Health: Lauterbach has no understanding of doctors’ strikes

Health Minister Karl Lauterbach has promised better working conditions in the face of doctors’ protests with closed practices, but continues to reject calls for more money. “I don’t see any scope for fee increases,” said the SPD politician on ZDF. Practices need less bureaucracy and money needs to be distributed more fairly. The minister has announced a meeting for January on improvements, especially for family doctors. Criticism of practice closures also came from the traffic light coalition and the statutory health insurance companies (GKV).

Medical associations had called for practices nationwide to be closed between the years. The action, planned until this Friday, is part of the “Praxis in Not” campaign. The chairman of the Virchow Association of resident doctors, Dirk Heinrich, said on Thursday that Lauterbach’s reaction shows that the protests are right and important and that we probably need a longer breath. “We have this staying power.” It is not about increasing doctor’s income, but about sufficient and sustainable financing of the existing outpatient structures.

Calls for an end to fee caps

One of the demands is to put an end to “budgets” with maximum fees for all specialist groups. In addition, a repealed regulation with extra fees for new patients in practices should be reintroduced. There are also complaints about overwork and too much bureaucracy, for example for billing and clarifications with health insurance companies. The Virchowbund was initially unable to provide any information on the number of practices involved because the strike was organized decentrally. Tens of thousands of practices were expected to be closed. They were called upon to provide representation in emergencies.

The Green Party health expert Janosch Dahmen criticized the actions between the holidays. “Many practices are already closed,” he told the German Press Agency. Patients should be able to rely on being able to receive treatment from their doctor in an emergency. “Instead, emergency care colleagues now have to step in, for example in hospitals, where people need help in an acute situation.” Strikes on the backs of patients in need of help are the wrong medicine. “Instead, next year’s main focus must be on strengthening the role of general practitioners and pediatricians.”

GKV boss: Employees would have to pay for wage increases

The head of the National Association of Statutory Health Insurance Funds, Doris Pfeiffer, told the editorial network Germany: “What doctors or pharmacists want to get more, the supermarket cashier and the truck driver have to finance with their health insurance contributions.” They also suffered from the increased prices. The gross net income of practicing doctors has increased on a nationwide average in recent years. Lauterbach said on ZDF that he did not consider demands for more money to be justified. “Apart from Switzerland, of course, nowhere in Europe do practices earn as well as in Germany.”

Lauterbach said: “Simply pouring more money into a system like in the past – which doesn’t really work well – we have simply practiced this solution too often. It will not be in the foreground.” However, the specific focus for a “crisis summit” in January is better conditions, especially for general practitioners. For them – as for pediatricians – the fee budgets should be abolished, as ministry circles said.

Income and expenses of the practices

Medical practices generate more than 70 percent of their income from billing the statutory health insurance companies. According to the latest information from the Federal Statistical Office for 2021, the average income was 756,000 euros. This was offset by expenses of 420,000 euros. This resulted in an average net income of 336,000 euros per practice. However, this value is influenced by practices with very high income and expenses, it was said. Around half had income of up to 464,000 euros and a net income of up to 233,000 euros. The information also refers to group practices and care centers with several doctors.

The statisticians explained that the net income cannot be equated with the profits or income of the doctors. It represents the results of the financial year for the entire practice, but does not take into account, for example, expenses for old-age, disability, survivors’ and health insurance for the practice owners. Personnel costs are included in the expenses. According to the Virchowbund, income tax and investments in medical devices also have to be paid from this. On average, less than a quarter of the total fee turnover remains at the end.