Enhancing funding for general practitioners (GPs) aims to improve healthcare services, especially in rural areas. While some GPs are optimistic about the proposed de-budgeting law, concerns persist regarding fair compensation for additional work. Criticism arises from health insurance representatives, who question the law’s potential impact on costs and care quality. Despite assurances from the Health Minister to relieve financial pressures, doubts linger about whether these changes will effectively attract more physicians to underserved regions.
Enhancing General Practitioner Funding for Improved Care
Boosting financial support for general practitioners (GPs) and ensuring superior healthcare services, particularly in rural regions, are the primary objectives of the proposed de-budgeting law. However, the question remains: will these goals be realized? While some GPs express optimism, others, including representatives from statutory health insurance (GKV), raise concerns.
“It’s disheartening to work harder without fair compensation,” shares Susanne Fischer, a GP operating in Pfinztal, near Karlsruhe. The anticipated law from coalition parties aims to secure payment for additional work done by GPs, even when their budget allocations have been exhausted. This change is crucial, as GPs have been limited by a fee cap, which often results in partial reimbursements when they treat more patients than the budget allows. Fischer elaborates, “When a patient comes to see me once a quarter, I might get fully reimbursed. However, if that patient returns a second or third time, the reimbursement significantly drops.”
Understanding the Implications of De-Budgeting
The GKV indicates that all general medical services will be exempt from de-escalation under the new de-budgeting framework. However, Fischer notes that certain services, like sonographies and psychosomatic consultations, still fall under budget constraints. This presents a challenge for GPs, as they need to accurately gauge the reimbursements they will receive and manage their practice finances accordingly.
The introduction of a chronic care flat rate is also on the horizon. Fischer points out that while she may not be able to increase her patient volume significantly, having additional funds would enable her to expand her practice team. This would allow her to delegate more responsibilities to employed doctors and medical assistants (MFAs), thereby improving patient care. “I have to operate within strict financial limits. Without a clear understanding of future earnings, I may struggle to afford additional staff,” she explains.
MFAs currently handle various tasks, such as vaccinations and wound care, which frees up Fischer to focus on more complex patient needs. This, she believes, ultimately allows her practice to accommodate more patients effectively.
Health Minister Lauterbach is also prioritizing improvements in the care provided in general practices alongside hospital reform initiatives. Fischer hopes that the de-budgeting approach will encourage more physicians to establish practices in rural areas, assuring them of adequate compensation and financial stability.
However, health economist Stefan Greß from the University of Fulda expresses skepticism regarding the immediate impact of de-budgeting on rural healthcare. He notes that while the legislation aims to enhance the appeal of rural practice in the long term, previous financial incentives have failed to offset the challenges of practicing in these areas. Many rural regions are already facing a shortage of medical professionals.
Greß acknowledges that de-budgeting may encourage additional services in underserved areas, but questions its effectiveness in more densely populated urban centers. He emphasizes that if these legislative changes could alleviate the overall medical supply shortage, patients would benefit, although he remains doubtful.
Criticism is echoed by GKV spokesperson Florian Lanz, who views de-budgeting as merely an increase in fees for GPs, a group he believes already enjoys adequate compensation. Lanz also highlights the potential burden on patients, predicting that de-budgeting could lead to an additional annual cost of 400 million euros for health insurance contributors, without guaranteed benefits.
In a recent meeting, Health Minister Lauterbach assured that reforms would be implemented to relieve the financial pressures faced by GPs. However, Fischer argues that the notion that GPs do not need additional funds undermines the recognition of their work. “Saying I don’t deserve more money simply because I’m already compensated well is not a sign of appreciation,” she states.
This issue was notably reported by MDR aktuell on January 20, 2025, at 4:10 PM.