Hospital.Help

Berlin – Exchange of blows over health policy: As is usual in the budget debate, the government factions praised each other for the upcoming and passed laws – the opposition from the CDU, AfD as well as the groups Die Linke and BSW hardly found a good word to say about the plans.

Federal Health Minister Karl Lauterbach (SPD) announced a major work program: “In health policy, we are facing an autumn of reforms,” ​​said the SPD politician in the debate. There are eight laws in the parliamentary process, one of the highest legislative densities ever.

The impetus for the many reforms is the high mortality rate compared to Western Europe and the large differences in life expectancy between rich and poor. This is a challenge that must be faced, said Lauterbach. “This can only be achieved with real structural reforms, not with trivial reforms and even less with stupid sayings,” said Lauterbach, referring to the Union faction, which accompanied his speech with many heckles.

The planned reforms include hospital reform, the law to strengthen care, which is intended to create better conditions for family doctors, and a nursing finance law to achieve financial stabilization of nursing care. The minister admitted that contribution rates were “under pressure”. However, citizens cannot be held liable for service cuts because politicians are not implementing reforms.

In his view, many reforms have not been implemented in the past 20 years and are therefore now overdue. Lauterbach stressed: “In health policy, the traffic light system works.” He also called on the opposition “not to sulk and not to retreat into empty phrases, but to go along with it.”

The opposition has been very critical of the plans: The health policy spokesman for the Union faction, Tino Sorge (CDU), accused Lauterbach of denying reality and warned that hospital reform “by forcing one’s head against the wall” would not work. He said the structural reforms that Lauterbach was talking about were lacking. There was a lot to criticize about the budget plans, particularly in light of the report by the Federal Audit Office, which was published last week.

With regard to the financial burden on those with statutory insurance, he asked: “How many times do you want to increase contributions?” He called for 15 billion to be saved quickly for contributors. For example, a lower VAT rate could be paid on pharmaceuticals or the statutory health insurance contributions for recipients of citizen’s allowance could be adequately financed by taxpayers.

Other Union politicians also accused the government of acting unwisely. CDU MP Dietrich Monstadt sees “chaos in the government” with regard to the EU Medical Devices Directive and also attested to incorrect prevention approaches in the area of ​​statin regulations as part of the planned Healthy Heart Act. CDU MP Sepp Müller focused his speech primarily on cannabis legalization.

AfD MP Wolfgang Wiehle criticized that health insurance contributions were rising because too much money was being spent on the wrong things. He also criticized the pandemic preparedness contracts, in which taxpayers’ money was being spent “on empty production halls.” For AfD member Martin Siechert, the government’s entire health policy is useless.

Ates Gürpinar from the Left group observed a “collapsing health system, with pharmacies and doctor’s offices closing uncontrollably” and demanded that a citizen’s insurance be introduced to stabilize the system. Andrej Hunko from the BSW group sees the review of the Corona period and a complete revision of the hospital law as the duty of the Federal Minister of Health.

Pandemic costs an issue

Green Party budget expert Paula Piechotta focused her speech on the costs of the pandemic, which will continue to burden the budget for years to come. “Jens Spahn will continue to burden the federal budget for a long time to come. The budget will suffer from Long-Spahn for years to come,” she said, referring to the unresolved procurement of masks and the resulting court proceedings under former Federal Health Minister Jens Spahn (CDU).

She also called for the expenditure of 17.8 billion euros on corona tests to be further clarified and for the federal states to check more closely whether the money was spent correctly. Here she called on the Federal Ministry of Health to name the federal states that continue to inadequately check the billing of test providers.

When it comes to hospital reform, one must also ask whether it is fair to burden the costs on those with statutory health insurance rather than on taxpayers, said Piechotta.

FDP budget officer Karsten Klein also criticized the states, saying that anyone demanding more spending on the hospital system should be honest and demand higher contribution rates. 30 billion euros in federal funds have already flowed into the hospitals during the pandemic. He could not perceive any reform efforts from within the system.

The health policy spokeswoman for the SPD parliamentary group, Heike Baehrens, called for better use of contribution money: “The capacity of the contributors must have a limit.” It is therefore necessary to also use tax money. This applies to the costs of the pandemic, the financing of statutory health insurance contributions for recipients of citizen’s allowance and for hospital care.

Members of the government factions emphasized the many prevention projects that parliament still wants to negotiate into the budget as part of the budget debates. This includes suicide prevention, which Green MP Kirsten Kappert-Gonther called for. The corresponding law must also be presented soon, she demanded, with a view to the Federal Ministry of Health.

Christine Aschenberg-Dugnus (FDP) also wants to do more for prevention and health maintenance. In addition to reducing bureaucracy – “that doesn’t cost any money” – this is important for the future of the system. The budget must also take alcohol prevention into account, demanded Green Party expert Linda Heidmann.

At the end of the debate, the chairman of the Budget Committee, Helge Braun (CDU), stated that “these will again be difficult budget negotiations.” This is because all members of the coalition had stressed how important prevention was.

“Last time, we included more money for prevention in the budget during the consultations,” Braun stressed. “And this time, the government has not considered that, so we can do the work here again,” he continued.

The emphasis on opening an institute for prevention with the Federal Institute for Prevention and Education in Medicine (BIPAM) is not reflected in the budget. “Not a single euro has been earmarked for a new establishment. Instead, the announcements in the coalition agreement have created great uncertainty at the Robert Koch Institute and the Federal Center for Health Education for years.”

The federal government is also at a loss when it comes to the question of prevention in relation to the next pandemic. “The national reserve for protective equipment has expired, and no new funds are planned for it,” said Braun. In an emergency, the government would have to procure protective material on the world market again – at potentially high prices again.

Lauterbach caused anger in the debate when he left the plenary hall after his speech during the ongoing debate. After a protest from the Union against his absence, citing an appointment at the Chancellery, the incumbent President Wolfgang Kubicki (FDP) said he shared the displeasure. He had therefore asked the government to ensure that the minister returned. This was promised to him. Shortly afterwards, Lauterbach took his seat on the government bench again. © bee/aerzteblatt.de