Joint statement by the German Society for Pediatric Dentistry (DGKiZ) and the Federal Association of Pediatric Dentists (BuKiZ) on the GKV Financial Stabilization Act
Children and young people are particularly worthy of protection, also in dentistry. The Federal Ministry of Health explains on its website: “Promoting the health of the rising generations is one of the important goals of health policy. Children in particular make great developmental strides in a short space of time. At the same time, essential foundations for health in later years are laid in childhood. It is therefore the aim of the Federal Ministry of Health to encourage children to grow up healthy and to detect and treat illnesses as early as possible through medical care.”
The present draft of the GKV-FinStG provides for regulations for the next two years that are tantamount to strict budgeting of dental services and prevent the achievement of these goals.
In 2011, the legislator abolished the budgeting of the total remuneration with the Supply Structure Act and linked the annual adjustment of the total remuneration to content-related criteria. In fact, the expenditure on benefits for dental care, based on the total expenditure on benefits of the GKV, has fallen continuously in recent decades – from a double-digit number in the 1980s to almost 9% in 2000 and only 6.25% in 2021. For there is no need for statutory budgeting of contractual dental services. Since the focus in pediatric dentistry is on prevention and conservative care on the one hand, and on the other hand there are hardly any services to be provided in the area of dentures or periodontology, specialized pediatric dental practices even make a significant contribution to compensatory savings. The German Society for Pediatric Dentistry and the Federal Association of Pediatric Dentists therefore vehemently reject the draft bill of the Federal Ministry of Health (GKV-FinStG) to minimize costs in the area of preventive and conservative surgical services in the years 2023 and 2024.
It must not be the case that preventive and conservative dental services are budgeted using flat rates per case. Pediatric dentistry in particular sets the course for the further oral and general health of our patients. Later orthodontic, prosthetic and periodontal treatments can be averted not only through early childhood examinations (FU), advice and prevention, but also through the necessary conservative surgical measures in childhood. The reintroduction of budgeting will inevitably cause high follow-up costs in the future. It is undisputed that there is a high need for treatment:
In the report on the “Epidemiological Accompanying Studies on Group Prophylaxis 2016”, which was published in 2018, the clear polarization of caries infestation and a great need for rehabilitation in the relevant age groups are impressively documented:
“For the three-year-olds … The weighted average value for Germany was 0.48 dmft. Because 86.3% of the children were caries-free on average (dmft = 0), the 13.7% of the three-year-olds who had experienced caries had an average of 3.57 affected milk teeth. … 73.9% of the teeth were carious and therefore untreated. Both the filling and the extraction portion were minimal, since small children with caries can usually only be treated in a very complex anesthetic treatment. The six to seven year olds.. The German mean was 1.73 dmft and 0.38 initial lesions. 43 to 62% of the children were at the defect level without experience of caries in the primary dentition (dmft = 0). On average, 3.96 deciduous teeth were affected in children who had experienced caries. In Germany, only a good half of all carious defects were treated (57.5%).”
If the budget for the conservative surgical services is used up, the specialized practices for the urgently needed dental sanitation of children in this age group will no longer have the medically appropriate range of treatments available. As a consequence, significantly more teeth will have to be extracted in acute cases, resulting in the follow-up costs mentioned above.
The German Society for Pediatric Dentistry (DGKiZ) and the Federal Association of Pediatric Dentists (BuKiZ) therefore emphatically reject the draft bill for the GKV-FinStG for the reasons given above. They demand the suspension of budgeting for all conservative surgical services for children and adolescents up to the age of 12. Financial stabilization in the health care system must not be at the expense of such a vulnerable group of patients, who have a high need for treatment and who first have to learn how to act independently and in a targeted manner with regard to their own dental health. The above-mentioned specialist societies, federal associations and working groups for young people’s dental care have been supporting families for decades. The goal we all share is a further reduction in the dmft and a caries-free future for the generations to come.
Source: DGKiZ, BuKiZ