The ENT doctors are on strike. Because of the poorer payment for tonsillectomy in children, doctors have suspended them completely without further ado. There should only be a resumption if the remuneration is better. Lauterbach reacted in horror.
“Until a significantly improved payment by the health insurance companies, no new appointments for tonsillectomy in children should be made nationwide from now on.” This is the somewhat surprising call from the German Professional Association of Ear, Nose and Throat Physicians and the German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery, last Monday. There is nothing else to do “to draw attention to the catastrophic situation and to persuade those responsible to act”.
They justified this with a reduction in the reimbursement amounts at the beginning of the year (partial reform of outpatient surgery) and with the fact that the interventions were no longer economical for the doctors. The doctors would “have to pay extra for every intervention,” said association president Jan Löhler. At the same time, the operators would be “overrun”. The average waiting time for an operation on children is four to five months – and the trend is rising.
According to the association, the problem is that the health insurance companies have pushed the prices down so that outpatient surgery is no longer worthwhile for doctors, and many have therefore long since stopped offering such operations. The result: Fewer and fewer surgeons and (too) long waiting times. A warning had already been given in 2019, but now there was another price reduction on January 1st. Because the general costs are rising due to inflation, the energy crisis and a shortage of skilled workers, this renewed cut is seen as an “affront”.
“It is outrageous how shamelessly some medical associations are trying to get more and more money out of the pockets of those who pay contributions to statutory health insurance and do not even stop at threats to children’s health,” said the Central Association of Statutory Health Insurance (GKV). He accused the medical associations of “excessive and unethical action” and called on politicians to intervene.
Federal Health Minister Karl Lauterbach (SPD) also found clear words: “Letting children suffer in order to extort higher fees is unethical and unacceptable,” he told the “Bild am Sonntag”.
Today, Monday, the ENT professional association drew a first interim balance: 85 percent of outpatient surgeons would take part in the campaign, according to an online survey by the association.
The association also rejected the criticism and also made it clear that the protest could not be expected to end anytime soon. “It is shameful how irrelevant and defamatory the doctors are being treated here. The health insurance companies in particular stand out with false statements and dull populism,” says Löhler. “No doctor will go back to surgery because of being insulted like that. Rather, it has the effect of turbocharging the exit from outpatient surgery.”
The statement by Health Minister Karl Lauterbach (SPD) was also criticized as “outrageous”. The “statements of the minister, which he had announced thanks to close connections in the tabloid media, reveal large gaps in knowledge about the billing system in outpatient care.”
In order to relieve clinics, the government wants more operations to be carried out on an outpatient basis – i.e. without a stay in the hospital. In a first package of measures, the National Association of Statutory Health Insurance Funds and the National Association of Statutory Health Insurance Physicians have decided on a partial reform of outpatient surgery. It has been valid since January 1st.
With the decision, uncomplicated operations (categories N1 to N3, including tonsillectomy) were reduced in remuneration. This means that the doctors get less money from the health insurance companies. Specifically, the focus is on the interventions of adenotomy with tympanostomy tubes and tonsillotomy. Health insurance companies have been paying around 105 euros (minus 6.42 euros) and 170 euros (minus 8.90 euros) for the procedures since January. Complicated operations (of categories N4 to N7), on the other hand, have been raised.
After all, the little patients don’t seem to suffer (at least initially). Because almond surgeries can be postponed. However, the ENT doctors previously reported a waiting period of four to five months – with a strike, this emergency will now continue to expand.
When asked by FOCUS online, the Starnberg ENT doctor Bernhard Junge-Hülsing advises worried parents to visit an ENT practice. “So that either the surgery can be planned for the summer or earlier in a real emergency, but then in a clinic.”
He also supports the protest. Attention is drawn to a condition that has lasted for years. “Child surgeries are underfunded, and children seem to have little lobbying.”