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Are emergency services and emergency medical services on the brink of collapse in Bavaria?
In Bavaria, the medical emergency service is on the verge of collapse, if not fundamental reforms are carried out, according to the notification of the Association of Statutory Health Insurance Physicians of Bavaria (KVB). This means that increased financial support from the statutory health insurance is also required. So far, however, health insurers have strictly refused to provide doctors with more money to build up an improved medical infrastructure.
"As part of an urgent meeting, the representative assembly of the Association of Statutory Health Insurance Physicians in Bavaria discussed yesterday in Munich the massive problems in the on-call medical service as well as in the emergency medical service in Bavaria", according to the latest release from the KVB. All parties involved agreed that there can be no "keep it up" if the on-call service and the emergency medical service are to be retained. The representatives of the medical profession criticized the position of the health insurance companies, which for their part have so far not agreed to additional financial benefits for the expansion of the medical infrastructure.
Criticism of the expenditure policy of the statutory health insurance funds The CEO of the KVB, Dr. Wolfgang Krombholz explained that "although the statutory health insurance companies are currently in a comfortable economic situation, the insured's money does not invest in their care." Ilka Enger, second deputy chairwoman of the KVB, added: "Instead of investing the contribution money in the care of their insured, expensive marketing measures or questionable studies are financed." You cannot afford such luxury as long as both the outpatient regular care and the On-call duty and the emergency medical service are not adequately remunerated, according to Dr. Krombholz and Dr. Narrower.
No increase in fees for the doctors of Dr. Krombholz further stated that there has been no real increase in fees for the medical profession in Bavaria for years. The rates of increase in remuneration can only be attributed to the growing number of treatments. "There was not even an inflation adjustment," criticized the KVB CEO. The first deputy chairman of the KVB, Dr. Pedro Schmelz, emphasized that the evaluation of the development of fees and the number of cases showed that there had been no real increase in fees since 2007. This "cannot go on like this", because the doctors could not live on their substance permanently, said Schmelz. "In this way, the comprehensive security mandate can no longer be fulfilled," said the deputy KVB chief.
On-call duty without far-reaching reforms before the collapse According to Dr. Krombholz's low remuneration combined with an extreme workload meant that the branch in its own practice was rather unattractive for young medical professionals. Therefore, "not only is the offspring missing in regular care, but also in care outside of normal office hours", the KVB announced. According to the KVB boss, the on-call service cannot be maintained across the board due to the shortage of young people without far-reaching reforms. Dr. believes that the core of the reforms Krombholz be the amalgamation of departments to have more doctors available per department. This would mean that the individual doctors would rarely have to do the strenuous weekend service, which was not very lucrative in the country. The aim of the standby service reform was to reduce service groups from 481 to 177 and increase standby practices from 40 to 109.
Seventy new standby practices required However, the KVB's proposal would require around seventy new standby practices, although this would not be possible without financial support from the health insurance companies. Although the statutory health insurers had agreed to pay a surcharge of ten euros from the second quarter and five euros in the third or fourth quarter to support the preparedness practices, this was not sufficient in view of the existing problems, emphasized Dr. Krombholz. The KVB not only demanded an adjustment of the flat-rate travel allowance and an appropriate reimbursement of material costs, but also start-up financing for the new emergency services to be set up.
Emergency medical service in Bavaria also threatened The second deputy chairman of the KVB, Dr. Ilka Enger also criticized the fact that not even all of the emergency medical services that have been performed are currently being paid for. The health insurance companies often questioned their necessity. In this way, a deficit of almost eleven million euros arose at KVB from 2009 to 2011, which made it necessary to reduce the remuneration in the area of emergency medical services from the fourth quarter of 2012 onwards. “It was a difficult decision for us and contradicts our conviction that the work done by Bavaria's emergency doctors should be properly remunerated, ”explained Dr. Enger added: "But as long as the health insurance companies do not recognize the legitimate fee claims of the emergency physicians, we have no other choice." Lowering the remuneration will probably make it even more difficult in the future to fill the services, the expert concludes. This means that the emergency medical service faces similar problems as the emergency service. (fp)
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