Health insurance against advance payment at the doctor



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Health insurance against payment in advance from the doctor: The chairwoman of the board of directors of the umbrella association of statutory health insurance is against reimbursement of costs for the insured. The model does not save costs, but encourages additional expenditure. The model also brings financial risks for doctors.

In an interview with the Frankfurter Rundschau (FR), the CEO of the National Association of Statutory Health Insurance, Doris Pfeiffer, spoke out against reimbursement of costs for visits to the doctor by those with statutory health insurance. Such a model would not save costs for the health system, but would even lead to additional expenditure.

The CEO of the National Association of Statutory Health Insurance, Doris Pfeiffer spoke out against the planned model of reimbursement in an interview. The Federal Minister of Health Philipp Rösler (FDP) plans to expand the model further. As with private health insurance, those with statutory health insurance should initially pay for each doctor's visit out of their own pocket. The insured should not submit the costs to their health insurance company until the end of the year. The Ministry of Health emphasizes that this regulation should be voluntary. Above all, health insurances and consumer advocates are warning of a newly emerging "three-class medicine". Those insured without reimbursement would very likely only need basic care.

Health insurance companies can negotiate tariffs and services
Pfeiffer affirmed that the current insurance system of the statutory health insurance has numerous advantages in terms of limiting additional expenses. Because the health insurance companies could conclude direct contracts with doctors and clinics. Pfeiffer told the Frankfurter Rundschau: “The cash registers can have a direct impact on quality and economy and thus on costs. If the insured persons settle accounts with the doctor themselves, as in private health insurance, the health insurers lose this opportunity to control costs. "

The model does not create transparency: insured persons want health help
The Federal Ministry of Health, however, emphasizes that the new model would create transparency. With the receipts, patients could understand what costs were incurred for health services. This argument does not apply to the head of the health insurance association, as sick people do not want to negotiate about treatment, but rather expect treatment that is beneficial to their health. Pfeiffer said: "The doctor is the expert the patient has to rely on."

Doctors would have to bear the risk themselves if patients don't pay their bills
Medical associations support the proposal for reimbursement. Patients would then be made more responsible for themselves. A new model of co-payment or reimbursement could address the problem of unlimited demand for medical outpatient health services. "Only then will it be possible to get down from the high number of doctor visits a year," argued head of statutory health insurance, Andreas Köhler. Unnecessary visits to the doctor could be avoided through the prepayment model. But for Pfeiffer these arguments are not surprising. She told the newspaper: “The doctors hope that this will remove all control instruments. Of course, it is easier to persuade people in emergencies to pay for unnecessary services than the health insurances in negotiations on an equal footing. ”But the model could also have negative consequences for the doctors, after all, they have to bear the sole risk if the treatment costs are not paid . After all, you would have to take care of when patients can't pay their bills. “From this point of view, statutory insurance is a safe bet.” Pfeiffer told the FR.

Higher costs for the insured?
In this context, Doris Pfeiffer also warned of higher costs. The billing with the health insurance companies inevitably increases the costs for the administration, as the effort becomes significantly higher. After all, it is no coincidence that the administrative costs for private health insurance are roughly three times as high as for statutory health insurers. At the same time, there is no performance audit. It could happen that the insured are confronted with higher costs because it does not work without deductions. (sb, 06.10.2010)

Also read:
Doctors are in favor of reimbursement
Rösler plans to pay in advance when visiting the doctor
Private health insurance: is it worth switching?

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