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We have to prepare better for crises

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We have to prepare better for crises

Neue Osnabrücker Zeitung (NOZ): Mr. Lauterbach, two years of war in Ukraine, and many fear further Russian escalation. It sounds bitter, but still: Would our healthcare system be prepared for a military conflict?

Federal Minister of Health Prof. Karl Lauterbach: The pandemic has shown that our healthcare system is not sufficiently prepared for scenarios that we long considered unthinkable. That’s why we already agreed in the coalition agreement to better equip the structures for major crises. After the criminal Russian attack on Ukraine, this challenge has unfortunately become more important. And that is why we have a loophole in the law that we are addressing in order to be prepared for a disaster or even a military alliance – as unlikely as it is.

What exactly is missing?

In the event of a crisis, every doctor, every hospital, every health authority must know what to do. We need clear responsibilities – for example for the distribution of a large number of injured people among the clinics in Germany. The reporting channels and the possibilities for patient transfers throughout Germany must also be clear. The regulations on stockpiling are not sufficient. Ultimately, the deployment and distribution of medical personnel must be clarified in the event of a crisis. And all of this has to be practiced.

Do you think it is necessary to make the healthcare system “war-ready”?

As I said: At the end of the 1980s, people were convinced that doctors did not have to and should not concern themselves with such questions. It was thought that this was the best prevention. But that was a step in the wrong direction. Yes, we not only have to prepare ourselves better for future pandemics, as we did with the new Infection Protection Act. We also need to prepare ourselves better for major disasters and possible military conflicts.

Aren’t you afraid of being accused of scaremongering?

No. It would be silly to say we are not preparing for a military conflict and then it won’t come. According to the logic, there would be no need for a Bundeswehr. Doing nothing is not an option. A turnaround is also needed for the healthcare system. Especially since, in the event of an alliance, Germany could become a hub for the care of injured and injured people from other countries. We have already taken in more seriously injured people from Ukraine for treatment than any other European country – there are almost 1,000.

When do you want to put the law on the table?

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This has to be well prepared. We have already exchanged ideas with specialists from the Bundeswehr and are working with the Ministry of Defense and the Ministry of the Interior. I expect that we will present a bill on this in the summer, which will then be initiated by the cabinet shortly.

One of your major construction projects is hospital reform. Will it come in time to avert major hospital deaths?

The financing of the transition phase until the start of the hospital reform is expected to be secured. We can support hospitals with six billion euros in liquidity support and compensation for higher salaries for hospital staff. In addition, there is another up to 2.6 billion euros from the hospital structure fund. Additionally, energy aid of up to 2 billion. Spectacular sums that show how inefficient the system is. And from 2026, funds will flow from the 50 billion euro transformation fund so that the structure finally changes. So yes: If the Transparency Act is passed by the Federal Council as planned on March 22nd, hospital deaths can be averted this year and next. But if we don’t get the major hospital reform done with the states, some houses will sink like stones in water in the next few years.

The reform is intended to provide better treatment and alleviate the staff shortage by centralizing the hospital landscape. How many houses will be left behind?

One thing is clear: we cannot invest ten billion euros or more every year in loss-making clinics. Many houses make losses, partly because they no longer provide certain services that they used to make money in the past in order to reach their budget. Today there is a lack of staff for this and there is no longer the medical need. There are too many beds, too many hospitals, because many things simply no longer need to be treated as inpatients, but rather as outpatients or not at all. The system is unsustainable, bloated and outdated. But in the transition to the new system, we will keep all clinics that are needed in the long term alive. Your economic situation will clearly improve. This is particularly true for clinics in rural areas, which would otherwise have no chance but ensure local care.

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Then why is there still so much resistance from the countries?

If the major hospital reform that we have been working on for almost two years does not come about, it would of course be a catastrophe for the hospital landscape and health care. All federal states, including those governed by the Union, understood this, except Bavaria. Bavaria is the only country so far to refuse constructive cooperation. I therefore do not expect that the law will be sent by the Federal Council to the Mediation Committee, but rather that we will achieve a broad majority through active joint work with the states. The next stage is the cabinet decision, which I expect on April 24th.

Cannabis legalization is scheduled to come as early as April 1st. Possession of 50 grams will then be permitted. Do you know how many joints you can build with it?

Yes. But it’s pointless to argue about it. I know what you’re getting at.

My sources say 0.07 grams of cannabis is enough for a joint. 714 bags could be made with 50 grams. Isn’t that way too much?

The number is wrong. But be that as it may, if everyone was only allowed to own five grams in a club or for self-cultivation, we wouldn’t be able to shut down the black market and we could save ourselves the action. The goal is to replace the black market so that children, teenagers and young people are better protected from criminal dealers and criminal gangs. And just because you can get 50 grams of cannabis per month as a member of a stoner club doesn’t mean you’ll be able to smoke it away. We don’t introduce a minimum consumption.

50 grams is enough to sell a lot of it…

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Anyone who wants to deal in cannabis is already doing it, just illegally, with toxic stuff that is addictive, often with harder drugs such as cocaine on offer. And the same applies to members of cannabis clubs: Anyone caught selling it commercially to minors faces two years behind bars. The aim of the reform is to dry up the black market. This requires a legal offer that is large enough. This approach has succeeded in shrinking the black market in Canada by more than 75 percent.

And if the states disagree, will the reform come to nothing?

I do not believe that the law will be held up in the Federal Council, but that it can come into force on April 1st. It is clear to everyone: our current drug policy has failed. It can’t stay the way it is. More and more young people are smoking weed. And we also have to protect adults from the increasingly brutal drug market. educate minors; decriminalization of adult use; Fighting the black market: This is the combination that renowned addiction researchers also find correct. And the debate about the law and our campaign have already made it clear to many young people: Be careful, this is brain poison. You can smoke yourself stupid with cannabis.

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