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Hospital in Stuttgart: Dispute between the federal and state governments

Photo: Bernd Weißbrod / dpa

The majority of people in Germany would prefer to have complicated treatments carried out in specialized clinics rather than in small local hospitals. This is a result of a new survey that signals support for large parts of Health Minister Karl Lauterbach's planned hospital reform.

The SPD politician will present the next steps for the planned clinic reform this Tuesday. Essentially, it's about how planned reform steps are intended to improve treatments for patients. The dispute between the federal and state governments over the reform continues, as a video link from the health minister showed.

As the states announced after the health ministers' conference chaired by Schleswig-Holstein, they asked Lauterbach to present the promised revised bill for reform. Under pressure from the states, Lauterbach wanted to make changes to the draft. The federal states complained that the amended draft was promised by the beginning of December. The states agree “that the clinics in Germany need clarity quickly about what plans they have to prepare for.”

Three different clinic types

According to the new survey on clinics, which is available to the dpa news agency, 94 percent of people in Germany would go to a specialized clinic for a planned operation - even if it is further away. Forsa surveyed 1,405 adults on behalf of the Techniker Krankenkasse. Five percent would choose an easily accessible clinic, even if it is not specialized.

There was also a question about an assessment of the reform goal, according to which complicated treatments should be carried out in specialized clinics. 66 percent rated the project as somewhat or very good, even if this means that some patients have to take additional steps. A third of those surveyed rated the project as bad or very bad.

With the hospital reform, Lauterbach wants to reorganize clinic financing so that clinics no longer carry out as many treatments as possible for reasons of revenue. The reform is intended to change the previous system of flat-rate payments introduced in 2003. With the system, the clinics generally receive flat rates for each diagnosis and the corresponding therapy, regardless of the length of stay.

According to the new reform, clinics should receive 60 percent of their budget as “reserve compensation,” regardless of operations and treatments. According to the planned law, the clinics will now have to adhere to uniform quality criteria in order to receive the money. A division into three levels should lead to greater specialization: clinics close to home for basic and emergency care, hospitals with “regular and specialized care” and “maximum providers” such as university hospitals.

Before that, however, a transparency law should come. It was initially rejected by the states and is now scheduled to be discussed in the mediation committee of the Bundestag and Bundesrat on February 21st. Patients should soon be able to compare hospitals’ services and treatment quality. A state online atlas is to be created - with information about, for example, the experience of a clinic or staffing ratios. Connected to the law are billions in aid for the clinics.

apr/dpa