20 euros entrance fee to relieve overloaded emergency departments? What the Union parties and KBV boss Gassen are demanding does not meet with approval everywhere.
The idea is not entirely new. And yet Andreas Gassen’s recent proposal made waves. In an interview, the head of the KBV advocated that patients should in future pay a fee for admission to the emergency room if they have not previously obtained an initial telephone assessment. The functionary’s argument: Those who can still go to an emergency room themselves are often not a real medical emergency.
The background to the advance is a long-known grievance. The emergency departments of German clinics are notoriously overloaded (read more about this here). Especially on the weekends, when the regular practices are closed, many patients use them as a point of contact for their major and minor medical problems. Accordingly, the doctors on duty are often primarily concerned with distinguishing between serious emergencies and minor complaints.
But is the fine demanded by Gassen really the way to salvation? While the Union parties are open to this idea, there is some harsh criticism from other quarters.
Patients go to the emergency room for lack of alternatives
The head of the German Hospital Society (DKG), Gerald Gass, doubts that Gassen’s proposal is ready for a decision at this point in time: “When we talk about sanctions, the conditions must first be met to ensure that all patients in an emergency situation are ideally advised and managed,” says Gass. This requires an initial medical assessment by the integrated control centers of the telephone numbers 112 and 116117, short-term appointments in surrounding medical practices and also immediate home visits by the KV emergency service. Only when these conditions have been created by the associations of statutory health insurance physicians can one seriously consider the proposal for a penalty fee. However, according to Gass, Germany is still a long way from getting that far.
It would also be a lot of work for the clinics to collect the fee. Either the procedure would have to be handled directly by the health insurance companies, or the money would have to remain with the clinics to cover the administrative costs.
Bad experiences with practice fees are a deterrent
Gass also refers to the not very pleasant experience with the practice fee, which is now history. “All of the reasons mentioned were also the reason for abolishing the practice fee in the private sector. We should avoid repeating mistakes of the past,” said the DKG boss.
The Federal Chairman of the German General Practitioners Association, Markus Beier. He also acknowledged an “obvious problem” in the emergency rooms. However, the discussion about a penalty fee is the third step before the first. The overloading of the emergency rooms is an expression of a system failure that needs to be addressed first. Similar statements come from the Green health politician Janosch Dahmen. According to him, it is above all the currently incomplete basic care, especially that of general practitioners, that makes some medical problems an emergency in the first place.