Warken: Digitalization and deregulation will not solve financial problems

Federal Minister of Health Nina Warken advocated for the planned health reforms at the 130th German Medical Assembly in Hanover, while also signaling her willingness to engage in dialogue. “We need proposals that are viable and that will actually close this financing gap,” said the CDU politician to the delegates.

The planned emergency reform, a primary care system with stronger patient management, and measures for deregulation are currently being worked on. Digitalization should also help to free up resources. “Of course, deregulation and further digitalization alone will not provide the financial resources that are currently missing in the system,” said Warken. “But it is, of course, essential because there are already many resources there that we can tap into,” she added. The goal is to give doctors “the necessary time” for the care of their patients.

Warken also announced that the reform of the medical licensing regulations will be advanced in the current legislative period. Medical studies should be more strongly oriented towards general medicine, and theory and practice should be integrated earlier. An expert opinion on cost development has been commissioned for the revision of the scale of fees for doctors (GOÄ). This is “the first step,” said Warken. The federal government wants to complete the GOÄ reform in the current legislative period, a project that has been discussed for years.

In addition, she particularly defended the planned GKV Contribution Rate Stabilization Act, with which the federal government aims to limit the sharply rising expenses of statutory health insurance and prevent a further increase in health insurance contributions. According to current forecasts, statutory health insurance funds will be short of around 15 billion euros next year. “Without the reform, a coverage gap of around 40 billion euros would have to be closed by 2030. Then we would reach a total contribution rate of almost 20 percent in health insurance,” warned Warken. The development of recent years “no system in the world can withstand,” she said. A “business as usual” approach is not possible. The federal government's goal is to “stop the unchecked contribution rate dynamics” and to link expenses more closely to the revenues of statutory health insurance again.

“Omnipotence fantasies of individual health insurance representatives”

The head of the German Medical Association, Klaus Reinhardt, expressed strong criticism of the legislative proposals in the run-up to Warken's speech. Regarding the Law on Data and Digital Innovation in Healthcare (GeDIG), he said: “Despite all perhaps positive intentions, I consider this draft to be absolutely overreaching in one crucial point,” said Reinhardt. It represents a “profound paradigm shift” if health insurance companies are allowed to analyze health data without the involvement of treating doctors.

This is an interference with the doctor-patient relationship. “How are such regulations compatible with the principles of medical confidentiality and the right to medical action? We clearly reject such omnipotence fantasies of individual health insurance representatives. And I am sure our patients will too,” said Reinhardt. Digitalization must be measured by “whether it reduces complexity or creates new complexity.” Not every digital innovation is automatically a gain for care.

Introduction of further structures “absurd”

The President of the German Medical Association also criticized the planned reform of emergency care. While it is correct that Warken is taking up the reform again after a long delay and is also taking the rescue service into account, the current concepts are out of touch with reality from the medical profession's perspective. “Against the backdrop of the planned cuts in all service areas, it is neither appropriate nor affordable to provide telemedicine and outreach services around the clock, and thus also during regular care hours, regardless of the actual need,” said Reinhardt. Responding to the “completely uncoordinated use” of various care levels by introducing further structures is “almost absurd.” A “coexistence of different initial assessment instruments, systems with different control consequences each,” cannot be the right way.

The goal must be to “noticeably relieve the existing structures and to organize acute emergency care across sectors and according to needs,” said Reinhardt. The medical profession sees “still considerable need for correction.” The German Medical Association is instead calling for stronger coordinated patient management through a primary care physician system with binding initial assessments. The goal must be a cross-sectoral and needs-based organization of emergency care.

(mack)