Pay attention to grown structures
Lauterbach is more flexible when it comes to hospital reform
02/23/2023, 7:39 p.m
Federal Minister of Health Lauterbach is at odds with the federal states in his plans to reform the hospital landscape in Germany. Now he signals to take a step towards her. There should be flexibility and talk about opening clauses.
In the struggle to reorganize hospitals in Germany, Federal Health Minister Karl Lauterbach is open to more flexible regional solutions, but insists on uniform rules. Opening clauses should now be discussed for this, as the SPD politician made clear after consultations with the federal states in Berlin. This is necessary because otherwise established structures would change too quickly. Nationwide, however, it must be specified what is possible. The costs of the reform are still unclear.
Lauterbach said: “It cannot be that a cardiological department in Hesse is defined differently than in Baden-Württemberg.” Because the planned reimbursement of costs for the provision of certain services should also be identical nationwide. As an example of possible opening clauses, he cited the need for a special department for strokes. However, the specification could be considered fulfilled if it is present in a neighboring house in the network.
The legislative plans should aim to classify the clinic network into three levels of care and to finance them accordingly – from basic care close to home to a second level with other offers up to maximum care providers such as university clinics. The planned second stage is in view of possible opening clauses.
countries are under pressure
The countries are putting pressure on it. The chairman of the health ministers, Manne Lucha from the Greens in Baden-Württemberg, said that the corresponding ideas of an expert commission could not be transferred to all countries in the same way. He warned against “prerequisites that are too rigid”. The Bavarian Minister Klaus Holetschek from the CSU called opening clauses “indispensable”. Otherwise the supply threatened to deteriorate. Hamburg Senator Melanie Schlotzhauer from the SPD made it clear that the federal government would also share in the costs of the transformation.
Lauterbach said that the amount of the costs is not yet known. The question of who finances it and what role the federal government plays in it only arises when a concrete model is available. The representatives of the federal and state governments spoke of constructive consultations. According to the information, four more meetings have been agreed. The Federal Council must approve the legislative plans.
The financial role of the federal states is also being targeted in the reform. Lauterbach told the “Handelsblatt”: “First of all, the federal states not only have the right to plan the hospitals, they also have the obligation to invest in the hospitals.” Clinics and health insurance companies have been demanding more money for this for years.
Funding is twofold
All in all, the expenses for the approximately 1900 clinics make up the largest individual item in the statutory health insurance funds. According to the association, it was more than 80 billion euros in 2021 and thus about every third euro measured in terms of all service expenditure. In general, the financing of the hospitals is divided into two parts: the operating costs, including staff, are paid by the health insurers, investment costs such as for new buildings or new equipment are to be financed by the federal states.
The German Hospital Society recently complained that the federal states had not complied with this obligation in 2021 either. An investment requirement of 6.7 billion euros would have faced 3.3 billion euros in payments. The problem of “massive underfunding” that has been known for three decades is continuing.