PKV wants to save costs on medical fees

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The PKV is currently arguing with doctors about steadily increasing fees. The cost of outpatient treatment has risen by 41 percent for private patients since 2001. The Federal Association of Private Health Insurance (PKV) is now demanding freedom of contract, which enables separate negotiations. The doctors, on the other hand, announce resistance "by all means".

A violent dispute broke out between doctors, dentists and private health insurance on Thursday. The PKV is pushing for future free negotiation of fees. For the medical profession, the suggestions are a "serious risk to medical and dental care in Germany". The PKV wants to increase its profit through separate negotiations and distract from its own problems, as stated in a joint statement by the German Medical Association.

Treatment of private patients almost twice as expensive. The costs increase especially in the outpatient health measures of resident doctors. According to the Association of Private Health Insurance (PKV), there has been a whopping 41 percent increase in expenditure in the past ten years. Because not only the statutory health insurance companies are suffering from the increasing costs, but for some time now also the private insurance providers. Spending on outpatient medical treatment per capita has risen in the past ten years from originally 583 euros (1999) to 822 euros (2009). The growing medical fees were thus above the general price increase of 17 percent and also above the cost increases of the statutory health insurance companies (24 percent). In the GKV, expenditure per capita developed from EUR 297 to EUR 370 in these ten years. "It can't go on like this. We fight for this in the interests of our insured. Otherwise they will have to pay the bill in the end, ”said Reinhold Schulte, chairman of the PKV association. Doctors now charge twice as high a fee for a privately insured person as for insured patients.

PKV Association demands freedom of contract between doctors and insurance companies The federal government is now planning to reform the medical and dental fee regulations. Reinhold Schulte, Chairman of the PKV Association, said: “The urgent need for reform is evident, especially with the decades-old fee schedule for doctors. The GOÄ is lagging behind medical progress, contains incomprehensible assessments of medical services and also gives false incentives for medically useless volume increases. Private health insurance therefore calls for a fundamental structural reform of the GOÄ. ”The private health insurance is now pressing for a massive cost brake on doctors' fees. In the future, there should be freedom of contract between insurance providers and doctors. For their part, the doctors criticize that such freedom of contract would partially undermine the state-prescribed fee system. The medical representatives therefore speak of a new “discount clause” and in turn announce fierce resistance.

Federal government is staying out of the dispute for now The Federal Ministry of Health has so far kept out of the dispute. However, a new fee schedule for dentists has been worked on for a few weeks without clarifying the exact details. Parliamentary State Secretary Daniel Bahr said that a fee schedule for doctors was in the works. "In the course of this reform, we will then deal with the details."

PKV wants to distract from its own problems Doctors and dentists see the suggestions of the PKV as "serious danger to medical care in Germany". With such individually negotiated contracts, insurers want to undermine the statutory fee schedule and distract them from self-inflicted problems. According to a joint statement presented today by the German Medical Association and the German Dental Association, the "exorbitantly high brokerage commissions" are also responsible for the high expenditure side at the PKV.

Instead, private health insurance companies would use misleading slogans like “create real competition” for the opening clause. "In fact, the opposite would be the case," said BZÄK President Dr. Engel, "the implementation of an opening clause, which in the end is nothing more than a 'discount clause', leads in reality to ruinous price competition between doctors, to less treatment quality due to cost pressure and one-sided dependency of the contractually bound doctors on the private health insurance." Free choice of doctor for the patient and freedom of therapy for the doctors would gradually fall victim to the price dictation and the one-sided savings requirements of the private health insurance, ”added DGVP President Wolfram-Arnim Candidus. Both medical associations have announced that they will tackle the proposed clause "with all available means", the doctors' representatives announced.

The PKV association, on the other hand, emphasized that the proposal would not impose anything on anyone. Rather, the aim should be to conclude an agreement that is mutually acceptable. However, it must also be a goal that doctors cannot charge higher costs for the same health services just because a patient has private health insurance. (sb)

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Image: Benjamin Klack /

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