Healthcare
Dispute about waiting for doctor’s appointments in Germany
Updated on December 28, 2024Reading time: 3 min.
Especially when it comes to specialists, those with statutory health insurance find that they often have to wait a long time before an appointment. People with private insurance should have it easier. What could change?
In the dispute over medical care in Germany, the German Patient Protection Foundation accuses some statutory health insurance doctors of cherry-picking. They would discriminate against statutory health insurance patients without this being discovered. “Cherry pickers are not identified,” said foundation board member Eugen Brysch to the National Association of Statutory Health Insurance Physicians (KBV).
In an interview, KBV chairman Andreas Gassen defended himself against allegations that statutory health insurance patients had to wait a long time for appointments. Gassen in the “Rheinische Post” called a current federal election promise by the SPD to abolish differences between privately and legally insured people on this point by guaranteeing appointments “populist nonsense”.
Brysch told the German Press Agency: “The KV chairman cannot distract from the fact that self-payers are clearly given priority when making appointments.” It is not medical reasons that disadvantage those with statutory health insurance.
The SPD and patient representatives have long been a thorn in the side of the differences that many practices make when making appointments between private and statutory. Doctors have occasionally argued that practices need such an approach so that they can compensate for problems in remunerating treatments for those with statutory health insurance.
Gassen is currently responding to the accusation by the umbrella association of statutory health insurance companies (GKV) that there is a preference for those with private insurance over those with statutory health insurance when arranging doctor’s appointments. Federal Health Minister Karl Lauterbach (SPD) also called the distribution of appointments unfair. The dispute takes place against the backdrop of the election campaign for the federal election on February 23rd.
The KBV boss argues that many general practitioners’ practices offer acute consultation hours. Even when it comes to specialists, you have to leave the church in the village; compared to other countries, the waiting times are short. “In Germany, patients also have a free choice of doctor. The price for this is that they have to accept waiting times for popular doctors,” said Gassen. Real emergencies would be taken care of immediately “despite all the propaganda in this country”.
With its proposal for a deadline guarantee, the SPD combines the idea that insured persons should be entitled to premium reductions in the event of non-compliance. Gassen rejects the entire initiative. “For this to happen, there would first have to be clear medically justified urgencies and practices would have to have free capacity.” The SPD could have freed practices from bureaucracy in the past legislature. “To now want to distract from our own government failure with a deadline guarantee that would never be implemented is transparent and somewhat pathetic,” said Gassen.
The National Association of Statutory Health Insurance Funds reacted briefly. “When you click on online booking portals, everyone can click on PKV or GKV and check for themselves whether the appointment is fair and equal or not,” said association spokesman Florian Lanz.
Brysch described the problem as “even bigger.” Not all practices can be reached online. Sometimes patients have to go to the practice in person to get an appointment. Private patients often get it quicker. But the National Association of Statutory Health Insurance Physicians does not provide transparency about this, said Brysch. Data was missing. “She has the security order.” This is the statutory mandate for the KBV to ensure medical care for those with statutory health insurance.
Difference between private and legal
Brysch said that the statutory health insurance associations could prevent a gap between private and statutory health. The common practice is damaging the reputation of many committed doctors. “But neither the emergency consultations offered, the accessibility nor the attendance times of the approximately hundred thousand practices are checked by the lobby of statutory health insurance doctors.”
The patient protection board therefore called for a scientific review and quality checks. “Populism from doctors and politicians helps no one.” Sick people across the country would experience that statutory health insurance on-call services and outpatient emergency practices would be cut. “Patients in structurally poor regions in particular are being hit hard, because statutory health care is also declining here.”
Brysch thereby drew attention to another circumstance that is repeatedly criticized as unfair. “Instead there are practices in lucrative areas,” he said. “These are also reasons why emergency services and hospitals are overloaded with their emergency rooms.”
When it comes to appointments, the head of the German Social Association (SoVD), Michaela Engelmeier, had already called for in August: “A fair allocation of doctor’s appointments is essential.” Especially in times when people with statutory health insurance often have to wait months or even years for a specialist appointment, they should not become second-class patients. A significant number of medical practices give appointments exclusively to those with private insurance or self-payers.
According to the National Association of Health Insurance Funds, around 73 million insured people in Germany are covered by a statutory health insurance company – around 90 percent of the population. According to their association (PKV), private health insurance companies had a total of around 38 million ongoing insurance policies in 2023, including 8.7 million full and 29.6 million additional insurance policies.