Health insurance companies: Number of medical practices too high

Health insurance association: Number of medical practices too high

The central association of statutory health insurers (GKV) complains about the too high number of physicians in private practice in Germany. In addition, medical practices are too unevenly distributed regionally. While there is only a low density of doctors in the countryside, there is a real oversupply in the cities. According to the Association of Statutory Health Insurance Funds, the number of medical practices in Germany has increased by 45,000 in the past twenty years.

Too many resident city doctors Doris Pfeffer, chairwoman of the board of the Federal Association of Statutory Health Insurance Funds (GKV) again criticized the steadily increasing number of resident doctors in Germany. "There are too many doctors with their own practice," said the chief executive. In the past twenty years there has been a real flood of doctors in the field of outpatient doctors. Around 45,000 new medical practices have been created. The real problem, however, is the overall uneven regional distribution. There is a clear oversupply of general practitioners and specialists in numerous cities. In some rural regions, however, there is often a shortage of doctors. The presidency of the GKV therefore asked the Federal Minister of Health Philipp Rösler (FDP) to reduce the oversupply with suitable means. Pfeiffer said on Saturday to the newspaper "Die Welt": "I am trying to convince the minister that the undersupply he complains about can only be eliminated by reducing the oversupply."

Time limit for health insurance approval According to the head of the health insurance association, doctors with their own practice should only be given time-limited permission to treat patients from the statutory health insurance funds. The sale of the health insurance approval at the end of working life should be prohibited by law. "Until now, every doctor has been able to sell the license to settle with health insurance companies at the end of his professional life. It would be better if the approval as a doctor were only granted for life," Pfeiffer told the newspaper. If a doctor retires, the health insurance should have ended. This could prevent "new doctors from settling in over-served areas."

24,000 doctors too much? According to the health insurance companies, there are around 24,000 physicians in Germany too many. According to this, every fifth doctor with his own practice is superfluous. The German Medical Association strongly opposes this and speaks of an incorrect calculation by the association. The Association of Statutory Health Insurance Funds would have used the federal government's needs planning for the calculation, which measures how many doctors per resident should work in a region. However, the number of doctors says nothing about how it really is about patient care, the doctors' representatives. Although there are more and more resident doctors, on average, doctors work less and less every week. The average weekly working time has dropped from 36.8 (1997) to 33.2 hours (2008). Accordingly, the real working hours should also be included in the calculation. In addition, the former needs planning from 1993 had little to do with today's medical health services.

Rural undersupply is undisputed
On the other hand, undersupply is undisputed in some rural regions. The Ministry of Health assumes that many doctors experience settling in the country as unattractive. The black and yellow coalition is therefore planning to redesign the supply law. Among other things, one wants to raise the medical fees for country doctors significantly. Doctors in sparsely populated areas are also to receive supplements for the training of assistant doctors. An initiative by FDP health experts, according to which a self-payment obligation should be introduced in the event of a shortage of doctors, currently does not find a majority in the black and yellow coalition.

Health insurance companies reject financial incentives for doctors
However, the legislative initiative would result in high additional expenses for health insurance companies. The health insurance funds fear that this will result in increases in premiums and additional contributions. Because in the future the higher costs in the billions would have to be borne by the insured and not by the federal government. Therefore, the Association of Statutory Health Insurance Funds proposes that restrictions be imposed on the approval of the till instead of financial incentives. Then more doctors would automatically settle in the country. (sb)

Read on this topic:
Health insurance companies: There is no shortage of doctors
Do doctors' fees lead to higher health insurance contributions?
FDP demands self-payment obligation in the event of a shortage of doctors
Doctors advocate reimbursement
Rösler plans to pay in advance when visiting the doctor

Image: Thommy Weiss /

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