Doctors’ Groups Clash Over Appointment Wait Times, Point Fingers at Budgeting adn Private Patient Claims
Berlin, Germany – A heated debate has erupted within Germany’s healthcare system over the causes of long wait times for doctor’s appointments, with major physician associations directly challenging claims made by the Bentele statement regarding preferential treatment for private patients. The dispute centers on whether prioritizing privately insured patients contributes to access issues for those with statutory health insurance (GKV), or if systemic issues like budgetary constraints are the primary driver.
The controversy began following a statement from [Name of Bentele, if available from context – otherwise, refer to as “the Bentele statement”] wich suggested private patients were being prioritized. This prompted a swift and forceful response from the Virchowbund, an association representing resident and outpatient doctors affiliated with the VDK (Social Association of German Civil Servants and Employees).The Virchowbund dismissed the claims as “greatest nonsense,” pitting its over two million members against practicing physicians.
Dirk Heinrich, federal chairman of the Virchowbund, directly accused the originator of the Bentele statement of relying on “false numbers” and unfairly blaming private patients for appointment availability. He argued that the focus shoudl be on the underlying financial structures of the healthcare system.
“If the lack of appointments is due to the alleged preference for private patients, how does Ms. Bentele explain that the longest waiting times for doctor’s appointments exist in the eastern and rural regions, i.e. where the proportion of private patients tends against zero and at least on paper?” Heinrich stated. “It is solely due to the budgeting that makes it difficult to operate practices. Doctors dates are part of these services.”
The Data Dispute: Hours Dedicated to Patients
The Virchowbund pointed to data from the GKV top association and a 2023 Forsa survey, which indicated an average of 29 hours per week are dedicated to GKV patients. the Central Institute for Statutory Health Insurance (ZI) has calculated that 82 percent of medical contact time is allocated to legally insured individuals. The National Association of statutory Health insurance Physicians (KBV) reported an average weekly working time of around 36 hours in contracted medical care in 2021. However, all parties acknowledge these figures may be outdated.
budgeting as the Core Issue
Heinrich emphasized that the VdK’s members – those with statutory health insurance – are disproportionately affected by the current budgeting system. He called for collaboration rather than antagonism, stating, “Instead of raising your own members against the practical doctors, we should work together on solutions that enable doctors to see more patients again.”
Adding further fuel to the debate, Spifa (Association of Contractual Doctors) also weighed in, presenting data suggesting specialists actually spend more time with GKV patients than contractually obligated. André Byrla, Spifa’s general manager, directly refuted the “private patient myth,” stating, ”The fairy tale of privileges for private patients discredits the specialist. Connect economically lasting fee.” He argued that adequate reimbursement rates are crucial for ensuring access to care.
Understanding the German Healthcare System & the Budgeting Debate
Germany operates a dual public-private healthcare system. The vast majority of the population (around 90%) is covered by statutory health insurance (GKV), funded through contributions from employers and employees. A smaller percentage (around 10%) opts for private health insurance (PKV), which generally offers faster access to specialists and a wider range of services.
The core of the current dispute lies in the Defizbudgetierung (deficit budgeting) system. This system sets fixed budgets for GKV providers, limiting the number of services they can bill for. Doctors argue this creates a financial disincentive to see more GKV patients,contributing to longer wait times. The system was introduced to control healthcare costs,but critics contend it has unintended consequences for access to care.
The debate over private patient prioritization is often linked to the perception that doctors can earn more from privately insured patients, incentivizing them to allocate more appointment slots to this group. However, associations like spifa and the Virchowbund argue this is a misrepresentation, and the real problem is the financial constraints imposed by the GKV budgeting system.
This ongoing conflict highlights the complex challenges facing Germany’s healthcare system as it strives to balance cost control with equitable access to care for all citizens. The debate is likely to intensify as policymakers consider potential reforms to the budgeting system and address the growing concerns about appointment availability.
