The National Association of Statutory Health Insurance Physicians Demands More Funding: The Risk of Collapse Looms

A blood draw in the practice of Dr. Mark Sajthy in Mainz. Three ampoules for a small blood count, the small tubes get their labels and the blood goes to the laboratory by courier. A routine that has become significantly more expensive for the nephrologist in the past year. Virtually all suppliers and service providers have increased their prices significantly, says Sajthty.

Laboratory, medication, equipment maintenance – everything is becoming more expensive

The specialist shows a folder with corresponding letters from his partners: The laboratory increases the prices by 7.5 percent. A drug manufacturer charges 20 to 110 percent more for its products, depending on the ingredient. Maintenance of the ultrasound device is 6.2 percent more expensive – and the practice rent increases by 21 percent. Sajthy calculates: “On average, the costs of a treatment have increased by at least ten percent for us.” During the same period, income increased by only two percent.

Federal association speaks of “broken savings”

The example from Mainz – not an isolated case, according to the National Association of Statutory Health Insurance Physicians (KBV). At today’s crisis meeting in Berlin, the main focus will therefore be on the demand for more money, says a KBV spokesman. Health Minister Karl Lauterbach (SPD) and his ministry promised the doctors a lot, but did not keep these promises, so the accusation. It is becoming increasingly unattractive for younger doctors in particular to have their own practice. The KBV chairman Dr. Andreas Gassen therefore warns of a collapse of the outpatient system.

Ministry of Health puts the numbers into perspective

The Ministry of Health defends itself against the accusation of “breaking savings” and calculates for its part: In the past ten years, expenditure on outpatient medical care has increased enormously. In 2013, the statutory health insurance (GKV) paid around 32 billion euros, in 2022 it was around 46 billion euros – an increase of 44 percent. From the point of view of the Ministry, medical practices can continue to be operated economically in the future. This applies above all with regard to the recently significantly increased operating costs of the practices.

Top club sees little financial leeway

The majority of the sponsors for the doctors in private practice are the GKV. Every year, the expenditure for outpatient care is renegotiated and, if necessary, increased. Last year, an increase of two percent was enforced with an arbitral award because the GKV and KBV could not agree. This year, the National Association of Statutory Health Insurance Funds is offering a similar increase. “This year, an increase of 2.1 percent is appropriate from our point of view,” explains a spokesman for the umbrella organization. “This results in additional costs of around one billion euros, which would have to be paid from the contributions of those with statutory health insurance.” It should not be forgotten that contributors are also suffering from the burden of inflation.

Negotiation tactics instead of collapse

Wolfgang Greiner is a health economist and health scientist at Bielefeld University. He also rates the last increase of two percent as rather low in view of the rising operating costs. With regard to terms such as “collapse” or “broken savings”, he points to the current negotiations between GKV and KBV. In principle, these are something like collective bargaining, says Greiner. “It gets loud and very demonstrative, it’s basically no different with the doctors and health insurance companies than with IG Metall and the employers’ associations, only the means are different.” He expects a more significant increase for the coming year than the 2.1 percent currently offered.

Frustration – and no solution in sight

Kidney specialist Sajthy from Mainz keeps talking about frustration. But it still has to go on. He doesn’t have a real solution to the problem. “Because if everything were implemented that we would see as appropriate for our work, then the system would probably collapse.” On the other hand, dissatisfied doctors and practice staff could not be in the interest of society.