It is undisputed that hospital reform is necessary. There is only concern about the design of the plans that have now been decided: In the daily topics the hospital society demanded more financial commitments.
After the federal and state governments agreed on the cornerstones of the hospital reform, trade unions and associations called for commitments to include financial injections for clinics. In the daily topics Gerald Gass, head of the German Hospital Society, called for immediate financial aid.
“We are on the eve of a hospital death,” Gass quoted the Federal Minister of Health, Karl Lauterbach. “Because we lack the urgently needed inflation adjustment, i.e. an adjustment of hospital revenues to the increased costs,” explained Gass. Politicians refuse that and thus also fair remuneration for the hospitals. “That is not acceptable for us and I don’t think it is for the population in the affected regions either.”
He was glad that an agreement had been reached at all. But if you take a close look at the paper, it becomes clear that there are still many undefined issues that need to be checked. He emphasized that the design must succeed well. “It has to be an orderly structural change,” said Gass. In this context, he called for a move away from 100 percent, performance-based financing.
doctors union calls redistribution naive
The chairwoman of the Marburger Bund doctors’ union, Susanne Johna, also sees a “crucial point” in the unclear financing. Such a transformation could not succeed without significant investments, she told the “Rheinische Post”.
“Anyone who thinks that you can simply redistribute the available funds and grant surcharges in a few places and then it would all work out is naïve to say the least,” says Johna. Even the merging of departments is not available for free if conversions become necessary and staff have to be hired.
GKV: “Must not be at the expense of contributors go”
The Central Association of Statutory Health Insurance (GKV) also criticizes the fact that the federal government has not made any specific financial commitments. And the countries still did not commit to financing the investment costs, it said. “This must not be at the expense of the contributors,” said Stefanie Stoff-Ahnis from the association’s board.
The German trade union federation praised the agreement in principle. However, further steps are needed to advance the structural reform in inpatient care. “It is also important to consider the interests of the employees,” said board member Anja Piel. Quality care for patients will only be possible if we succeed in persuading more specialists to stay.
Lauterbach does not want to “give hope” for financing
In the run-up, there had already been a dispute over demands from the federal states for an upstream extra financial injection from the federal government. Lauterbach said on Monday evening, also with a view to the budget situation, that this would be checked and added: “I can’t get any hopes of it.” Only after the reform has been implemented in the federal states will it be possible to receive money from a transformation fund.
The plans, which the federal and state governments had agreed on Monday evening, essentially provide for changing the remuneration system with flat rates for treatment cases in order to relieve hospitals of the financial pressure to deal with more and more cases. Therefore, they should receive a large proportion of the remuneration simply for providing services.
The basis of the financing by the health insurance companies should be more precisely defined performance groups of the clinics – for example “cardiology” instead of rough terms like “internal medicine”. The performance groups are intended to ensure uniform quality specifications, for example in terms of equipment, staff and treatment experience.