Berlin doctors shut doors to protest draft health insurance law

Around 2,000 doctors in the German capital shut their offices Wednesday for a one-day protest against a federal draft law that could make it harder for new patients to get timely appointments.

Berlin doctors shut doors to protest draft health insurance law
Dr. Kerstin Zeise is one of about 2,000 Berlin doctors who shut their practices on 7 September 2022, to protest a proposed law that could make it harder for new patients to get appointments. Photo: picture alliance/dpa | Christophe Gateau

With around 7,000 practices in Berlin in total, the 2,000 closed practices represent just under a third of all doctor offices in the city. Last week, patients at these practices with appointments scheduled for Wednesday, September 7th received phone calls telling them to rebook for another day.

The temporary closure is part of a mass protest against a new federal draft law from federal Health Minister Karl Lauterbach (SPD). If passed, Lauterbach’s plan would cancel the “new patient” regulation passed in 2019. That law tried to make it easier for incoming patients to get appointments—by giving additional financial incentives to doctors willing to take on new patients.

To help control costs, German law limits the number of consultation hours or patient appointments a doctor gets paid for by the public health insurance funds (Krankenkassen). Before 2019, this cap stood at 20 consultation hours a week. The new patient regulation raised this cap to 25 hours and made extra money available to doctors taking new patients.

Lauterbach now wants to cancel this due to the financial strain Covid-19 put on Germany’s health system. If he does so, the cap will go back down to 20 hours and the extra money for new patient care will end, reducing the number of available appointments patients can book.

Kassenärztliche Vereinigung (KV) Berlin — an association of doctors covered by German public health insurers — called for the protest, arguing that the situation was already dire in the capital. Many doctor practices in Berlin are already turning new patients away, while at some offices, appointments need to be made weeks or even a month in advance.

READ ALSO: Why more than 20 million people in Germany face higher health insurance costs

KV Berlin says Lauterbach’s plans will only make that worse. “Medical care for new patients in particular would quite possible be limited again,” KV Berlin said in a statement, adding that new patients would probably find it even harder to find new practices or get timely appointments.

Patients needing emergency care on September 7th were asked to seek it directly from KV Berlin or to visit the emergency room at their nearest hospital. 

Member comments

  1. It seems public healthcare is not all it’s cracked up to be. When I call to make appointments, I’m met with apologies and an offer weeks or months away, until of course, I mention I’m private pay, then, their schedule suddenly clears up.

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‘Breaking point’: Why German pediatric wards are filling to capacity

Overcrowded patient rooms, days-long stays in the ER, transfer of sick babies to hospitals more than 100 kilometers away: the current wave of respiratory syncytial virus (RSV) infections in Germany is pushing children's hospitals to their limits. 

'Breaking point': Why German pediatric wards are filling to capacity

The German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) said on Thursday that there was a “catastrophic situation” in children’s intensive care units. 

According to the physicians, a wave of respiratory syncytial virus (RSV) infections can be expected every year starting in the autumn. 

Yet this year “there are fewer and fewer pediatric hospital beds available overall” as well as a lack of nursing staff, Divi Secretary General Florian Hoffmann explained Wednesday on ZDF’s Morgenmagazin.

Because all beds were full in one case, a child was transferred from the Hannover Medical School (MHH) to Magdeburg on Friday night, a distance of around 150 kilometers. 

“My colleagues had called 21 clinics,” said Gesine Hansen, Medical Director of the MHH Clinic for Pediatric Pneumology, Allergology and Neonatology, told DPA. 

The child, who was about one-year old, had an RSV infection, which can be life-threatening, especially for babies and children with pre-existing conditions.

READ ALSO: 7 things to know about visiting a doctor in Germany

‘Catching up’

Some health experts have said that hospitals are now filled to capacity because children had minimal social contact during the pandemic and are now catching up on infections.

According to the Robert Koch Institute (RKI), an estimated 5.6 severe cases of RSV respiratory illness occur worldwide per 1,000 children in the twelve months after birth. 

Within the first year of life, 50 to 70 percent would typically have experienced at least one infection with RSV, and by the end of the second year of life, nearly all children should have experienced at least one infection. 

In the wake of protective measures against Covid-19, however, many such infections had temporarily failed to materialise. 

‘Breaking point’

According to Divi, hardly any clinics had a free crib or free pediatric intensive care bed in the past few days.

“Children have to lie in the emergency room for days,” Hoffmann said.

Yet the peak of the current wave of respiratory infections in children has by no means been reached, Hoffmann said. “The situation in practices and clinics will get even worse in the coming weeks.”

“We are at the breaking point,” said Matthias Keller, head of the Children’s Hospital Dritter Orden Passau already. The rooms are often double-occupied, he said. In some cases, there were too few monitors and not enough equipment for respiratory support.

READ ALSO: Flu season makes a comeback in Germany

A child with RSV being treated at the Olgahospital in Stuttgart. Photo: picture alliance/dpa | Marijan Murat

“Some patient rooms are like bed storage areas, where you really have to crawl over the beds to get to the sick child, because the parent bed is lined up with the patient bed,” said Keller, who is also chairman of the South German Society for Pediatric and Adolescent Medicine.

This has far-reaching consequences for other young children who need treatment. When an infant who has just been resuscitated is admitted to a children’s hospital that is actually fully occupied, a three-year-old has to wait there for the third day in a row for his urgently needed heart operation.

‘Responsibility of politicians’

A wave of infections usually lasts six to eight weeks. In Bavaria, Lower Saxony and Berlin, as well as North Rhine-Westphalia, clinics are reporting a “maximally tense situation,” reported Divi on Thursday.

The Düsseldorf University Hospital, for example, is experiencing a wave of influenza among its young patients in addition to the RSV wave, which is “causing massive problems primarily for children up to elementary school age,” said University Hospital spokesman Tobias Pott.

In the Rhineland, “all beds are completely full” at times, said Jörg Dötsch, president of the German Society for Pediatric and Adolescent Medicine. An ER waiting time of six to seven hours is not uncommon, he says. 

“It is very unpleasant when children and their families have to virtually camp out in the emergency room,” says Dötsch, who is also director of the Clinic for Pediatric and Adolescent Medicine at the University Hospital in Cologne. 

READ ALSO: Healthcare in Germany: How to get a faster appointment with a specialist doctor

What are the solutions?

At their meeting on Thursday in Hamburg, intensive care physicians and intensive care nurses will discuss approaches to solving the crisis. 

One solution may be to temporarily bring nursing staff from adult facilities into the children’s hospitals, says Hoffmann, who is also a senior physician at Dr. von Hauner’s Children’s Hospital at the University of Munich. 

But above all, he says, many more pediatric nursing staff need to be trained. “We need to strengthen nursing,” he explained. “Only then do we have a chance.”

Others said more money needed to be invested in pediatric medicine and vaccines, even if it is less profitable.

“The fact that children’s lives are currently in danger is the responsibility of politicians,” said Jakob Maske, spokesman for the Professional Association of Pediatricians and Adolescents.

“Nowadays medicine has to be profitable – not cure diseases, but make money.”

READ ALSO: How private investors are buying up healthcare practices in Germany