(Gemini Audio)
(de-news.net) – Regarding the possible reinstatement of a practice charge for German patients, the National Association of Statutory Health Insurance Funds (GKV) has expressed notable caution. Oliver Blatt, its chairman, underscored that the statutory health insurance system already spends in excess of one billion euros per day on healthcare services, a sum he considered sufficient to guarantee comprehensive provision without additional fees. He argued that discussions about additional patient contributions should only be addressed at the conclusion of broader reform negotiations and insisted that new costs, such as a practice fee, would not lead to any tangible improvement in the quality of medical care. Blatt emphasized the necessity of structural reforms instead, pointing to the importance of curbing the sharp rise in pharmaceutical prices and concentrating inpatient treatments in specialized centers where efficiency and expertise could be maximized.
The proposal to reinstate the fee was also firmly rejected by Andreas Gassen, the head of the National Association of Statutory Health Insurance Physicians (KBV). He recalled that the earlier version of the practice fee, introduced two decades ago, had failed to achieve its intended objectives, particularly the reduction of unnecessary doctor visits. In his view, the measure was excessively bureaucratic and ineffective as a steering tool within the healthcare system. Gassen advocates for an alternative: the introduction of optional insurance tariffs, which would allow patients who agreed to be guided through the healthcare system to benefit from lower contribution rates. He maintained that such steering mechanisms would not deprive patients of services but would encourage a more rational and efficient use of increasingly scarce resources, thereby ensuring sustainability in the long term.
Federal Health Minister Nina Warken (CDU) recently adopted a nuanced position in the debate, reflecting an attempt to balance the need for steering mechanisms with the principle of equitable access to healthcare. She suggested that a practice fee could serve as a potential instrument within a primary care system designed to reduce waiting times for specialist appointments. At the same time, she considered alternative incentives, such as bonuses or rewards for patients who consistently adhered to the general practitioner pathway. Warken emphasized that she regarded a fee for each doctor’s appointment critically, as she did not wish to create a two-tier healthcare system or discourage individuals from seeking medical attention when necessary.
In North Rhine-Westphalia, employer associations have called for more radical reforms to counter rising contribution levels for patients. Johannes Pöttering, chief executive of Unternehmer NRW, argued that the system must be reoriented toward greater personal responsibility. He supported the reintroduction of the practice fee alongside higher co-payments for medications and encouraged a debate on abolishing free co-insurance for spouses who are not on parental leave.
The position was mirrored by the Confederation of German Employers’ Associations (BDA), which proposed adjusting co-payment limits for medication in order to reflect inflation and price developments since 2004. Specifically, the BDA suggested raising the minimum and maximum co-payment levels from the current five and ten euros to 7.50 and 15 euros respectively. Such measures, in BDA’s view, would contribute to cost containment and help stabilize the financing of the battered healthcare system.
