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Berlin The pace is high: Hardly a week goes by in which Federal Health Minister Karl Lauterbach (SPD) does not launch a new initiative or a new law. Seemingly unburdened by all the coalition disputes, the minister announced again at the weekend in the Picturenewspaper announced its Healthy Heart Act.

We want to encourage children and young people across Germany, 25-year-olds, 35-year-olds and 50-year-olds, to have their values ​​measured using a voucher system: blood pressure, including the risk factor of diabetes, explained the minister. The plan was already met with a lot of criticism from experts yesterday. The usually well-informed circles did not have the law available until this evening.

People in Germany should take part in preventive medical examinations more often, it is said in the reports. Vouchers for heart check-ups will be redeemable in pharmacies and doctor’s offices. We will handle this later via the electronic patient file, said the minister in the PictureAccording to Lauterbach, the heart law should be presented before the summer break and come into force as early as next year. Whether this is realistic in view of the general political climate and the federal elections next year remains to be seen.

The draft law apparently provides for heart checks for adults aged 25, 35 and 50. Examinations should also be carried out in childhood and adolescence, for example to find out whether there are hereditary reasons for lipid metabolism disorders. Medicines to help people stop smoking and to lower cholesterol levels (statins) should also be able to be prescribed more often.

But one thing is certain: According to almost all health experts, a restructuring of the health care system towards more prevention is urgently needed. Because it prevents illness and suffering and because it also saves costs in an increasingly aging society. However, such a restructuring is costly. And there are many adjustments that need to be made.

Last week, Lauterbach presented a draft law to strengthen public health. A Federal Institute for Prevention and Education in Medicine (BIPAM) is to be set up from January to teach health literacy nationwide and to take care of the prevention of non-communicable diseases such as cancer, dementia or cardiovascular diseases. Germany spends more on health than any other EU country, but life expectancy is still only average, said the minister. There is a lack of effective prevention, our system is too focused on treating existing diseases.

The Science Council, which advises the federal and state governments, also spoke out in favor of a turnaround in May. Hundreds of thousands of cardiovascular diseases, diabetes and cancer could be avoided through prevention. Prevention is a key to keeping society productive and ensuring care. The ageing society and the lack of skilled workers are already putting too much strain on our health system, emphasized chairman Wolfgang Wick. A close collaboration between politics, science, doctors, health insurance companies and the media is required.

The Science Council agreed: There is no lack of individual findings in health prevention. Rather, there is a lack of implementation and networking between the actors. A different distribution of the available resources in the health system is necessary. Health insurance companies that invest heavily in prevention must expect financial disadvantages. In 2023, statutory health insurance funds spent around 584 million euros on health promotion. That was nine percent more than in the previous year and an increase for the second year in a row. Medicine, health insurance companies and politics must change course more to make prevention more attractive, demanded the Science Council. In addition, more health data, including from healthy people, must be collected, networked and used.

The Science Council also believes that economic incentives are necessary, for example by promoting healthy food. However, every citizen is also required to do their part: even the Fifth Social Code states that people are jointly responsible for their health, for their lifestyle and for participating in preventive measures, said the outgoing chair of the German Ethics Council, Alena Buyx. Everyone must ask themselves: What can I do to prevent myself from needing care for as long as possible? Financial provision could also become more important in the future, at least for those who can afford it.

But the draft law does not assume this. The chairman of the board of the National Association of Statutory Health Insurance Physicians (KBV) also criticized this. The plans of Federal Health Minister Prof. Karl Lauterbach for a heart law, which have been made public in the media, contain positive approaches such as regular additional check-ups. However, a really consistent implementation of the prevention concept is lacking, said Andras Gassen in an initial statement. For example, there should be more information about a heart-healthy life in schools. By means of further preventive examinations, as apparently planned by the minister, we could also reach patients who do not fall directly into the risk group, but still have high cholesterol or blood sugar levels.

The minister’s implicit criticism of the health insurance companies that their previous prevention programs had not been quality-tested was countered by the chairwoman of the Association of Statutory Health Insurance Funds (vdek), Ulrike Elsner: The statutory health insurance offers its insured persons easy access to 110,000 different prevention courses. The quality and effectiveness of each individual course was tested nationwide by a separate institution of the statutory health insurance, the Central Prevention Testing Office, said Elsner in a statement.

This testing center ensures that the courses offered are taught by qualified specialists. The insured can choose from four areas of activity: exercise, nutrition, stress and resource management, and drug use. At the request of the legislator, prevention activities were significantly expanded in 2015, emphasized Elsner. © kna/bee/dpa/aerzteblatt.de