14:02:11 physicians do not practice with her in the province
The government wants to encourage physicians who work in the country, and stop the brain drain to foreign countries. Many German doctors are unhappy, according to a study.
irritating life as a country doctor, very few medical students: Only five percent of the doctors can think of to open a practice in the country. In the case of self-employment attracts the city: 42 percent said they would settle in a big city, 36 percent in a small town. One representative survey of the research institute TNS showed on behalf of Commerzbank than 300 established and employed physicians.
"What doctors do not tell"
Nine out of ten doctors expect that the future is lacking in rural areas of medical talent. Attractive than a practice in the village is working abroad. Of the doctors who are planning a career change, it takes one third of the border. More than three-quarters believe that in future more medical centers and will communities.
The current study sheds light on two major problems in health care: The shortage of doctors in the country and the increasing migration of health professionals abroad. The average age of the German doctors now stands at 52 years. Thousands of divorce due to age over the next few years. By 2020 there will be fewer than 7000 family doctors today, expected before the medical associations. At the same time migrate more and more doctors from Germany, 2500, it was in 2009. The black-yellow coalition plans this year a law specifically to improve medical care in Germany. The focus of the Pension Act while there are no measures, the rural areas more attractive for physicians.
are planned to include financial incentives for doctors who are willing to go in under-served regions. "This may include investment subsidies, salary increases or promotion of students are," says a 14-point document of the health policy of the Union. Thought is also about setting up in depressed areas medical care centers (MCC) and physicians stations, in which doctors from different disciplines to offer consultations. In addition to hospitals and doctors work more closely together.
What practice Doctors will prefer
The surplus supply in the cities of the coalition through the acquisition approach of practices. "The previous practice in which the law can be for the settlement with the insurance companies in Germany is virtually inherited and sold to end," calling for the health policy-makers. The Pensions Act to the shortage of physicians is expected to close in March outlined at least in his key points, announces the CDU politician Health Jens Spahn. He even calls 2011 the "Year of the patient" and refers to a "challenging program in health policy." Because, besides the Pensions Act, the coalition is planning a patient's rights law, the care reform by mid-year and a law to improve hospital hygiene. Spahn: ". All actions that put the patient and his needs at the center of the considerations"
welcomed the panel physician Federation that plans to adopt the policy of the regional managed care. "The current planning is too rigid," says KBV chief Andreas Köhler. "The supply planning must be flexible and take into account the special needs of villages, small, medium and large cities." The Federal Medical Association called for the debate about the shortage of doctors making the medical profession generally more attractive.
How to the attractiveness of the profession is ordered, it also gives the Commerzbank-study information. So there a third of the physicians to be dissatisfied. However, while only one in four hospital doctor said that he was less or not satisfied with his job situation, the figure for nearly half of all doctors (44 percent).
What makes a successful doctor? This also has asked TNS Emnid. The result: work around professional competence, emotional resilience, self-motivation and the ability to draw people, according to the respondents of a good doctor. Just highlights the investigation to the relationship between patient and doctor: Because time for discussion and understanding is for the patient's situation, according to the doctors less important for a good doctor. (The World)
16:02:11 depression cost billions €
Hamburg has the most days lost in Germany because mental illness. Health insurance companies to demand more health on
usually catches the disease from creeping. We sleep at night no longer in the morning, tired and sweating and feels marginalized in the workplace. Stress and anxiety in the job to take. At the end, then often the diagnosis of depression or other mental illness. According to the Health Report the health insurance company DAK, the number of mental disorders in Germany almost doubled since 1998. "One in four women and one in eight men will once in a lifetime psychological problems attests," Hans-Peter Unger, chief doctor says the Center for Mental Health at the Asklepios Clinic Harburg. For the Health Report evaluated the DAK and the IGES institution sick leave of 2.6 million workers insured.
three days was an average of 2010 every hamburger sick due to mental disorders, according to a study presented yesterday also hosts the Health Insurance Fund (TK). Thus, the Hanseatic city on a nationwide level at the top. "Mental illnesses cause a longer disability than other ailments. The diagnosis is now recognized but the doctors in the city earlier. Patients also go faster than in the past to the doctor because depression can no longer be stigmatized as strong, "says Unger. In addition, the Hanseatic city now had a well-elaborated psychosomatic treatment system." Mild problems we are oversupplied in the city, major- disorders still underserved, "said the doctor.
In four out of five enterprises employees have high pressure
victims are not only the patient but the entire Economy. According to the Federal Statistical Office, cause mental illnesses cost a total of almost 30 billion € per year. One reason for the disease is found in the workplace, the trade-related research institute Hans-Böckler Foundation has found. "In four out of five German companies employees are constantly under extreme time and performance pressure, mental stress at work have grown in recent years," according to a study by the Institute. In 84 percent of German firms there are employees who work permanently at high time and performance pressure.
If you add up all sick leave in Germany, are, according to the technician Health insurance young workers in the top position. Are you sick twice as often as their older colleagues. The 15 - to 25-year-olds are missing, therefore an average of twice per year. Older workers were on average only once a year at home. However, take the time to failure with increasing age. While medical leaves just below the youngest employees between 15 and 19 is six days, there are the over-55s almost 19 days.
The main reason is the more severe diseases with increasing age. "Diseases such as back pain, cardiovascular disorders and mental disorders, according to experience are very lengthy occur more often in older workers, "says telecommunications expert Gudrun Ahlers." However, we also see in younger workers in recent years a significant increase in sick leave due to psychological diagnoses. "In addition to increased demands of the working world to play the uncertainty through fixed-term contracts with illness in young people a role.
companies to their employees' health promoting
DAK also surveyed 3000 people in employment aged 18 and 29. About 60 percent of young workers have thus feel more to be able to afford, as required in the job is. A prolonged underload can also cause stress.
for the German economy it is important in view of demographic change and the declining number of qualified professionals to promote the health of their employees in the long term, the TK. For years, the sickness rate in Germany is probably too low for fear of the workers before a job loss. The TK coming in 2010 Germany had a rate of 3.3 percent for its policyholders. When there are DAK 3.4 percent nationwide and 3.2 percent in Hamburg. (Hamburger Abendblatt)
17:02:11 DAK health insurance chasing criminals
Not every massage can settle on a cash cost - but often it is made
pay just is not always to the liking of the German Employees' Health Insurance. She looks at the bills very carefully - and brings more and more fraudsters to track. The abusers do not just sit in the medical profession.
in the health system more and more accounting frauds are discovered. Investigators concluded the insurance company DAK last year from 861 cases, 56 percent more than in 2009. About two million € could be retrieved in this way, shared with the DAK in Hamburg. That was 52 percent more money than last year. Manipulated give detailed accounts in all areas. Focus were just under 40 percent of remedies such as massage and speech therapy. It scams follow the medical treatment, nursing or aids such as wheelchairs and hearing aids, each with around ten percent.
were processed in 2010 total nearly 1000 new references. DAK is currently the Hamburg headquarters to 2,000 suspected cases. "Could see and bring back more money for our policyholders," "Our balance sheet for 2010, we improved research methods more cheaters and" Black Sheep, DAK said to the chief investigator Volker Heide. "The broad mass of the supplier under the contract settles and can get nothing wrong. "
The results are based, according to the DAK only to cases where there is deliberate accounting fraud with criminal backgrounds or imposed for breach of contract which, because of penalties. Monetary returns from the routine payroll audit had not been included. The DAK is working to combat misconduct in health care with other providers, associations of panel doctors and dentists as well as the police and the prosecutors together. (Focus)
18:02:11 PKV commissions
go of the criticism against high BaFin.Unionsparteien PHI commissions. FDP indicated their support. (FAZ)
18:02:11 Rösler: doctors should their services
order to improve billing (FAZ)
18:02:11 Rösler coding billing system moves the doctors
Federal Health Minister Dr. Philipp Rösler (FDP) will not reform the accounting system of the doctors for the time being. The new so-called "outpatient coding guidelines" were of the physicians' been Confederation (KBV) and the SHI-leading organization designed to enable more detailed and therefore the cost-cash settlements. Several physician groups and physician associations, individual cash (KVs) had protested vehemently against it. From the Federal Ministry of Health (BMG) said now that the Neureglung will come earlier than the end.
Under the new coding guidelines, the patient's diagnosis in their encrypted form in much more detail than was previously reported to the Panel. This should create the conditions to pay doctors to just after illness of their patients. Numerous medical associations worry more bureaucracy and are concerned about data protection.
Originally, the new rules are already in place at the beginning, then a transition period was agreed by mid-year. The new shift is to "allow time for all concerned partners to simplify the application in everyday practice significantly. In a letter to the parties established the provisional Rösler stop with the fact that the coalition wanted to reform the medical field this year anyway with a power law.
support in principle the Ministry of the introduction of the new guidelines: "They provide a correct and unambiguous diagnosis encryption, "said a spokesman for BMG. "This is the basic prerequisite for the health of the insured may be taken into account in the allocation of funds in public health insurance." (AP / PHARMACY ADHOC)
18:02:11 fees. Doctors unduly subordinated
What's your expense account for their treatment, measured by the fee schedules of the doctors schedule () and dentists (GOZ). The costs orders are getting on in years and should be modernized. But the mantle of the fees impeding competition. An analysis of Andreas Mihm.
Insurance companies require the ability to enter into contracts with physicians on a deviation from the tariff
18th February 2011
lawyers and notaries expect their performance after a scale of fees, architects and engineers for a fee scale, only doctors and dentists have two price lists: one for the treatment of funds insured, the bread-and-butter business of the average practice one for private patients. What is billed for their treatment is calculated, in accordance with the fee schedules the doctors schedule () and dentists (GOZ).
The costs orders are getting on in years, so has black and yellow promised their modernization. It seems that this remains, however, depend in part in the thicket of conflicting interests of physicians, state and private insurance. Only the core completed new fee structure of 85 000 dentists may soon come into force. It is regarded as an example for the financially significant reform of the scale of the 324 000 doctors, but the latter will hardly occur before the election 2013. Too big is the need for changes to the comprehensive health care reform and policy agenda with a country doctor supply.
This is not good news for doctors. Many private medical services are a necessary extra income for their survival under-funded by the treasury practices. Unlike cash, they know the patients private patients already in treatment, which brings them into euros and cents. Moreover, they can easily settle on performance drivers several times the rate of royalty. Not least, private medical services, other than cash benefits, not limited in quantity. The doctor can diagnose and treat what he deems necessary, the costs are passed on to private insurance. This is reflected in their spending. Commutes Proportion of outpatient treatment costs to the expenditure of the funds for years around 17 percent, he is in private insurance to 24 percent.
insurance industry fears cost push
From the perspective of the doctors could all remain so if performance specifications and cost estimates did not come from the eighties. Since then, new treatment methods were introduced, inflation has nibbled at the fee. There are constant therefore conflict with patients and insurance companies for the "right" interpretation of the tariff. want to see
As much therefore the insurance industry, these uncertainties adjusted, so much fear they right to a cost push through the revision of fee schedules. It requires, therefore, the possibility of concluding contracts with physicians on a deviation from the tariff. The under high cost pressure private insurers to justify not necessary savings but plan to improve quality: more money for more quality, but based on a narrowly calculated fee structure. Also, it was free the doctors to accept the offers. Encouragement learns the private insurance in the interior ministries. They see a chance, its growing aid spending for the privately insured officials reduced.
dispute clause
The Medical Association in which a vigorous campaign there, rejects this, as well as the Dental Council. Both drives the fear of price-cutting and "destructive" competition, before the possible loss of free choice of doctor and alteration of the supply. But the accusations have no reason to deny clauses. Conversely, a shoe out of it: the mantle of the fees regulations impeding competition for prizes and services to ensure quality. If that was not a starting point for a liberal Minister of Health.
can Philipp Rösler But in a dispute with doctors, state and private insurance gain little. Therefore much to be said for a Postpone with doctors and a lukewarm compromise the dentists with adherence to a little better tariff. Because the private insurance saves money, and the doctors have been spared the clause.
But why should not apply to private insurance, which can be insured patients for several years at the supply - to use special offers to their insurance companies, such as special treatment contracts - voluntary and in moderation? Many doctors have made it experiences. In this respect, sound survey of private insurance, which the doctors were open to selective contracts over plausible.
involve clauses for the private insurers but also risks. So far they are only in relationship to their customers. The more they turn on in the care given and negotiations with the doctors, the closer they move to the statutory funds. There is no indication if they adjust the systems to compete for better care. But then the next step would be not far off: the cost to a single order for cash and private patients of doctors and dentists, as with the lawyers and notaries, architects and engineers. (FAZ)
18:02:11 The rate of doctors is not yet the time being amended
really is in the coalition agreement that is to be renewed, the fees for doctors in this legislative period. This is now adjourned, as the FAZ has learned. Instead, only the dentists' fees are amended. For patients, this could be expensive.
By Andreas Mihm
14th February 2011
The black-yellow coalition wants to amend no longer meet their commitments in the coalition agreement, the fees of doctors in this legislative session. "On the agenda is only the reorganization of the scale of the dentists," the FAZ learned from well-informed Circles of the government coalition. The new fee structure of the dentists are on the fee increases to 10 percent in the conversation, should therefore be introduced without delay. For this Thursday, a top-level talks with representatives of the Federal Chamber of Dentists and the Association of Private Health Insurance (PHI) with Health Minister Philippe Rösler (FDP) is attached.
The fee schedules are the fees covered by the 326 000 84 400 active physicians and dentists for the treatment of private patients expense account. Both fee schedules are from the eighties and are therefore not as many medical innovations. Therefore, it always comes back to battle about the "right" amount of the settlement between patients, insurance companies and doctors. Against the background is what the years by doctors and dentists reform demanded a new description of the benefits associated with an increase in fees would be. could
fee increase for dentists to insured patients by beating
The Federal Chamber of Dentists in such a specially provided recalculation had calculated an increase of 55 percent. Because such gains, however, are not enforceable, it brought in political discussions, no such claim. Involved in the talks expect that will come out on balance an increase in "low double-digit percentage range." Such a fee increase at the dentists could in part be felt among patients on a cash, because teeth are treatments that go beyond the standard care of the cash, paid for by private fees. Dentists make about 40 percent of their income from private fees, and the rest from the settlement with the insurance. to be charged
The Association of Private Health Insurance (PHI), which has long complained about more than the cash and avoid further cost increases will as far as possible, opening clauses required in the fee schedules. This should he Enabling legal depart from the tariff and to meet with individual physician groups and special performance fee arrangements - like the rules at the box office doctors. Such clauses in private insurance are accepted by doctors and dentists strongly. According to surveys of private health insurance is the resistance in the medical profession itself was only modest. Doctors and private health insurance have submitted their opposing views and arguments in the past week, publicly and in mass mailings to politicians.
The position is for the Federal Health Ministry, which issued the regulations must not become easier, that other government departments and the countries have a say. It is precisely the interior ministries as carriers of the aid for private health insurance of officers such as private health insurance are interested in possible cost savings. The negotiations at government level in Berlin are still in progress, countries must also agree.
The government, it seems obvious politically attractive, to avoid a major conflict with the doctors on one side and the private insurance on the other side of the road by drops the "big" reform of the medical fees until further notice, regardless of the down in the coalition agreement: "The rate of doctors is the current state of scientific knowledge adapted. It will cost trends are taken into account. "facilitates argumentative action by the forthcoming election in June, the Bureau of the Federal Medical Council, which conducts the negotiations.
contrast to the negotiations on the fee structure of dentists (GOZ) will be completed soon. The dispute about this clause is a compromise in the call after the private insurance could negotiate fees for laboratory services separately. For dentists this fall at the fee volume is not significant. (FAZ)
18:02:11 / 01 March 2009 Government: No Reform of the dentist's fees
threatened by the ongoing dispute over the doctors' fees is now also a dispute over the fees of dentists. On the new pricing plan that would have the dentists ten percent higher fees introduced, will give the government. The reform is of concern to all patients. is
By Andreas Mihm, Berlin
Going to the dentist and financially painful: Patients must be part of the services themselves often pay
01 March 2009
The federal government will waive the fee proposed reform of dentists and the prepared regulation to the Federal Council not expected to present for decision. That said, the Parliamentary State Secretary, Federal Ministry of Health, Marion Caspers-Merk (SPD) of the FAZ
After her reading the some 55,000 practicing dentists escapes to a fee increase for non-paid for by health insurance benefits of 10 percent. The dentists, who does not fit the direction of reform deny this bill. The fee structure of the dentists (GOZ) was last reformed in 1988, against the wishes of doctors.
The reform is of concern to all patients. For in contrast to general medical need for dental treatment even insured patients often pay a portion of the services themselves. Hogue after the tariff.
"50 percent more, which is completely utopian"
Caspers-Merk said her house was ready, submit the draft to the Cabinet. "However, this depends on whether the actors do anything, just that it seems to me, but currently not the case at all." The dentists do not accept the reform, "because they have sufficient 10 percent no more, the private health insurance and the interior ministers are against because it gives them too much money. "The Home Secretary must apply for aid for the privately insured officers and therefore have to power expansion as little interest as the private health insurance.
"The dentists do 50 percent more, this is totally unrealistic, especially in an economy like ours," said Caspers-Merk. Because dentists deny that the reform at the end would have actually provided an increase of 10 percent, would be guaranteed the volume. "But that was the dentists not enough, have never contributed constructively to a regulation."
negotiations not to procrastinate
The SPD Health politician, the officials warned of the misconception that they could under a different government constellation cut after the election the better. The next parliament will not have more money than the present. "I do not believe you about new negotiations over the fees the dentists so an offer can be maintained, we live in the worst possible time for fees in the double-digit percentage range."
The President of the Federal Chamber of Dentists, Peter Engel, reaffirmed its basic criticism of the reform proposal. The Ministry called the output volume increase by 10 percent follow only the addition of new services in the fee structure. This had already been provided but similar to other positions and the scale been settled. Also, the fees are positions incomplete and "not in conformity with the principles of modern scientific dentistry. Do not agree with the dentists are particularly trying, the level of private medical fees adapt to the health insurance. (FAZ)
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