Hospital reform: Revolution must not become a small reform

Even a militant Lauterbach can’t manage a hospital reform alone – the federal states have to go along with it so that the revolution doesn’t turn into a little reform.

Revolution – the word is not an exaggeration. But so far it only exists on paper. Now it takes courageous people to push it through. Who dare to overthrow the financing of the hospitals and turn them upside down. Otherwise the colossus threatens to collapse. This is shown by the contradictory undesirable developments of recent years.

Politicians have a double responsibility

Germany spends more on its healthcare system than any other European country. Despite this, the nursing staff in children’s clinics is becoming scarce, and yet there is not enough money for good care in rural areas.

Politicians bear twofold responsibility for this: They set the wrong incentives by trying to trim the health system for efficiency and paying a lump sum in every case. And then she watched the hospitals go from class to mass. And not only because of private operators’ bad profit interests, but also from a purely practical compulsion to stay afloat financially.

Lauterbach now wants to correct

Federal Minister of Health Karl Lauterbach now has the opportunity to revolutionize a system that he helped develop. 20 years ago, as a professor of health economics, he advised the ministry, which he now heads himself – including on the case-based flat-rates. It was not intended that way, Lauterbach tries to downplay it: The undesirable developments have only become apparent in the past ten years. But it is commendable that he now wants to correct them.

Only a combative Lauterbach can’t do it alone. The Commission rightly pointed out, almost begging, that individual interests must now take a back seat. And only a short time later, the first health insurance companies reported alarmist: There is a risk of nationalization of the health system if politicians allocate fixed budgets to the hospitals – and the insurance companies lose influence as a result.

States have an obligation

But a revolution that changes as little as possible is not a revolution. And just sticking a small plaster on it doesn’t solve the big problems in the hospitals. That is why the federal states also have a duty: they are partly to blame for the misery because they do not pay enough money for new construction and renovations. Now it’s time to do their part: The federal states are responsible for planning where and how many hospitals are needed with which services. The hospitals and their finances can only be reorganized if they work together with the federal government.

It’s not about possessions or political interests: clinics are waiting to be rescued from bankruptcy. Emergencies should not travel long distances to the next free intensive care place. And medical and nursing staff want to take good care of the sick.

This only works if the proposals of the scientific commission are not boiled down to a minimum consensus. The planned revolution must not shrink to a small reform.