine Zeitung” still pleaded against withdrawal. Instead, the health insurance companies should make provisions for bad times and accelerate the build-up of further reserves.

Practice fee misses the point and purpose In international comparison, Germany is the leader in terms of doctor contacts. The additional flat-rate fee should discourage patients from "unnecessary consultations". A study by the Central Institute for Statutory Health Insurance in Germany showed, however, that over 50 percent of all medical therapies are accounted for by around 16 percent of the insured, who are primarily chronically ill. This means that on average every insured patient goes to the doctor about 17 times a year. However, if the 16 percent of permanent visitors are deducted, an insured patient only goes to the family doctor or specialist only on average four times a year. In addition, the evaluation came to the conclusion that the additional payments did not achieve the desired effect of "preventing cash benefits that are not absolutely necessary".

77 percent of Germans vote for the fee A representative survey study by the opinion and research institute "Emnid" asked 503 Germans on the subject of practice fees on behalf of "Bild am Sonntag". Over two thirds of the respondents (77 percent) were in favor of abolition. Only 22 percent said "the fee should be maintained".

Federal Minister of Health for abolishing the practice fee Due to the billions of surpluses in the health fund, the Federal Minister of Health Daniel Bahr (FDP) also advocated a reform of the practice fee. "The health insurance funds currently have 20 billion euros in reserves," reports the minister. Given the high surpluses, the practice fee could be abolished. The coalition partners from the CDU and CSU, however, reject this and refer to the need for reserves. The National Association of Statutory Health Insurance Funds warned that the surpluses would be used up in 2014 at the latest due to the economic downturn, demographic change and increasing expenditure in the health care system. Nevertheless, the practice fee should be decided in the next coalition committee.

Only in June 2012 did several federal states vote for a revision, but failed to meet the required majority. At the health ministers' conference in Saarbrücken, eleven of the sixteen ministers voted to abolish the 10 euro fee. For a Federal Council initiative, however, thirteen countries must have the same will. (sb)

Also read about the practice fee:
Bahr calls for the abolition of practice fees
DGB: Practice fee should be abolished
Private cash registers are no longer portable
Health insurance: What will change in 2016351a2cc0b08c03 /> Photo credit: Matthias Preisinger /

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