Family doctors association insists on system change

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Dispute between AOK and general practitioners association

Medical Association insists on system change: After the immediate termination of the family doctor contracts on the part of the AOK, the Bavarian Family Medical Association insists on the demand for a system change. An end to the conflict between the health insurance company and the medical association is not in sight.

Yesterday, the General Local Health Insurance Fund (AOK) announced that the general practitioner contract between the Bavarian General Medical Association (BHÄV) and the health insurance fund would be terminated without notice. Just a few weeks earlier, the medical association had announced that it would call on the medical profession to hand in the health insurance approval at the beginning of 2011 in protest against the health care reform. The AOK reacted to this announcement with drastic means and terminated the family doctor contracts without further ado. This means had to be used because the BHÄV committed another “breach of the law” by calling on its members to exit the cash register system.

Despite this drastic measure, the Bavarian Association of General Practitioners remains to renegotiate their fees. As the deputy BHÄV chairman Dr. Wolfgang Krombholz said yesterday that the termination on the part of the AOK does not change the core demands of the association. The medical association continues to demand securing long-term tariff sovereignty, planning security for the future and renewed fee negotiations “at eye level,” said the medical representative. The controversy only started because "because we do not believe in the statutory protection for family doctor contracts that was fixed by mid-2014", argued the BHÄV Vice.

The tones in the argument have increased in sharpness. For the AOK it is "impossible and unreasonable" to work with an association "that behaves illegally in central questions of social legislation, calls others to break the law, and also wants to force the contracting party to a new contract under the threat of an illegal system exit and also publicly disparaged, "said Dr. Helmut Platzer of the AOK Bayern. In addition, the general practitioners association had been warned of the termination before the termination if the system exit was propagated.

In the meantime, other medical associations are showing solidarity with the BHÄV. In a joint statement, the General Practitioners' Association in Baden-Württemberg and Medi agreed to support their Bavarian colleagues. According to Dr. Berthold Dietsche, Chairman of the Baden-Württemberg General Practitioners' Association, and Dr. Werner Baumgärtner, chairman of Medi, must now approach the AOK to the medical association and start negotiations. Both associations also asked their members to show solidarity. This applies in particular to general practitioners who work in the neighboring regions to Bavaria. These should not undermine the decisions of the Bavarian colleagues. The press release of the two organizations says: "We will ask our members not to be available for a transitional pension from Bavaria". "We will not make up for the deficits in medical care, for which politics and health insurers are responsible, in Baden-Württemberg," Dietsche and Baumgärtner agree. "With its threatening gestures against the Bavarian general practitioners and the HÄV, the AOK Bayern shows that it does not want the general practitioner contract and even goes as far as to violate the legal provisions in SGB V," continued Dietsche and Baumgärtner. Both also sharply criticized the AOK threat to cut final payments for the third quarter by around 16 million euros.

Meanwhile, the AOK counters in an equally sharp manner. One cannot allow AOK insured persons to "become the game ball of the BHÄV's political ambitions", explained Dr. Burst. The aim is to provide its 2.6 million members with detailed and comprehensive information. The Association of General Practitioners wants to use its actions to force the AOK to "enforce a new family doctor contract based on the German Civil Code (BGB) and to the exclusion of the Social Code". But one can only conclude contracts with doctors who do not want to return their health insurance. "According to the Social Security Code, it is not possible to conclude a new contract with doctors who have collectively waived their approval," said Platzer.

For patients, this dispute initially means a few restrictions for some health services. Although AOK health insurers can still use their family doctor, patients must now pay the full practice fee again, which was previously excluded from the regulations. The annual health check was also dropped.

The dispute currently appears absurd to many insured. Without being closely involved in the matter, many do not understand what it is all about. In short, as always, it's about money. The medical associations are of the opinion that the tariffs in their current form will not be sufficient to guarantee medical care in the future. The AOK is of the opinion that the negotiated contracts are sufficient. How the conflict develops now depends on both opponents. (sb)

Also read:
AOK Bayern terminates family doctor contracts without notice
PKV and doctors argue about fees
AOK boss: problem with medical oversupply
Dispute between AOK and family doctors escalates

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