Karl Lauterbach is a politician who likes to present himself as a “scientist,” for example as an Adjunct Professor of Health Policy and Management at the Harvard School of Public Health. Of course, he no longer conducts research himself and he didn’t do it for long before, and he doesn’t appear as the first author of scientific articles that often.
Yesterday he opened the “Poverty and Health” congress. The 29th Congress now. Federal President Frank-Walter Steinmeier was there last year. This shows how relevant Congress has become in politics, that it has found its way out of the niche of fringe issues, and of course that politicians are trying to score points with it. Shortly after Lauterbach’s speech, individual topics were in the media, without, as is often the case, accompanied by critical comments.
That’s why I’ll take it over here.
What I found interesting about his appearance was that he once again presented himself primarily as a scientist and less as a politician. As he often does, he presented studies, this time on the relevance of social influencing factors and climate change on health.
The message to the plenary session of congress visitors: I am completely on your side, I am one of you.
He then placed some of his current political projects into this framework and interpreted, for example, the planned health kiosks or the upcoming hospital reform as answers to the social inequality of health opportunities. This is actually explicitly written into the order book for the health kiosks that are to come with the Health Care Strengthening Act. They should be set up in socially disadvantaged regions as a low-threshold offer of health advice and referral to the care system. There will be 1,000 such health kiosks one day. As useful as such an offer can be if it is well made and well networked, there is controversy about how much health kiosks will contribute to reducing socially caused inequality in health opportunities. Perhaps you don’t have to denigrate it as the famous drop in the bucket, but rather see it as another piece of the mosaic in the overall picture – unfortunately no one knows the whole picture. Many critics therefore see the health kiosks as just another extra sausage in the system, with new interfaces, instead of the standard care being better geared towards the socially disadvantaged, for example in terms of greater control over the establishment of doctors or social medical offers from the health authorities. From their point of view, it is of course understandable that doctors prefer to go to wealthier regions, but shouldn’t there be a need to talk about a reform of the statutory health insurance mandate of the statutory health insurance associations? A minefield, health kiosks are not quite as explosive.
Lauterbach’s statement was somewhat strange: the planned hospital reform would also reduce socially-related inequality in health opportunities because poorer people would be treated primarily in the smaller, not well-equipped hospitals. Is there really any data on this? Does this also apply to the many small clinics in Munich?
Whatever. Here I just want to point out that I would have liked to hear more from the politician Lauterbach: How does he imagine a systematic strategy to reduce socially caused inequality in health opportunities? How is the weighting of new medical care offers compared to better primary prevention through sufficient wages, good education, effective occupational and environmental protection, the reduction of tobacco and sugar consumption, etc.? Does he really have ideas for a national public health strategy or will it remain a federal institute for prevention “in medicine”, i.e. possibly a focus on early detection of diseases? How does he plan to discuss this with the Finance Minister? Does he have the Chancellor on his side? How does he try to get public health issues, which have received little public attention, onto the cabinet agenda despite the war in Ukraine? Unfortunately, Lauterbach said next to nothing about this; he did not have a 10-point plan to combat socially caused inequality in health opportunities. The politician Lauterbach remained in the background.
Instead, Lauterbach has once again shown that he knows how to score points with the “epistemization of the political” (Bogner). The congressional plenary applauded for a long time. Instead of political authority, he wanted to radiate scientific authority. But his job as a minister is different. The constitutional lawyer Klaus Ferdinand Gärditz judges this in his book “Court Suppliers. “How politics uses science and falls apart because of it” quite ungraciously (p. 81):
“Identifying with a political agenda and not with your own specialist knowledge is a personal ability that not everyone has. Without this, collective aggregation and assertion of interests does not work. Political agendas in scientific garb are (at best) bad science, scientific specialism in political garb is (at best) bad politics.”
Karl Lauterbach has not yet found out about this role conflict and perhaps this is one of the reasons why, despite some good approaches, his reforms are not making any real headway, are in danger of becoming bogged down in the mix of conflicting interests and he is classified by experienced observers as an “announcement minister”. becomes.