The small Christmas tree in the hallway in front of the waiting room is already starting to pine, the water bowl in the stand is dry.

Nobody has time to water at the moment, says a receptionist, "You can see what's going on here".

In the pediatric practice in Berlin, all the chairs are occupied, many people waiting have to stand.

"Anyone who hasn't already caught a virus will get it here in the crowd," says a mother with gallows humor.

Most of the boys and girls suffer from cold symptoms, cough, runny nose, sore throat, some have fever.

Christian Geinitz

Business correspondent in Berlin

  • Follow I follow

A pathogen with a complicated name is hitting particularly hard this winter, the human respiratory syncytial virus, or RSV for short.

Almost all children go through the disease in the first years of life, but many infections did not occur during the Corona period.

Probably because of the closure of kindergartens, schools, leisure facilities, because of contact restrictions and distance rules, because of increased hygiene and masks.

"Now many people who have been spared so far are getting infected," says the pediatrician with the battered Christmas tree.

"We have two waves at once and don't know where our heads are."

Instead of 70 patients, there are currently 90 and more

She doesn't have much time to talk, instead of 70 small patients, 90 or more come a day.

Does this mean that in practice the ruble rolls in the days leading up to Christmas?

"I have no idea, we'll take care of the billing later," says the doctor.

"But the fact of the matter is that every additional case brings in less and less."

This is due to the complicated billing process in the statutory health insurance (GKV).

The total remuneration is fixed and is distributed according to certain keys to the disciplines and ultimately to the individual doctors.

This creates budgets for a certain number of patients.

If a doctor exceeds this cap, the average fee falls.

Once the limit has been reached, there is little incentive for additional treatments.

In order to change that in the current exceptional situation, Federal Minister of Health Karl Lauterbach contacted the bodies that negotiate the remuneration, the National Association of Statutory Health Insurance Funds and the National Association of Statutory Health Insurance Physicians (KBV).

In a letter available to the FAZ, the SPD politician writes that, according to the findings of the Robert Koch Institute (RKI), the rate of acute respiratory diseases is already "above the level of previous years at the peak of severe flu waves".

The number of visits to the doctor also reaches such “peak values”, especially in pediatric and adolescent medicine.

Exception without declaring a special threat

Lauterbach therefore wants to remove the remuneration from the upper limit on expenditure in the so-called morbidity-related total remuneration.

This is possible if the evaluation committee of the KBV and the central association determines an "unforeseeable need for treatment", as it has already done with flu waves.

In his letter, Lauterbach asks the committee to clear the way by Jan. 20 so that pediatricians can receive "a short-term improvement in compensation" for services rendered through at least the end of March.