Thursday, February 8, 2024, 5:12 p.m
At the beginning of this year, the Federal Republic of Germany is under considerable threat to its domestic and foreign policy existence. The current situation is the result of years of cross-party failures and shifting problems into the future. Now this future has become present, the problems continue to increase in number and scope and solutions have become even more distant. At the same time, systemically relevant and democracy-strengthening pillars of our society, such as the education and health systems, are not being regulated accidentally, but deliberately broken. Neither the current traffic light coalition nor its many predecessor governments came up with the clear idea that the two are connected, complement each other and affect all levels of society across generations.
The political elemental force that these undesirable developments can have is demonstrated by the status quo at the turn of the year 2023/2024: the sparse health skills in the population continue to decline, so that the inadequate use of health facilities continues to increase and thus the scarce resources in the healthcare system, especially in relation to Personnel and time are wasted unnecessarily and irresponsibly. At the same time, the population’s demands are increasing, fueled by bold promises from health insurance companies and politicians and the tendency to turn into verbal and physical violence if they are not fulfilled.
Young people are told to keep their eyes open when choosing a career! Unfortunately, democratic parties in government have been given the understanding too late to keep their eyes and ears open when it comes to selecting candidates for government offices. The designated Chancellor Olaf Scholz knew very well who he was entrusting with the leadership of the Federal Ministry of Health. And he also knew exactly what health policy legacy and wrong decisions were associated with this personality and what additional ones could be expected. On top of that; For over two years he has paid almost no attention to the feared and implemented health policy measures in his cabinet. You can’t take care of everything and be responsible for it?
No matter how large the special assets are, special incapacity cannot be cured with them. While the Defense Department considers an emergency in the near future to be a reality, in the healthcare sector it has occurred here and now. This required less the increasing cyber attacks on clinical facilities and their digital vulnerability, but rather permanent friendly fire from the government’s own health policy. As with internal security, the climate crisis, the transport transition, etc., paper is patient, as are the statements on health policy in the coalition agreement. The trendy digitization is still only piecemeal, partly in an amateurish-looking manner and far from having a high level of cognitive maturity. The combination of an e-prescription and an electronic medication plan is already an intellectual challenge. Not to mention the technical implementation. Only someone who has never worked as a hospital doctor, MFA, in nursing or as an independent family doctor or specialist for a significant period of time can decide on the brighter minds of those affected. The imminent release of cannabis cannot go unmentioned in this qualifying discourse. Here too, internal party ideology is once again taking precedence over extra-parliamentary expertise and their concerns regarding foreseeable damage settlements.
The inadequate health policy result is right before our eyes: Instead of hospital reform, we are experiencing a real destruction of the hospital landscape without taking into account the local and regional need for medical care. At the same time, the network of general practitioners and specialists that used to be close to home and nationwide is increasingly thinning out. As a nationwide and interdisciplinary professional association, the BAO can assess this development very well. Just as the number of hospital insolvencies serves as a key figure in the assessment of hospital reform, the number of members leaving professional associations for reasons of age illustrates the loss of specialist medical care in private practice. Very few of these colleagues find successors, a lot of statutory health insurance doctor positions go to MVZ and the location that was previously relevant to care is lost. At least a third of the practices affected cannot find a successor. This threatening development is the result of Professor Lauterbach’s repeated denigration of specialist medical practices on many occasions over the past 20 years as being double – therefore unnecessary. Like Ulla Schmidt ff. SPD, he calls for hospital-centered specialist patient care; Now, thanks to his position, he has come a lot closer to his destination station. The longed-for polyclinics of the past have been renamed health kiosks.
The minister came up with a special trick for the last section of the route. Ostensibly, at the end of 2022, he gave in to the urging of traffic light health policy common sense and allowed sector-level remuneration for outpatient medical services provided by clinics and practices in a new legal paragraph (§115f, SGB V). If he is currently using this from scientists and from the BAO for 30 years! Lauterbach was unable to prevent the paradigm shift that had been called for, so he delayed it. By authorization and legal regulation, he created a billing chaos that turned the limited start of the so-called Hybrid DRG on January 1, 2024 into a false start. These arbitrary actions and uncontrolled powers of action harm our health system and thus the entire population. Even the regular simmering of jealous debates regarding doctors’ incomes or the over-privileging of private patients can no longer conceal the extent of the BMG’s politically incorrect decisions under his leadership. Why don’t practices find successors when such high incomes are available, and why is private patient status no longer useful when emergency aid is overcrowded and consultation appointments are no longer possible due to exhaustion of human and structural resources.
As if the damage to medical care wasn’t already great enough – in 2023 alone, 500 pharmacies disappeared from the supply landscape. It is strange when the last parliamentary backbencher can accurately say the term demographic change, but is unable to perceive the age- and generation-appropriate needs of our society and constructively incorporate them into his considerations. This is exactly what would define a responsible health policy. With and without government responsibility. A way out of the misery is, as the BAO has been calling for for 30 years, to continuously shift unnecessary inpatient treatments that are important for the economic survival of clinics into outpatient care structures, regardless of whether they are located in a clinic or a doctor’s office. It is important that high medical standards of care quality and patient safety are guaranteed during this transformation.
These demands can only be met if real cost compensation for the necessary structures and processes is politically guaranteed. This requires active support of the transformation process at the clinics and stabilization of outpatient care through general practitioners and specialist practices. This process could have been underway for years if there had ever been a serious will to fill empty words with content. Anyone who communicates with their employees late at night on talk shows and discriminates against the medical profession in uneducated media is unmistakably admitting to being indoctrinated. In doing so, he is aware of his political sense and accepts that in regions where medical care has collapsed, trust in democratic structures could also be in decline. Instead of the federal government, the state level is ideologically free to reach a sustainable consensus that takes everyone into account! In order to make efforts to ensure service providers, the minister regularly confronts his country colleagues. So far, opposition parties have only used health policy to pursue fundamental opposition politics. All on the backs of the population and health professionals.
The BAO therefore calls on all health politicians responsible at the state and federal level to finally jointly dedicate themselves to the tasks just described and carry them out democratically. We call on patients and voters to make health policy an important component of their voting decision in the upcoming state elections this year.
X = Your cross is important!
The BAO and the associated associations of the Future Group for Outpatient Surgery 2022 represent around 4,500 specialists.