The section “The Daily Scandal” should have appeared in German daily newspapers long ago. It would say again and again that millions of people still starve to death every year, and the trend is rising again. The political tragedy of climate protection would be described. And alongside other scandals, there are always new examples to read about how fatal it is to focus the healthcare system primarily on profit maximization.
Intensive care physicians and paediatricians have just sounded the alarm. Yet again. There is a lack of space in children’s intensive care units. Emergency patients are regularly turned away, who only find an intensive care bed after delays and a lot of hesitation, sometimes a hundred kilometers away. A survey has shown that more than half of the clinics have to refuse children again and again, including university hospitals. Instead of top-quality care close to home, which representatives of “centers of excellence” in university medicine like to boast about, there is unworthy haggling over the last free bed. This is the case every autumn and winter, this year it threatens to be worse than usual, also because the respiratory virus RSV is raging violently.
Because payment is made per case, some children are “bloody” discharged
The causes are complex. Lack of care has been complained about for years – poor pay and rigid duty rosters continue to contribute to this. In children’s intensive care units, the stress on staff is particularly high, both mentally and physically. In addition, the system of flat rates per case has resulted in an extreme increase in work density. Because payment is made per case, some sick people are discharged irresponsibly early – in technical jargon this means: “bloody” – which often overtaxes the resident doctors in further care. Keeping intensive care beds ready is expensive, other areas in the clinic are more lucrative, so stable funding is not guaranteed.
Occasionally there is an outcry when a child is about to die because they could not be accommodated or it took too long to vacate a bed. After that, exactly: nothing changes. It is high time that the clinics weight their financing more according to patient interests and that health policy sets new priorities. Otherwise human lives are in danger. Health politicians like to adorn themselves with non-application research projects. Good and safe care is what counts for patients in everyday life.