Practice fee 20 euros: Please donate for the health system!

How should you drive it out to us Germans to visit a doctor’s office because of every runny nose and ziepen in the back – or the emergency room? The question arises more and more because the waiting rooms overcrowded and land on land, a lack of doctors is perceived.

The situation would be much more relaxed if patients would deal more responsibly with our fully comprehensive health. And we would all benefit from it if we are really sick.

According to their family doctor, Germans seek ten times a year. This is a top value in European comparison and fifth place worldwide. In addition, the Germans are notorious for medical hopping because the legally guaranteed free choice of doctor allows them to consult specialists almost at will. They can then be removed two or three times three or sent to the MRI, the costs for it get stuck on the solidarity community. And that’s all of us.

Nevertheless, we are not particularly healthy – on the contrary: Although Germany affords one of the most expensive health systems in the world, our is known only in the lower midfield.

So fewer visits to the doctor would probably do it without harm. According to hope, the practice fee could discipline the Germans.

Now it has unfortunately already existed, in the years from 2004 to 2012. It failed at the time. Their goal of reducing the number of visits to the doctor was missed – ten euros per quarter may not be painful enough. According to a study by the Bertelsmann Foundation, patients from low-income layers of doctor visits also saved, which may have had negative health effects.

The practice fee was also a bureaucracy monster: the practices had to issue receipts, manage cash and initiate dunning procedures if the money was not paid. That’s why the doctors didn’t want them anymore. Different now: Different medical organizations, especially the Federal Medical Association, are vehemently advocated for a practice fee.

But how do you make it that she reaches her goal this time? Sounds somehow logical that a fee would help to contain superfluous visits to the doctor, according to a recent survey, even a narrow majority of the population is convinced.

But as with the highway fee, you wonder: Why do we darn again in Germany don’t get something that works perfectly elsewhere? For example, the Swedes have been paying fees for consultations for more than 50 years. These are currently.

The Obolus was introduced there in 1970 to control health expenditure, and that seems to work, measured by the number of visits to the doctor: in the OECD ranking, the Swedes are far back, they only go to the doctor 2.6 times a year. So that things are fair – justice is always very important to the Swedes – the deductible is limited with a maximum amount of around 130 euros a year. There are exemptions, for example for asylum seekers or recipients of disability pensions.

Do the rare medical contacts lead to the Swedes are sicker or sink into the grave earlier? Not at all. Live over three years longer than German, Swedish women at least two.

Of course, this higher life expectancy has many causes, but a conceivable would be that the Swedish primary physicians – the counterpart to the general practitioners – take a lot more time for their patients: in Germany.

According to a study, the lower limit for a visit to the doctor is five minutes. If it takes shorter, he can hardly fulfill his purpose. In addition to poor communication, the negative consequences of short doctor contacts are also more prescribes in some cases, sometimes unnecessary medication, especially often antibiotics.

The German doctors are just above the five-minute limit. Ten visits to the doctor a year do not help much if a patient’s illness situation is complex.

Swedish patients rarely visit doctors, but have more quality time there. You get rid of your worries and needs, and your doctors have enough time to inquire, make better diagnoses and carefully weigh therapies instead of just picking up the recipe block quickly.

It might be good that the need for many patients to consult new doctors to their symptoms would decrease.

So that this can also be achieved in Germany, the conversation time would have to be paid better, otherwise it will remain unsatisfactory 7.6 minutes. But that is a very old topic: speaking medicine has never been paid fairly in Germany.

Let’s try a conclusion: Basically, the practice fee seems to be a sensible instrument in order to reduce the number of often unnecessary medical contacts. However, it must be embedded in a health system in which it can also meet this purpose. It must be socially just. She must take into account that chronically ill often have to go to the doctor and allow exceptions for socially disadvantaged. Regulations have to be found so that it does not become a bureaucratic monitor again.

Can all of this succeed in Germany? I Doubt it. But it would be nice.