Aims of the health system modernisation act (GMG) from a medical point of view
Richter-Reichhelm, M.
Zeitschrift für Arztliche Fortbildung und Qualitatssicherung 100(1): 11-14
2006
ISSN/ISBN: 1431-7621 PMID: 16524222 Document Number: 595067
Like all its predecessors the Health System Modernisation Act (GMG) means to preserve solidarity-based statutory health insurance and to ensure a sufficient, appropriate and efficient treatment of all patients. The instruments are higher co-payments from patients (such as practice fees), cost containment through exclusion of certain services, and more competition. Competition is supposed to be encouraged through new forms of care. In particular, ambulatory healthcare centres are meant to centralise specialist healthcare services and release profitability reserves. Integrated care is to promote co-operation across various sectors and disciplines facilitated by knock-on financing and an extensive freedom of contract. Decoupling integrated care involves the real danger of drying out regular care and defragmenting the healthcare landscape. GP-based care and disease management programmes are supposed to provide better and more structure to patient care. Extra premiums create an incentive for the insured to largely accept the loss of his right to freely choose his doctors. It remains to be evaluated whether the improvement of patient care and cost reductions can be achieved this way. Competition can only work if equal opportunities are ensured for all providers, which requires abolition of dual hospital funding, implementation of equal quality requirements and reimbursement systems and budgets so that prices may follow performance.