German patients rush to doctors before new 10 charge starts
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《英国医生杂志》
Throughout December, doctors' surgeries in Germany, especially in the east, have been overcrowded with patients who want to escape the extra cost of a flat rate "entrance fee" that was due to start on 1 January.
As a result of the recent health reforms patients in Germany will have to pay 10 (￡7; $12) for a visit to their GP, though any subsequent visit in the next three months will be free ( BMJ 2003;327: 250 and 2003;327: 1307). The most visited doctors were GPs, specialists in internal medicine, gynaecologists, and ophthalmologists.
The National Association of Statutory Health Insurance Physicians estimated that about 30% to 70% more patients were seeking treatment than in the last months of 2002. Many patients were keen to get prescriptions for drugs and for glasses, because under the new health reforms part of their costs are not going to be covered.
The argument between doctors, the health ministry, and health insurance companies over how the fee would be administered was solved at the last minute. Doctors had protested about having to take responsibility for administering the fees, which are passed on to the health insurance companies without any compensation for doctors.
An independent board has decided that doctors will have to send letters to remind patients who have not paid the fee, but the postal fees will be refunded to the doctors. The financial risk if patients don't pay the fee will eventually be carried by the association.
J?rg Dietrich Hoppe, president of the Federal Doctors' Chamber (the German medical council), criticised the decision, saying that doctors' administrative costs were not covered. "If the case is not urgent, doctors might send patients away who cannot pay the 10 immediately," he warned.
Patients will also be able to make immediate payment by mobile phone. Doctors can register through the internet with a service number that the patient can call. An email message from the service to the doctor certifies that the fee will be paid. However, this service costs the patient an extra 2.8.(Annette Tuffs)
As a result of the recent health reforms patients in Germany will have to pay 10 (￡7; $12) for a visit to their GP, though any subsequent visit in the next three months will be free ( BMJ 2003;327: 250 and 2003;327: 1307). The most visited doctors were GPs, specialists in internal medicine, gynaecologists, and ophthalmologists.
The National Association of Statutory Health Insurance Physicians estimated that about 30% to 70% more patients were seeking treatment than in the last months of 2002. Many patients were keen to get prescriptions for drugs and for glasses, because under the new health reforms part of their costs are not going to be covered.
The argument between doctors, the health ministry, and health insurance companies over how the fee would be administered was solved at the last minute. Doctors had protested about having to take responsibility for administering the fees, which are passed on to the health insurance companies without any compensation for doctors.
An independent board has decided that doctors will have to send letters to remind patients who have not paid the fee, but the postal fees will be refunded to the doctors. The financial risk if patients don't pay the fee will eventually be carried by the association.
J?rg Dietrich Hoppe, president of the Federal Doctors' Chamber (the German medical council), criticised the decision, saying that doctors' administrative costs were not covered. "If the case is not urgent, doctors might send patients away who cannot pay the 10 immediately," he warned.
Patients will also be able to make immediate payment by mobile phone. Doctors can register through the internet with a service number that the patient can call. An email message from the service to the doctor certifies that the fee will be paid. However, this service costs the patient an extra 2.8.(Annette Tuffs)