Hospital.Help

Berlin Today the Bundestag discussed the bill to strengthen heart health (Healthy Heart Act, GHG) in its first reading, with which the federal government wants to promote improved early detection and care for cardiovascular diseases. The submission was referred to the Health Committee for further discussion.

Federal Health Minister Karl Lauterbach (SPD) warned that cardiovascular diseases represent an increasing burden in Germany. With the planned strengthening of corresponding prevention and the establishment of extensive screening programs, we are firmly on the ground of evidence-based medicine.

Health politician Dietrich Monstadt (CDU) replied that the law was unnecessary and expensive. The Federal Minister of Health’s plans caused many stakeholders in the health system to shake their heads, particularly the threat of funding cuts for existing preventive measures. Instead of actionism, there is a need to strengthen proven prevention programs that would achieve real effects.

Johannes Wagner (Greens), member of the Health Committee, defended the draft law as necessary and correct. But he also said that the GHG would be improved further in the parliamentary process.

Nezahat Baradari and Herbert Wollmann (both SPD) made similar statements. According to Baradari, she takes the criticism from various sides about the influence on existing prevention structures very seriously. Wollmann emphasized that corrections would be made in this regard.

The regulations of the GHG provide, among other things, to establish a legal entitlement to extended services for the early detection of lipid metabolism diseases as part of examinations for children and adolescents (U/J). In addition to the existing health examination (GU), so-called check-ups in the area of ​​cardiovascular diseases are planned for adults aged 25, 40 and 50.

Health insurance companies should also be obliged to offer their insured persons structured treatment programs (Disease Management Program DMP). The Federal Joint Committee (G-BA) is to decide on requirements for a new DMP for insured people with a high risk of cardiovascular disease.

Sharp criticism of the health insurance companies

The National Association of Statutory Health Insurance Funds said that the plans support the goal of strengthening heart health in Germany. However, the measures provided for in the law are overall not very suitable for this purpose.

Stefanie Stoff-Ahnis, deputy chairwoman of the National Association of Statutory Health Insurance Funds, emphasized that a whole-of-society approach should play an important role. The consumption of alcohol, tobacco and unhealthy foods must be reduced and health-promoting living conditions created.

Primary prevention is the most effective lever for reducing cardiovascular mortality, but it still has too little importance in politics and society, says Stoff-Ahnis. This is also reflected in the Healthy Heart Act. With this, the federal government is relying unilaterally on the increasing medicalization of disease risks, and preventative measures are being largely ignored.

In addition, the introduction of new services by the legislature represents a step backwards compared to the evaluation standards of evidence-based medicine achieved in the Federal Joint Committee (G-BA) in recent decades.

The health insurance companies are also critical of the planned cost-neutral counterfinancing. The GHG is a prevention reduction law in which the funds for primary prevention are cut in favor of further medicalization, warned Stoff-Ahnis.

In the Movement Development Plan, Federal Health Minister Karl Lauterbach describes sport and physical activity as the best medicine against cardiovascular diseases. At the same time, he is endangering the financing of 110,000 individual behavior-related prevention courses with the ‘Healthy Heart Act’, criticized Anne-Kathrin Klemm, board member of the BKK umbrella organization. This is the opposite of a modern understanding of health and maintaining health.

With the GHG, the legislature is accepting considerable collateral damage to well-functioning areas of health care, warned the CEO of the AOK Federal Association, Carola Reimann.

Despite vehement criticism of the questionable evidence of the planned measures, the motto remains pills instead of prevention. If the GHG is passed in its current form, it would mean the end of individual health courses financed by statutory health insurance companies.

Stefan Willich, director of the Institute for Social Medicine, Epidemiology and Health Economics at the Charit – Universitätsmedizin Berlin, assessed the GHG as too limited in the run-up to the Bundestag debate. He expects little effect. Mere high-risk prevention would bring less benefit than a population-based approach and proportional prevention. © aha/aerzteblatt.de