GKV association criticizes refusal of doctors



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According to a survey, half of the physicians surveyed have not yet undergone treatment due to cost pressure. The umbrella organization of health insurance companies made it clear that doctors risk their approval if they do not provide the necessary health services.

According to a survey by the Allensbach Institute on behalf of the financial service provider MLP, every second doctor has withheld health care from a patient for cost reasons. Twelve percent of the physicians surveyed even stated that they had not carried out the necessary therapy several times due to the cost pressure. The umbrella organization of statutory health insurance companies (GKV) reacted with outrage to the results of the study. So said the chairwoman of the GKV association, Dr. Doris Pfeiffer, treatments that are medically necessary, are paid "without ifs and buts" by the health insurance companies. Doctors should withhold the necessary measures from patients, however, if the question of whether such handling does not violate the professional ethics.

The majority of doctors have never carried out the necessary treatments
When asked by the Allensbach Institute, general practitioners admitted that they would refuse certain treatments to their patients for cost reasons. According to the survey, 55 percent of the doctors surveyed nationwide stated that they had “never” carried out important treatment. 12 percent of the doctors even said that they had not used treatments several times due to cost pressure, as the head of the institute, Renate Köcher confirmed. The cost pressure seems to be a bit higher among general practitioners, here 62 percent of the doctors said that they had already given up therapy. The number of doctors in hospitals was almost half (49 percent). A total of 500 doctors were interviewed in the survey.

The head of the GKV association appealed that doctors should not push their patients to unnecessary individual health services, which would then have to be paid out of their own pocket. If general practitioners invoice health services separately, even though these are covered by the health insurance companies, there is a risk of withdrawal of the health insurance approval. "Anyone who is denied medically necessary services should definitely contact their health insurance company," said Pfeiffer.

Medical Association: Essential health services not affected
The deputy chair of the German Medical Association, Dr. Frank Ulrich Montgomery said that the Allensbach result should make everyone think. However, the doctor's representative pointed out that this is not about vital health services or emergency situations, but about treatments "that can be postponed." To date, no cases have become known "where patients have been harmed."

Some treatments have not been scientifically proven
Patients also repeatedly state that they feel that they have not received health care from their doctor. The GKV chairman, on the other hand, holds that there has been this "blanket claim" for years that treatments are being refused by the health insurance funds. However, there is often no concrete evidence for this. In this context, the health insurer pointed out that the benefits of many therapy and examination methods are scientifically doubtful and are therefore not funded. “Today we still spend a lot of money on examinations and treatments that either don't help the patients or, worse, even harm them. Only if examination and treatment methods have proven their usefulness and harmlessness in studies do they belong in the general care. The safety of patients must be the top priority here. ”However, this still includes many naturopathic health methods, although in practice these have repeatedly proven to be helpful for the patient. Only gradually are treatment methods such as acupuncture also recognized as a health insurance benefit. (sb)

Also read:
Do doctors disregard important treatments?

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