Had a heated exchange at the summer reception of the GKV-Spitzenverband: Federal Health Minister Karl Lauterbach (SPD) and the Chairwoman of the GKV-Spitzenverband, Doris Pfeiffer. /picture alliance, Boris Roessler (Laurerbach), Kpenicker/stock.adobe.com (boxing gloves), Collage: D
Berlin Verbal exchange of blows between the GKV-Spitzenverband and the Federal Minister of Health at the summer party of the health insurance association: The chairwoman of the GKV-Spitzenverband, Doris Pfeiffer, attacked Federal Minister of Health Karl Lauterbach (SPD) for his policies.
“I will never tire of reminding you of the coalition agreement. The situation is difficult, but I would have liked to see more commitment from you on behalf of the insured,” said Pfeiffer in the direction of Lauterbach, referring to the many laws that are to be paid for primarily from the contributions of those insured in the statutory health insurance scheme (GKV).
A particular thorn in Pfeiffer’s side is the transformation fund of the Hospital Care Improvement Act (KHVVG), half of which is to be paid for by the statutory health insurance schemes (EUR 25 billion). Yes, the transformation costs something, and it is in the service of all citizens, and no, half of that cannot be passed on to the contributors, Pfeiffer continued.
The KHVVG had a few positive aspects, but has been torn apart in discussions for a year. As it stands today, it is a draft with expensive measures. The same applies to the GVSG, which does not bring any significant improvement in care, but only promotes family doctors in urban areas.
In their view, the principle of economy must also be preserved in the health care system. They speak of the deconomization of the health care system. We need more economic orientation that will enable efficiency in the system, said Pfeiffer. Therefore, all laws are going in the wrong direction.
She also had a bad word to say about the recently presented draft bill for the Healthy Heart Act. Prevention was yesterday, today we go to the doctor, is how Pfeiffer described the intention. The budgets for prevention are deliberately tight by politicians. Now prevention is being made even more discrete. All prevention courses run by health insurance companies are certified, there are binding measures and no marketing effects, emphasized Pfeiffer.
There is also clear criticism of the Federal Government’s plan to transfer key competencies in drug approval, prevention and the design of anamnesis tests within the framework of the Heart Act away from self-administration and towards federal politics.
It is a step backwards in terms of evidence if these competencies no longer lie with the Federal Joint Committee, said Pfeiffer. The plan is now a continuation of the long series of laws that are undermining the self-administered health system.
And I am personally disappointed in you that you do not take the principle of evidence into account. You are damaging the principles of self-government. I would not have found that surprising in your predecessors, but I would not have expected it in you, she concluded her speech to applause from those present at the self-government meeting.
The following day, at the meeting of the GKV administrative board, they once again supported her and praised Pfeiffer for this clear speech against the health minister.
Lauterbach defends himself
Lauterbach did not let the sharp criticism of his government’s actions go unnoticed. I think it’s good when people exchange ideas openly and clearly, you can’t beat around the bush, he said right at the start of his 15-minute reply.
I am clearly behind self-government, even if we do something different here or there. The self-governing system is the best system in Europe and it should stay that way, the minister stressed. But one has to look at where the country is now. One could get the impression that self-government has done well, the committees are functioning, said Lauterbach.
The conclusion that a little more tax money would improve the revenue side and give us time for major reforms is a fallacy. But the truth is: we don’t have revenue problems, we have significant quality and efficiency problems. These can only be solved if we focus more on the medical problems and don’t believe that economics can solve them.
Therefore, his motto is: We are making very fundamental reforms that no longer follow the German solution of simply putting more tax money into the system and then everything will stay as it was, Lauterbach continued. He believes this is wrong.
Therefore, we must start with prevention: Of course, it is simple and plausible to say that young people should do more sport, then they don’t need statins, said Lauterbach about his plans to simplify the prescription of statins for children and adolescents.
But there are children who have a congenital disorder of fat metabolism, they can do as much sport as they want, and at 25 their blood vessels are just as good as those of 80-year-olds. There must be solutions for them. If we take prevention seriously, then we cannot replace prevention through medication with prevention through lifestyle.
Overall, the question arises as to why there are so many cardiovascular diseases in Germany. I can only say over and over again: eat healthier, go vegan, do more sport in class. But if I want to do this seriously, I have to consistently address blood pressure levels and lipid metabolism disorders, Lauterbach continued. This is not just the minister’s opinion or a betrayal of evidence-based medicine, it also corresponds to recommendations from guidelines.
It is very common for evidence-based medicine to be implemented by self-administration. But it is not correct to say that there is only evidence-based medicine when self-administration has participated, Lauterbach continued, referring to the question of how much self-administration is still involved in the law. We should not go that far. If we take the evidence directly from science in this exceptional case, then we are doing it to gain time, because I do not want to lose any more time with young people.
Regarding hospital reform, he defended the financing of the transformation fund: Of course I would prefer if we had 25 billion euros of tax money for it. The truth is that we don’t have the tax money at the moment. When the coalition agreement was being negotiated, which you keep reminding me of, there was no war in Ukraine. If I postpone the reform now until there is money again, then we will do what we have always done: We will do the German system, we will put more and more money into the system, but structurally little will change. Lauterbach does not want that.
For the Medical Research Act (MFG), which according to information from the German Medical Journal In the parliamentary debate that is to be concluded and voted on in parliament next week, Lauterbach hinted at some changes.
The companies that do research here should have an advantage in terms of AMNOG pricing. I can already see your outcry about how the two can be combined. But in my view, this is a win-win situation. We are creating incentives to ensure that significant clinical research takes place again. In his view, Germany has fallen significantly behind as a study location. This is not a good sign for Europe either.
Overall, he concluded that the federal government is making reforms for patients. The Federal Finance Minister has an interest in ensuring that costs are not so high, and I have an interest in improving care. This also means that the high number of doctor-patient contacts (Lauterbach now estimates that there are one billion doctor contacts per year) must be significantly reduced.
At the same time, there are long waiting times for specialists and in psychotherapy: This is an issue where the self-administration has not made any progress without the help of the minister. As a first step, the quarterly flat rate for general practitioners will be abolished, digital options should help in everyday practice, and Lauterbach wants to examine suggestions for specialist practices. © bee/aerzteblatt.de
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