Survey: Health insurance funds' financial situation worsening again - we're all being fooled. By politicians who promise to lower contribution rates and naturally can't. By funds that are supposed to represent our interests but naturally don't. By doctors who promise cooperation in cost reduction but naturally don't want to give up their income (*). By pharmacists who are supposed to serve as a trusted source for patients but have long since lost that trust.
Of course, the contribution reduction for employers - there's always money for that. Only the patients, they have to pay for all of this again. Funds, doctors, and pharmacists, on the other hand, sit on their vested interests and refuse to contribute even minimally to a reduction that would also affect their income.
Funds then do great things like the family doctor model and the in-house pharmacy model - but it doesn't help if the doctors simply refuse to participate (which happens here in Münster quite often). Correct billing of the practice fee is also rarely experienced - if a prescription is simply picked up, without the doctor providing even a bit of service (except for his signature), if the medication has been taken for years - doesn't matter, the practice fee is quickly taken again.
Quality control of doctors? No show - they refuse, that would be too much influence for the patient. So they continue to hide behind the allegedly free choice of doctor - which has long since become laughable only through the emigration of specialists from the associations of statutory health insurance physicians. In some specialties, as a statutory health insurance patient, you only have a chance in the hospital to meet a really qualified doctor - outside you only find quacks ...
At the same time, more and more politicians and functionaries of the various associations are talking about patients taking more responsibility and having to bear more of the costs. Of course, we are supposed to trust the doctors in consultation. We are supposed to trust the pharmacists in choosing the drug manufacturer. We are supposed to trust the funds in billing. How are we supposed to take on more responsibility in such a situation that is based on trust without control? What does taking responsibility mean in this context at all - it's not about responsibility, it's solely about cost shifting. And risk shifting: What, your complaints have worsened because you stopped the treatment too early because of the costs? Your own fault, why do you do such a thing. If patients are asked to take more responsibility, they must also be given the means to do so in the form of possibilities of influence and controls. Otherwise, these are just empty phrases.
Doctors receive preferential treatment from the pharmaceutical industry and then obediently prescribe their results - it's so conveniently practical and comfortable and you benefit from it. The funds sit there and deal more with their own bureaucracy and their own security than with keeping an eye on the doctors and ensuring that this very connection to the pharmaceutical industry does not get out of hand. The pharmacists fight for the preservation of their privileges and go against any alternative form of drug supply and argue with their consulting services - which, however, de facto often no longer exist, if in a pharmacy only one or two trained pharmacists work, the rest are at best better drugstore clerks ... (and the main turnover in pharmacies is made with care products, gummy bears and all kinds of obscure nonsense - hey, why should one trust people who offer homeopathic nonsense and "advise"?)
And the pharmaceutical industry? They are the laughing fifth in the background. Decent profit margins, of course, reduce jobs, because the margins have to increase. In principle, monopolies through absurd patent policy (I recall the nitrogen patent from Linde - which fortunately was overturned) and an increasingly opaque approval bureaucracy. Of course, medicines must be tested before approval - but what the current tests really bring, one has seen in various cases recently (Lipobay, Vioxx and other COX-2 inhibitors - just to name two cases).
What is needed is a much more radical restructuring of the health system, a restructuring designed to enable the patient to actually take responsibility, because he is given the information he needs for this and because he is given advisory facilities that support him in this.
Separation of the billing system and the control function in the funds - the control function is not sufficiently exercised by them anyway, it belongs to independent institutions financed by mandatory contributions from those involved in the health system (doctors, pharmacists, pharmaceutical industry and proportionally health insurance contributions).
The billing procedures should be handled by independent accounting offices for patients and doctors, which should only finance themselves through their billing services - this is already common practice in the economy, where billing services are outsourced to separate companies that are then financed by shares in the cost savings of the parties involved.
More transparency in the pharmaceutical industry - research results must be released if a company wants to obtain approval for medicines. Many research institutions are partly state-financed anyway or are close to universities through their state affiliation. A transparent testing guideline for medicines must be introduced - one that scientists and physicians can understand and in which these people are involved, so that problems can be detected earlier - and cannot be concealed by the company (as was the case with Vioxx).
At the same time, effective cost control for medicines must be introduced - the justifications with research costs are not sufficient here, the whole thing must be traceable. If you add up the alleged research costs of the pharmaceutical industry from various medicines, you eventually reach the point where the gross domestic product is generated alone in the research institutions of the pharmaceutical industry. Here, there must be much greater transparency in order to effectively prevent price gouging for medicines.
And the pharmacists? Sorry, but they simply have to think about what role they still have. This would include that they take their consulting services seriously again and concentrate on what their task would be: the application advice for medicines and the advice on the use of non-prescription medicines. However, a specialist saleswoman with a drugstore education cannot provide this. Justifying one's own existence with a sales monopoly for medicines is certainly not enough. And reading the package leaflet is not enough either.
(*) Here, of course, doctors in hospitals are excluded - their job is then pretty much the last in the health industry and decent working hours cannot be spoken of for them.
