Criticism of the planned restructuring of patient advice
Health/Hearing – 03/01/2023 (hib 153/2023)
Berlin: (hib/PK) The planned restructuring of the Independent Patient Advice Service Germany (UPD) has met with criticism from social organizations. With the Central Association of Statutory Health Insurance (GKV) as the main sponsor, the independence of the advice is not guaranteed, the social associations explained in a hearing on the draft law (20/5334) of the federal government. The GKV itself rejects such a financing model and speaks of a design flaw. The experts commented on Wednesday in the hearing of the Health Committee and in written statements.
According to the draft, the UPD is to be restructured and consolidated in a foundation under civil law. The National Association of Statutory Health Insurance Funds and the private health insurance companies (PKV) are to allocate a total of 15 million euros annually to the foundation at the beginning of 2024. The proportion of private health insurance should be seven percent.
The call center company Sanvartis has been operating the UPD since January 2016. The contract was previously carried out by a bidding consortium consisting of the VdK social association, the Federal Association of Consumer Organizations and the Association of Independent Patient Advice (VuP).
The VdK supports the foundation solution, but is critical of the role of the GKV. Independence is not guaranteed with the GKV as sponsor and founder. The UPD advises many people on matters relating to statutory health insurance benefits, often it is about claims against payers. It is absurd to create a consultancy funded by an actor against whom a large part of the consultancy process is directed. The VdK spoke out in favor of financing the UPD from tax revenue.
The Federation of German Consumer Organizations (vzbv) made a similar argument, which also advocated financing from tax revenue to ensure the independence of the foundation. In addition, the work of the foundation requires a separation of strategic control and operational implementation as well as a connection between the patient organizations and the foundation’s board of directors.
The National Association of Statutory Health Insurance Funds explained that patient and consumer advice is primarily a cross-sectional task for society as a whole, which should be financed from tax money. The GKV should finance the UPD Foundation and act as a founder, but do not receive the constitutionally required participation rights and reject this construct.
The individual expert Rolf Rosenbrock disagreed and explained that the financing by the GKV with a subsidy from the private health insurance was appropriate because information and advice undoubtedly belonged to the scope of services of a social health insurance. The health researcher assumes that the structure of the foundation is suitable for guaranteeing an independent, state-remote and permanent range of information and advice. However, he pleaded for patient organizations to be able to appoint their own representatives on the board of trustees.
In the hearing, experts not only raised constitutional concerns, but also expressed doubts as to whether there would be enough time to implement the planned structure by the beginning of 2024. A representative of the current UPD warned of a loss of staff in the consultation. Employees are already reorienting themselves because they could not see a clear perspective. If this does not change in a timely manner, it may not be possible to maintain the advisory service.
The statements of the associations and experts on bundestag.de: