Status: 12/14/2022 1:53 p.m
Newspapers, cigarettes or beer are available at the kiosk around the corner. But doctor appointments or dressing changes? Around 1,000 health kiosks are to be built nationwide – but Minister Lauterbach’s plans are on shaky ground.
November 3rd is an average November day in Central Thuringia. At least it’s not raining when the large train station is in the small town of Urleben: the first health kiosk in Thuringia is opened.
Contrary to expectations, the Thuringian project has little to do with the Federal Minister of Health’s idea – apart from the name. Karl Lauterbach announced in the summer that he wanted to set up 1,000 health kiosks nationwide. And perhaps Berlin would not have known anything about the Thuringian project if the International Building Exhibition Thuringia (IBA) had not been responsible for the buildings for the four Thuringian kiosks. And sent an invitation to the opening in the capital.
A place for “Agathe”
The small towns not far from the state capital of Erfurt see the kiosks as an enrichment for community life. Among other things, the so-called community nurse, the “Agathe” project, should have a permanent place in the kiosks. They should help to integrate the aging population into social life.
And for the project that the “Landleben” foundation launched, the kiosks were actually rebuilt, partly with subsidies, partly borne by the foundation. Tele-consultation hours with specialists should also be possible here. In fact, there is the building first – and it must now be filled with life more and more, which also depends in part on what money and staff can be found for.
health kiosk
Health kiosks should offer low-threshold advice on health issues and help reduce the need for treatment in medical practices or hospitals. Patients can have simple treatments carried out there, such as measuring blood pressure and changing bandages. Federal Health Minister Karl Lauterbach (SPD) is planning 1,000 health kiosks nationwide by the end of 2023. According to this, municipalities should set up health kiosks in districts that are characterized by poverty and finance them together with the health insurance companies. According to the cornerstones of Lauterbach’s legislative initiative, the public sector should bear 20 percent of the expenses, while the statutory health insurance companies should be obliged to take on 74.5 percent and private health insurance companies 5.5 percent.
The health kiosk in Hamburg-Billstedt was started in 2017 as a model project. Its financing was uncertain after the withdrawal of Techniker Krankenkasse, DAK-Gesundheit and Barmer announced for 2023. According to AOK, a solid financial basis is now secured. Another health kiosk is to be opened in the Lurup district of Hamburg in the first quarter of 2023.
Multilingual offer
Lauterbach had a slightly different idea in mind when he spoke of his planned 1,000 kiosks. The SPD minister visited the pilot project in Hamburg’s Billstedt district in the summer and was impressed. From his point of view, it is trend-setting for the German healthcare system. Appointments for specialists are arranged here, there is addiction counseling or consultation hours for mental health – everything is as unbureaucratic as possible and, above all, often multilingual. Because in Billstedt, the proportion of foreigners is above average at around 27 percent. One in five of the approximately 70,000 people in Billstedt receives Hartz IV, making the district one of the poorest in Hamburg.
Specialists prefer other locations, there is a shortage and the existing doctors are even more burdened. The health kiosk should at least partially cushion this. The basic idea is: Those who take advantage of the offers here get sick less often, need treatment less often and don’t have to go to the hospital as often. “In Germany, neither the wallet nor the place of residence should decide on the treatment of patients,” said the minister when he visited the kiosk in August. Health kiosks can make a difference, especially in structurally weak areas. The SPD politician wants to reach those who don’t have regular access to doctors: “Those who you usually only reach when it’s too late.”
Who pays what?
Nationwide, 1000 such kiosks are to be built in Germany. But the plan is met with resistance, especially since it is not clear who will pay for the facility. According to an answer to a small request from the CDU/CSU parliamentary group, the ministry is planning that 74.5 percent of the budget for the kiosks should come from the statutory health insurance companies. Municipalities should pay 20 percent. The Techniker Krankenkasse, the DAK and the Barmer have now withdrawn from the pilot project in Hamburg. They fear the emergence of expensive duplicate structures. And that scarce medical staff is then missing in hospitals or practices. In addition, the health insurers do not want to pay for offers that are only remotely related to health.
Others suspect that this is a warning signal for the Federal Minister of Health, because the cash registers are bothered by the fact that they are supposed to pay the lion’s share of the kiosk budget. So far, however, the cash registers have been publicly silent about this. There is talk of “misuse of insurance contributions” behind closed doors.
Urleben is not Hamburg
In Urleben, on the other hand, the offer is not multilingual like in Hamburg. In fact, it’s far from finished. “The structure in Thuringia is completely different than in Hamburg,” says Guido Dressel, head of the Techniker Krankenkasse in Thuringia. Social hotspots with particularly poor access to medical services do not exist to the same extent as in districts with tens of thousands of inhabitants such as Hamburg or the Ruhr area.
In rural Thuringia, it is more important to ensure the supply of an aging population. “If a health insurance service is due, we pay for it like a normal outside consultation,” says Dressel. However, access to the billing system would be a prerequisite for this. But that is not planned, “since the health kiosks are not initially intended to provide any services that require networking via the telematics infrastructure,” says the response from the Ministry of Health to the small query. Because the financing should be lump sum.
In Berlin, people looked at the first kiosk in Thuringia with interest. The opening was attended by the Parliamentary State Secretary in the Federal Ministry of Health, Edgar Franke. He asked exactly what the initiative from below from citizens and associations looked like – because this could be a good approach for rural areas.