The board chairman of the umbrella association of statutory health insurers (GKV), Oliver Blatt, is calling for doctor’s appointments to be allocated by medical need in future and for people with statutory insurance to be better off. “We must organise access to outpatient care in such a way that appointments are allocated according to medical need – and not according to how someone is insured,” Blatt told the Funke media group, as tagesschau.de reported on Saturday.
75 million people are covered by statutory insurance and finance the vast majority of doctors’ fees. Nevertheless, they are often disadvantaged when appointments are allocated – for Blatt a “blatant injustice”. However, according to tagesschau.de, he rejects the term “two-tier medicine”: in hospitals and with most doctors, people with statutory insurance are treated just as well as private patients. The unequal treatment is mainly evident in waiting times. “Doctors should continue to treat private patients, but not automatically give them preference,” demanded the GKV chief.
Federal Chancellor Friedrich Merz had sparked a debate in September about the dual system of statutory and private health insurance. He spoke of a fairness problem if the impression became entrenched that private patients were given preferential treatment, and held out the prospect of changes. With the reform of statutory health insurance, the government aims to curb spending in the healthcare system.
In the Berliner Morgenpost, Blatt pointed to the financial situation of the insurers: the estimation committee expects that the average additional contribution can remain at 2.9 per cent in 2027. That is a calculated figure; the actual average is currently 3.13 per cent. The Contribution Rate Stabilisation Act is having an effect. Blatt sees risks, for example, in the idea of location subsidies for the pharmaceutical industry financed from contribution funds.
The Health Finance Commission appointed by policymakers is due to present proposals for structural reforms in December. These would have to be adopted in time in 2027 so that they can take effect in 2028, said Blatt. He named prevention and digitalisation as priorities. Financial penalties for unnecessary doctor visits, as proposed by DIHK President Peter Adrian with greater cost-sharing and by Doctors’ President Klaus Reinhardt with a kind of malus for insured people who go directly to a specialist, are not suitable in Blatt’s view: the former practice fee had no steering effect.
