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Cancer, chronic lung diseases or diabetes: many people suffer from previous illnesses which, in the event of a Covid 19 infection, could lead to a severe or even fatal course.

They should therefore be given preference when vaccinating - everyone agrees on that.

On the other hand, there is heated argument about how this should happen - and to what extent the insurance status may play a role.

So far, the federal and state governments have failed when it comes to the crucial question of who in Germany has any previous illnesses.

The authorities simply lack the data.

In contrast to the statutory health insurances (GKV): You have almost all information about diagnoses of high-risk diseases.

On this basis, they could inform those affected and invite them to vaccinate - quickly and easily.

Even data protection would still be preserved.

Further bottlenecks in general practitioners' practices

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Currently, all those affected, as stipulated by the vaccination ordinance, have to make a detour via their family doctor and have a certificate issued there.

With this you must then submit an application to the responsible health department.

This is time-consuming, bureaucratic and unreasonable for people who are at risk.

In addition, there is a risk of further bottlenecks in the allocation of appointments in general practitioners' practices.

Nevertheless, most countries refuse to accept the support of the health insurance companies.

They refer to the vaccination ordinance, which does not provide for cooperation with the health insurances.

In addition, each case must be assessed individually, and it cannot be decided on the basis of a diagnosis whether someone should be preferred for vaccination.

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In addition, some data are not complete.

But the pressure on the authorities to give up this defensive stance is growing.

Privately insured would then have a major disadvantage.

Privately insured persons are excluded

This is shown by a Berlin advance.

Here the Senate Administration wants to use the billing data of the Association of Statutory Health Insurance Physicians (KV).

The KV should send invitations to the chronically ill between 65 and 70 years on the basis of diagnoses made.

That is about 60,000 Berliners, according to a statement from the KV.

The first letters with an appointment booking code should be sent at the end of the week.

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The biggest problem with this: KV only has data on SHI patients.

Privately insured persons are excluded from this procedure.

This applies above all to doctors, civil servants and state employees such as police officers or teachers, entrepreneurs and many high-income earners.

They would also prefer to be vaccinated in the event of a previous illness, but would have to go through the family doctor.

Code also specifies the vaccine

In Bremen, too, the responsible authorities are committed to cooperation with the health insurance companies when inviting vaccinations for risk groups.

The local AOK, in particular, was very involved.

"We want to spare our insured the unnecessary bureaucracy," said a spokesman.

The insured should receive a letter from the AOK explaining why they were selected.

In addition, the code for the registration should be included.

In this code it should also be stored which vaccine is to be vaccinated in the patient.

In addition, the invitations should be sent out in stages so that hotlines are not overloaded.

At the same time, data protection would be preserved: the authorities only receive information from the health insurance companies about how many patients suffer from a severe or moderate previous illness.

Based on this, they provide the codes for the vaccination appointments.

However, the codes are again assigned by the cash registers.

Critics also see problems with data protection

The process therefore has great advantages.

However, it is only easy to use in SHI patients.

The private health insurances cannot access the data of their insured persons in this form.

Due to the reimbursement principle, the data are not complete.

Many people do not submit invoices at all because of the deductible, and there is no systematic evaluation.

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The outrage is correspondingly great here: The rushing ahead of the Berlin Senate to try a different solution when informing people about their vaccination appointments is inadequate, said the chief lobbyist Florian Reuther.

"This grossly violates the legal right to equal treatment for all citizens."

With the plan of the Berlin Senate, contrary to the provisions of the Corona Vaccination Ordinance, the group of authorized persons who are informed about vaccination appointments is limited to those with statutory health insurance.

In this way, the Berlin Senate would exclude those with private insurance.

The use of medical billing data for third-party purposes is also problematic in terms of data protection law.

In addition, there is no information on hospital treatments in the KV data.

And even within the statutory health insurance there are not only advocates of this procedure.

The Techniker Krankenkasse, for example, criticizes the fact that some of the data can be older than six months.

If patients fall ill during this period, they are not invited and would have to go to the family doctor.

According to TK assessment, cash register data could therefore only serve as a supplement to the medical diagnosis of an existing illness when implementing the vaccination ordinance, so as not to disadvantage people with relatively recent diagnoses. A path that Bremen will initially take - if the vaccination regulations are not changed and support from the health insurers is possible. The fear of putting someone at a disadvantage is obviously greater than making everyone equally bad.