Is the future doctor's visit to become a high-end experience?
In a move that has sparked controversy, the German federal government is considering a revival of the practice fee, a policy that was in place from 2004 to 2012. The practice fee required patients to pay ten euros per quarter to visit doctors, with the intention of reducing unnecessary appointments.
However, the revival of the practice fee is met with opposition from doctors and health insurance companies. Dr. Jürgen Peter, board chairman of the AOK Lower Saxony, the largest health insurance company in the state, is against the revival of the practice fee. He believes that the old practice fee did not bring the desired steering effect and was associated with a large bureaucratic administrative burden for practices.
Dr. med. Ilka Aden, chairwoman of the General Practitioners Association of Braunschweig, also rejects the proposed practice fee 2.0. She states that the new fee would impose new bureaucracy and neither the Federal Ministry of Health nor the health insurance companies would pay for the administrative activity.
The AOK Lower Saxony is not involved in the revival of the practice fee, but Dr. Peter suggests that to stabilize the finances, the federal government should take responsibility for non-insurance-related services on the revenue side.
The original practice fee, according to the AOK, had no steering effect. Moreover, it heavily burdened practice teams with additional paperwork. The practice fee was abolished due to its questionable effectiveness and additional bureaucracy.
Doctors and health insurance companies in Braunschweig consider a new practice fee the wrong way and call for reforms that will actually stabilize the system without burdening patients additionally. They argue that further billions can be achieved through reforms in pharmaceuticals and clinics, including reduced value-added tax, higher manufacturer discounts, and stricter audits.
If financed from tax funds, lowering the contribution rate by 0.5 points could be achieved with the ten billion euros that the revival of the practice fee is expected to generate. However, Dr. Peter calculates that the treatment costs for citizens receiving benefits alone burden the insurance companies with almost ten billion euros annually.
An expert group of the Federal Ministry of Health will present concrete proposals for the reintroduction of the practice fee in 2026. The financial instability of statutory health insurance companies is predicted to result in double-digit billion-euro deficits from 2027 onwards.
As the debate continues, it remains to be seen whether the practice fee will make a comeback and how it will impact patients and healthcare providers in Germany.
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