Mr. Magnus v. Stackelberg - deputy Chairman of the German National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) – took stock for the SHI of the end of the legislative period
First of all, the implementation of the concept of nursing care dependency, the appointment services and the anti-corruption law have been identified as positively assessable activities of the great coalition. In addition, the initiation of the Innovation Fund created a legal basis for the development of innovations in the German health care system. The main objective is to overcome the highly sectoral structure of the current insurance system. In regards to the market access of new medical products the introduction of §137 h SGB V for the assessment of high risk classes of medical devices can be seen as a first step. A further assessment – similar to the market access of new drugs (AMNOG-process) – is still pending.
Due to the enormous potential of a great coalition to develop profound reforms, Mr. v. Stackelberg identifies missed opportunities –especially in the hospital sector as well as in the over- and under-supply areas with physicians. Although many individual measures have been initiated, there is no overall strategy embedding these measures. This is precisely the reason why the next government has the central task to develop such an overall strategy for cross-sectoral demand planning. The reorganization of the outpatient treatment in the hospital as well as the “mega-topic” digitalization are further topics for the future government. With regard to the stronger focus on specializations in the hospital sector, the need for clear limitations and responsibilities is obvious. A further step with the focus on quality orientation through the new formation of the IQTiG (Institute for Quality Assurance and Transparency in Healthcare) is still to be pursued consistently.
In the midterm a strict rationalization of services with maximum limits for service-decisions (like the health care system in UK) should not be feared because of the considerable increase in expenditures during this legislative period and the “grotesque” situation that there is an under-supply problem in rural areas on the one hand and a upper-supply problem in metropolitan regions on the other hand.
Last but not least, the question if the dual health insurance system will still continue to exist over the coming years can not be clearly answered today, but in competition to the private HI sector the SHI is well positioned – which by the positive development of the change rates proves.
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