28.02.11 experts also consider income for doctors covered
doctors earn in the treatment of insured patients more money than its officials have identified with health insurance. The average net income of any medical practitioner is, according to the health insurance at 164.000 euro - the target of 105,000 euros was exceeded by far.
doctors earn in the treatment of insured patients more money than its officials have identified with health insurance. Contract doctors achieved "on average a higher net return per regular practice owners than from the Self-government partners have agreed, "says a study by the specialized health issues IGES Institute for the central association of statutory health insurance (SHI). The cash also fear that lead planned improvements to the supply of fee increases.
" If the so-called rural doctors more want to give money, then you have to redeploy within the medical profession "demands of the Vice-Chairman of the Association of Statutory Health Insurance Funds, Johann-Magnus von Stackelberg." With an average total income of all physicians from around 164,000 € is enough money in the system. It must be distributed only better. "Among those taken off the practice costs, revenue from treatment of private patients were admitted. Stackelberg stressed that they wanted to not lower the fees charged currently. "But with the motto: Always be more for the doctors, the pay, after all the contributors, has to stop!"
physicians 'association: The average working doctors 51 hours a week
Andreas Köhler, CEO of physicians' Confederation (KBV), replies that long waiting times, proved to full waiting room and the shortage of doctors, "that health insurers and doctors all must do to make the medical profession to be attractive especially in the establishment ". On average, worked Physicians 51 hours a week. "Who then speaks like that here too much is earned, threatened with a still good supply."
Stackelberg says, however, already received the doctors' fees more clearly than it has even kept the CBD as their advocacy for appropriate ". In October 2007 we have set a target of 105,000 euros, the average salary of a senior physician at the hospital. This sum will now surpassed criticized Stackelberg and refers to the term-study on the plausibility of the calculation of medical fees. The Institute finds it "clear indications that the average physician income in comparison to that in the calculation scheduled physician income is too high. "The panel doctor fee is calculated by multiplying the performance-based points with point values. The amount is negotiated between the sickness funds and the CBD. Currently the score is 3.5 cents. The CBD has a point value of 5.1 cents is economically necessary.
In the CBD to the 105,000 euros were no target, but only one of several benchmarks. why is irrelevant to the allegation. The term Institute is however to the conclusion that the income practice owners - despite a 3.5-cent "real power price, 31 percent lower than the imputed value point" - that of the self-administration of fixed income exceeding 105 572 € wide. 2007 the average net income has reached 142 000 €. Today he is, according to SHI Association at 164.000 euro. Stackelberg sees it the actions of the doctors done, the point value of 3.5 cents was too low: "With this legend, the report does finally end." (FAZ)
28.02.11 lead to higher medical fees cash contributions?
Supply Act against a lack of doctors in the country
higher medical fees lead to higher cash contributions? The Federal Health Minister planning a new Pensions Act. Country doctors will in future receive higher compensation to offset the shortage of doctors in rural areas. The health insurance companies fear the other hand, further increases in contributions.
02/28/2011 Does a fee increase for doctors more cash contributions?
The association of statutory health insurance (SHI) fears that planned by the black-yellow coalition fee increases for physicians a significant increase in insurance premiums. The federal government wants the law to supply the shortage of doctors in the country . Proceed With higher fees and premiums should be made to physicians, doctors' offices to open in rural areas. The health insurance denied the other hand, a serious shortage of rural doctors.
The statutory health insurance companies fear a further rise in insurance premiums, although it was raised only at the beginning of the contribution rate to 15.5 percent. The Federal Health Minister Philippe Rösler (FDP) is planning a new Pensions Act, to ease the shortage of doctors in the country. In essence, physicians receive a private practice with higher fees when they move to the country. Precisely the fee increase could be for Insured negative effect. Finally, the higher health costs to the Panel members will be passed on.
In an interview with "World Online", the Minister stressed that they wanted to make sure to pick up the shortage of doctors in the country. This would require incentives for doctors. Finally, we must ensure that it reflects more doctors, "said Roesler. Situation is completely different to the Federation of health insurance. Especially in cities conquer a real surplus. The physician density is so high that it is actually 25 000 doctors too much give up. On the other hand, land just missed 800 doctors instead of that of Roesler number of 20,000. A better strategy is to reallocate the fees within the medical profession, the deputy chairman John SHI-Magnus von Stackelberg told the "Frankfurter Allgemeine". "If you want the so-called rural doctors to give more money, then you have to redeploy within the medical profession." This means that the health insurance propose to reduce the fees of doctors in the cities and the rural doctors to provide higher compensation.
But the federal government wants to hear nothing of such proposals. On the contrary, instead of spending millions of dollars more are planned. "Hospitals in underserved areas are given financial incentives for when they train junior doctors in general practice", said the health minister. Parallel to the ceilings of the cash expenditures are reserved for practicing dentists. From the ranks of the coalition, it was said that this had an annual sum in the three-digit number can be applied. The news agency "dpa" is now for a similar position paper of the Federal Government. It states among other things, that doctors should receive more funding if they give up in a city with a high density of physicians in a practice and instead the Country to open a. Exact amounts are in the paper but not mentioned. Even here, however, should the funds go into the millions. In March of this year, will the black-yellow coalition negotiating within their parties on the draft Rösler. At the same time wants the Federal Minister of Health with the countries enter into negotiations.
The Health Insurance Association made it clear that the doctors have already had very high remuneration. On average, a physician in private practice earned around 169 000 € (excluding taxes, practice costs, including income from private patients and services). That means a net profit year on year by around 5000 € per Year. Overall, the health insurance companies have to pay for doctors' fees to 33.4 billion euros. They are an estimated 1.3 billion euros more than in 2010.
criticized in this regard, the Vice-Chief of the General Local Health Insurance Association of AOK, Jürgen Graalmann the unreliability of the government in terms of agreements. So this told the "Handelsblatt": ". We have to trust that the Union will reach its announcement not to burden the contributor for additional fee increases for doctors, dentists and hospitals," Now give it the pressure of the doctors lobby for, so Graal man.
There has never been so many doctors, as is now the case, warned the chairman of Federation of spare cash, Thomas ballast. In the period from 1993 to 2009 the number of doctors has risen to 104 600 137 400. Ballast demanded that doctors with a security scheme must always be treated legally insured. Recently, namely the Association of Otolaryngologists of its members had been asked to deal with fewer insured patients in order to sell more private services may.
must increase their contributions to health insurance, the insured must bear the burden on contributions itself. For the parity Principle was abolished in January in the course of the health reform. The employer's share has been frozen until further notice. (Sb) (naturopathic naturopathy &) is
1:03:11 The tale of the doctors surplus
it lobbies in many healthcare. Only the patients have no strong. Federal Health Minister Philipp Rösler (FDP) has been about a noble task. He wants to take better care to patients and their medical care after the past few years, particularly the interests of different professional groups were served.
But the task is difficult. For whatever is changed in favor of the patient, has an impact on doctors, pharmacists or nursing services. Thus, Roesler is in these days, the simple but difficult question: Do we have enough doctors for a good, close to home medical care for the population? The response of the health insurance is clear: "Germany has more doctors than are needed for good medical care," said the head of the Health Insurance Association yesterday. In Germany there are about 24,000 doctors too much. From the perspective of the cash that is one in five practice doctor is unnecessary. Many patients, for days and even weeks at a Doctor's appointment waiting to be shaken in the face of this calculation only the head.
a question of hours
fact, there is not such a great doctor surplus. Nevertheless, the bill of health insurance is theoretically correct. It is based on the planning of the Federation. This determines how many doctors per capita are expected to work in a region. Based on these figures, there are actually too many doctors in Germany. But the planning was built in 1993 and has to do with today's realities, nothing more. What is decisive is not how many doctors work in a region, but how much work the doctors.
And this show figures from the Federal Medical Council, that was the total number of hours worked in 2007 about the level of 1997. The individual doctor is working, therefore, on average only 33.2 hours per week, while ten years after 36.8 hours. The significant increase in doctor numbers was offset by increases in part-time work and total shorter working week, because young doctors put more emphasis on leisure and family.
Substituting the volume of total hours worked in relation to the significant increase in number of treated cases of illness, it appears that doctors today have even less time than before for the treatment of a patient.
remains true that the supply is regionally different. Anders than in large cities are missing in the country more and more doctors. The problem is difficult to solve because the number of young doctors is not enough to replace the doctors who go into retirement soon. It is therefore to act at the time. The health insurance companies should recognize the interests of the insured. Which it will not help if the cash will keep it low for fear of higher costs, the number of physicians. Because of illness, a doctor is more important than a low contribution rate. (Frankfurter Rundschau)
01:03:11 will win cash billion dispute over cholesterol drug
The lipid-lowering drug Lipitor by the statutory health insurance funds continue to pay only a smaller amount. This was decided by the Federal Social Court (BSG) in Kassel. The ruling relieves the statutory health insurance from a risk of costs in the billions. But have tens of thousands of patients who are taking Lipitor afford to remain a high co-payments.
background, the so-called fixed amounts in the statutory health insurance. You select a maximum amount, pay the health insurance for certain drugs or drug groups. If the price is higher, the insured must pay the difference out of pocket. The
is still patent-protected drug Lipitor Atorvastatin for Group of statins. The funds are used to lower the blood levels of the dangerous LDL cholesterol. To high LDL levels are among the main causes of cardiovascular diseases. From 2005 to statins, a fixed amount established and then lowered several times. Depending on the dosage, the additional payment for patients, by up to more than 100 € per month. Through the co-payments, the market share of Lipitor fell 50 percent (1.4 billion prescribed daily doses) in 2004 to around one percent (19.2 million days doses) 2009.
Regulations 2009 correspond to a figure of 52 600 patients. In his application, the pharmaceutical company Pfizer claimed that compared with other statins Lipitor bring for 150,000 patients in Germany therapeutic benefits. In the opinion of the SPA, the pharmaceutical company could not prove this but. The active ingredient atorvastatin was not compared with other statins beneficial, "therapeutic improvement by Lipitor has not been established, were the judges in Kassel.
This showed the SPA from the action of an affected patient. After the verdict Kassel patients in atypical cases, but still be able to apply to the health insurer exception. Pfizer announced in Berlin, not to decrease despite the BSG Case prices for Lipitor. (AFP)
02 03:11 Tips for health insurance fund or private?
Since January, consumers can easily switch to a private health insurance. But the rates are often more expensive than it seems: "financial test" has compared the performance of statutory and private providers - and shows what buyers should look for in a replacement.
fund or private? Since early 2011 more people will be spoiled for choice: employees may now back out private insurance if their income once the insurance liability limit of 49 950 € gross was. So far, their merit had three years above the limit.
But beware: the choice of insurance is often a decision for life. Back in the state insurance insured can usually only if they are as a worker with income to cover the insurance liability limit. From the age of 55 years remains the way in which public health insurance in almost all cases, blocked.
a private health insurance can have many advantages: in most rates, the higher the fees insurers pay to doctors, take over-the-counter medications, treatments by alternative practitioners and the cost to the chief doctor.
However, this has its price: The contributions are for young earners but often lower than in the statutory system, but can rise sharply over the course of life. No matter how much the insured then earned - he must pay the high fees. Once guaranteed benefits remain valid until expiry of the contract.
For social health insurance, the contribution shall, however, always according to income. Those who earn less, pay less. Non-working spouses and children are insured free of charge. But the benefits are not secure. In recent years politicians have launched a consultation fee, among other things, reduced the subsidy to dentures and deleted the reimbursement for eyeglasses and prescription drugs.
officials have private health insurance anyway - even the little policeman with low incomes. The employer pays him instead of an employer subsidy half of medical services. For the other half is on the insurer. The insured must have the performance to advance, however. As he half of the fee paid by the employee gets a private insurance for civil servants is generally very favorable.
What makes a good wage - and what it costs
employed persons generally receive no aid for medical services, and income is also not safe for all time. For them, the private is therefore a financial risk. Therefore, for them the legal insurance is usually the better choice.
a disadvantage both: Because the life expectancy and healthcare costs steadily increasing, insurers have to calculate the contributions regularly. Therefore increase the contributions. As a rule of thumb is: After 30 years, the contribution of at least tripled.
To lift to reach retirement contributions should be able to put insurance money aside each month. Those who are not civil servants and does not aid should save up a month in addition to contribution from about 150 to 250 euros. Because the contribution is even too high, usually leaving only the change to a different rate - with fewer benefits.
does not always more than the private health insurance, health insurance funds - this is true in many cases for the refund Psychotherapy, or loss of earnings for a long illness. For the dying in hospice or home care after a hospital stay, the private sector generally pay even nothing. (Mirror)
03:03:11 fees. No clauses. Rösler waived competition among dentists
Use of opening clauses in the tariff would make private health insurance with dental treatment fees and agreements which are exempt from the state guidelines. So if there is more competition. But Minister Roesler, the project has now tilted.
desired by the private health insurance clauses in the fee structure of the dentists (GOZ) is not there. The Health Minister has announced Philipp Rösler (FDP).
means of the clauses would make the private insurance companies to doctors fees and treatment contracts that deviate from the state guidelines and allowing for more competition. The President of the Federal Chamber of Dentists, Peter Engel, said that it had "reached one of our main goals." An "important and correct step," said the Federal Chamber of Dentists.
private insurance see Rösler announcement critically
The Federal Chamber of Physicians, in the reform of the GOZ provides a precursor for reform of the fee structure of the doctors schedule (), found an opening would have "a price dumping through selective agreements to ensure that the quality of reduced patient care and physician groups placed in the direct dependence of private insurance.
This saw the announcement Rösler in the "Medical Newspaper" critical. Clauses are needed, said association director Volker Leienbach. In addition, the GOZ is only one adjustment and amendment does not prejudice the fee structure for for doctors, in the face a fundamental structural reform.
expressed less satisfied the dentists on the second part of the reform. With only 6 percent fall from the fee increase is too small, complained angel. That was after 23 years of stalemate unacceptable and contrary to "the requirements of the Act and Dentistry of the coalition agreement". The higher rates of fees also take insured patients, because part of the dental services will be charged to private. The change in the GOZ must agree to the countries. (FAZ)
4:03:11 annual balance sheet. Health insurance live from Substance. The tight financial situation makes additional contributions likely
order to prevent additional contributions, many health insurance in 2010 lived on the substance. Their financial position makes it likely that they do not get along with constant transfers from the health fund with the money.
Many public health insurance in 2010 have lived on the substance to prevent additional contributions. Even in big cash as the financial situation is tense. Private plans to negotiate with the union over a contract agreement plight. Had health insurance in 2009 still a surplus of 1.1 billion euros recorded, so this is largely melted away in 2010.
This is clear from the data requested by this newspaper data of the annual accounts 2010, the gathering of the associations of health insurance currently. The spare cash register but claims to have a surplus of 212 million €. Is but an overall view of the POS system by deficits of company funds (103 million €), guild funds (70 million €) and miners (17 million €) have largely absorbed. Of the general local insurance companies, which with 24 million policy behind the statutory health insurance is the second largest group, was reported it expected a deal "to the zero line."
members of high migration affected
The tight financial situation makes it more likely that more funds get along with constant transfers from the health fund with the money and not raise additional contributions. The revived merger talks as among the guild coffers. Currently 14 operational and two spare cash have to rely on additional contributions. The contributions are thus about 5.5 members - more than 10 percent of all health insurance members.
In some cases such as the City and BKK BKK Hoesch he is since the beginning of as many as 15 € a month or 180 € a year. Funds that charge an extra premium, are of exceptionally high emigration affected members, which complicate the financial situation in each case further can.
how tense the situation, data from the Association of private plans. There, the engineers health insurance has a surplus of just over half a billion euros (and twice as large fortune) off, smaller funds such as the HEK and HKK are clearly positive - also in view of their reserves. The KKH alliance but has achieved only because of additional contributions by a small surplus.
leader Barmer / GEK which requires of its 4.3 million members, no additional contribution is called a net loss of 298 million € and has to have his assets to 308 million euros, almost halved. The DAK is despite the additional contribution from 8 € a month with 79 million Euros in deficit. According to data of the spare cash reserves to cover the Association of DAK and KKH Alliance nor the expenditure of a day. Already being negotiated with an emergency contract agreement. Is to allow damp spare cash to reduce the working week from 38.5 hours without a salary decrease by up to five hours. (FAZ)
07:03:11 First AOK before additional contribution
The twelve local German health insurance in 2010, half a billion euro loss did. AOK Bavaria is planning to levy additional contributions. has
from a surplus of 771 million euros in 2009 Part of the twelve General local health insurance the previous year with a loss of 500 million € complete. , Reports the Handelsblatt, citing cash circles. The cause of the deficit reduction requirements apply through the disease-risk compensation among the 150 health insurance companies. The Federal Insurance Office has corrected payments from the pot later. Without this reimbursement the local sickness had made no losses.
What AOK has a deficit? Known so far that the AOK Bavaria 91 million euros must be paid to the health fund. It administers the federal insurance office. The nation's largest local box office with 4.2 million insured persons (contributors and Family members) has also yet to arrears of 19 million euro fee Bavarian family physicians.
respond, as the local banks on the deficit? After the black and yellow health reform must raise additional debt cash contributions, pay only for workers and retirees. Officially denied by a spokesman for the AOK Bavaria, that it is this demand from their 3.1 million members. According to reliable information about the fund but plans to offset its deficit by it. Eight to € AOK members pay extra per month. Whether the amount be paid by April or in July, seems to be open. The Board of Directors of the AOK Bavaria wants 15 March to decide. So far, ten members pay health insurance this additional contribution.
anger is the AOK Bavaria, even after termination of the contract doctor in the house. The Health Minister Philippe Rösler (FDP) and Markus Söder (CSU) urge the AOK Bavaria, complete with family doctors a contract for the GP-centered care.
Here are the doctors get more fees than their physicians' association. In addition, tens of thousands of insured has opposed the dismissal of the old general practitioner contract. Here, the Munich prosecutor under investigation for suspicion of fraud against the AOK Bavaria. Showing she has Renate Hartwig, author and chairman of the citizens to Shoulder. (SOUTH PRESS)
03:03:11 employed tests for Type 2 diabetics are unnecessary
The Cologne Institute for Quality and Efficiency in Health Care is of the opinion: blood glucose monitoring for type 2 diabetes does not work.
The health service in Germany have to save, if not the contributions are expected to rise even more. That is why many are already available or in pre-market scientific standing medical and pharmaceutical products under scrutiny. There is the issue: the existing products have an advantage or offer new products an additional Benefit? The Cologne Institute for Quality and Efficiency in Health Care (IQWIG) evaluates from existing studies that meet scientific standards - that is objectively verifiable and which are not influenced by interests.
Based on the Institute's recommendations will be decided by the Federal Joint Committee (G-BA) - the joint self-administration of health insurance, doctors' associations and hospitals. The G-BA determines whether the products are paid for by health insurance at all, and also influenced the decision to be determined market price.
Looking at the significance of the studies on the subject test strips for type 2 diabetics falls on two things: First, set the - albeit few - science-based studies suggest that in stable set, non-insulin-dependent type 2 diabetes no measurable benefit for patients - and no clinically significant disadvantage - in the case of a regular measurement or non-measurement to determine the blood sugar level is. plays for the health of this diabetic group it does not matter whether it is now measured or not, is how the IQWIG. Measure is more expensive, but does nothing.
Even more striking, however, that further study is repeatedly cited as supposed evidence of the benefits of measurement in this patient population, some inconsistencies exhibits. First, both this study and their later supporters in medical journals sponsored almost entirely by the pharmaceutical industry, especially from Roche Diagnostics GmbH - a leading manufacturer of blood glucose meters and test strips. Above all, this study - the so-called Rosso study, published in 2006 - a severe methodological difficulties.
According to a GEK-Heil-aids Report 2008 analysis published in the Rosso study basically two diabetic groups were compared. Those that perform blood glucose tests and as a comparison group of those that do not perform measurements. Significant influence on the outcome however, had the allocation of patients to the respective groups: For it came just those with diabetes in the measured group that was at least one year continuous blood glucose monitoring documented and who had previously suffered no typical secondary disease such as heart attack, stroke, blindness, amputation and kidney failure. In short: At the beginning of the study were those measured clinically with diabetes significantly healthier than the non-control group.
For in the second group were not measured in diabetic patients with complications have already occurred. Nevertheless, the study leader to assert today that it had been the blood sugar measuring, one group a lower disease risk (minus 28 percent) and lower have risk of death (42 percent) brought. Many scientists Rosso study therefore speak from any evidence.
The Bremer health economist Gerd Glaeske keeps restricting the prescription of blood glucose test strips as state insurance fully justified medically. There is "no evidence on which also occupies only approximately, that the use of test strips from treated exclusively with diabetes tablets makes sense," said Glaeske. The evaluated scientific studies have shown that regular blood glucose monitoring in stable controlled type 2 diabetes only minimal benefits "without any clinical significance for the Health offer.
There is also documented by studies anomalies in the health system in terms of uncontrolled prescription of test strips. Thus it has been found were "some far-coated Regulations of 10,000 test strips per person," said Glaeske. There, the question of "whether these individuals, the test strip may have further prescribed or traded. This applies to prescription abuse costs the insured in the GKV to counteract it.
Glaeske stressed that the non-insulin-dependent type 2 diabetics with about three million people by far the largest group of the 4 to 4.5 million diabetics treated were in Germany. It is no coincidence that "three products, which are among the 20 best-selling products in the pharmaceutical market, are test strip products." Critics of the prescription restriction had "more economic interests rather than clinical arguments."
The health economist also said that blood glucose monitoring for insulin-requiring patients with more intensive treatment and related training in advance makes sense. "There's no doubt about it, with four or five test strips daily and annually makes about 1800 to 2000 test strips per patient, the blood sugar control in these patients well."
DAPD / cl (The World)
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