A lot of money is wasted in the health system without increasing the quality of life or the lifespan of the population. According to the European Statistics Office, life expectancy in Germany is 80.8 years, only slightly above the EU average of 80.1 years. In countries like France, Italy, Spain and Portugal it is significantly higher, complained Health Minister Karl Lauterbach (SPD) in Berlin on Wednesday. In addition, it is increasing less rapidly in Germany, and socially we are also lagging behind: the gap in life expectancy between rich and poor is much deeper than in Scandinavia, the minister complained.
These problems are not due to a lack of money, as every German citizen spends 5,000 euros per year on health care. According to data from the industrialized countries organization OECD, this is a higher amount than anywhere else in Europe. Germany exceeds the EU average by almost 53 percent. The lack of efficiency has many reasons, one important one, in Lauterbach’s opinion, is that Germany focuses too little on prevention and too much on therapy.
Avoidance of common diseases
“There is a lack of effective prevention, our system is too focused on treating existing illnesses,” said Lauterbach and therefore announced on Wednesday the founding of a Federal Institute for Prevention and Education in Medicine (BIPAM). The new facility will focus on preventing non-communicable diseases, especially cancer, dementia and cardiovascular diseases.
Taking the basis of these common diseases, providing comprehensive, evidence-based information about them and recognizing them in a timely manner is of paramount importance, said the minister. They accounted for more than 75 percent of all deaths. Strengthening public health not only increases quality of life and expectations, but also reduces costs. Because these were “also due to a lack of primary prevention”.
The Federal Center for Health Education (BZgA) will be incorporated into the new institute. All employees will be taken over and can remain at their current headquarters in Cologne, although BIPAM is being built in Berlin. The former head of Germany’s largest health authority in Cologne, Johannes Nießen, was appointed as the installation representative. The specialist in general medicine, public health and social medicine also sat on the Corona expert council.
The institute is scheduled to be built by 2025
The legislative process for the new institute is scheduled to begin at the end of this year and the cabinet will decide on it at the beginning of 2024. In 2025 there will only be the BIPAM. The BZgA disappears and Nießen’s contract as construction representative also ends. Lauterbach thus fulfills a requirement from the coalition agreement. The BZgA will then be incorporated into an institute for public health in the ministry, “in which the activities in the public health sector, the networking of the public health service (ÖGD) and the federal health communication are located”.
Nießen said that the new institute was overdue, after all, nine out of ten people do not die from infections. The aim is to improve and network prevention, health literacy, research and communication and to collect and evaluate the necessary data on health status. The aim is not to patronize municipalities and states, which are responsible for the health authorities, but rather to act as a “central contact and source of ideas”. For example for heat action plans or when using social media.
RKI should focus on communicable diseases
Lauterbach announced that the acting head of the Robert Koch Institute, Lars Schaade, would become its new president, succeeding Lothar Wieler. In contrast to BIPAM, the RKI will concentrate on communicable diseases in the future and transfer staff to the new position. Schaade said no one likes to lose a department, but the division of labor is correct and creates added value. The minister announced ideas for a new law to prevent cardiovascular diseases in the coming weeks.
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In addition to praise for the new BIPAM, concerns were also raised. The German Association of Cities said that they were “only marginally involved in the planning”. The FDP health politician Andrew Ullmann called for additional costs to be avoided: “The BIPAM must under no circumstances become a know-it-all institute that ignores the reality of the citizens and does not involve local doctors.” Ullmann congratulated Schaade on the RKI presidency, but criticized him : “The sign of departure could have looked different after Lothar Wieler left. There is usually an advertisement for such an important position.”