Rationing (prioritizing) in the German national health service and the health of the German population - the facts

Written by, and translated from the German original by, Dr. Angelika Schaumberg

The German Medical Association (Bundesaerztekammer) considers that safeguarding good medical care is one of its tasks {6}.

Not only patients but also doctors benefit from good medical care for the whole population. And all benefit who are working in the German national health service, almost every ninth employee in Germany.

According to media reports Dr. Frank Ulrich Montgomery, Vice President of the German Medical Association, considers that medical services provided by the German national health service should be limited. He proposes a general prioritizing (rationing) of medical services {1}. The question arises: why? However, no facts are provided.

The facts are given in the recently published report 'In the German national health service, is the medical care available to over a quarter of the German population, to the socially disadvantaged, being restricted?' {2}. These facts need to be considered, if decisions are made about the medical care of the German population. The report describes clearly and comprehensively, how rationing would affect the health and medical care of the German population, under headings such as:

How many people could not afford to pay privately for denied services, if medical care is rationed

How poverty affects health

Whether money is lacking in Germany

How much is being spent on health

The effects of rationing of medical services, on the treatment of patients, on doctors, on hospitals

A comparison of the money being provided for the national health service with the aid money paid by the German state to unsuccessful banks and companies

The media reported recently that many Germans earn less today than 20 years ago, if inflation is taken into account. And the average income of doctors in Germany shrunk by 50% in the years between 1990 and 2008 {3}. This happened while the German Medical Association was in being and is neither in the interest of patients nor of doctors.

The German population does not deserve that their medical care is rationed only to give many thousand million Euro of tax money to unsuccessful banks and companies, directors and managers.

Why is the German population not being asked - everybody is a patient at some time during his life - how much money is to be spent on health and the national health service? Why is the German population not being asked if many thousand million Euro of their hard earned tax money should be given to unsuccessful banks and companies, managers and directors and their bonuses? In this context it is worth while having a look at Manfred Davidmann's report 'The Style of Management and Leadership' {5}.

It is possible to avoid that by rationing over a quarter of the German population receive only limited medical services.

We, the people in Germany, have to decide how much money is spent on the German national health service. Everybody in Germany should and can get good and all embracing medical services. All of us should stand up for it, patients and doctors together.

I agree with Heinz Stuewe, chief editor of the German magazine for doctors (Deutsches Aerzteblatt, published by the German Medical Association), saying "One should not have to look at America to know what really counts: a good medical service for the whole population."{4}

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