Persuading Doctors

Gadfly minister Jens Spahn takes on German healthcare

121. Deutscher Ärztetag
"Can't you see? I'm not doing this for me." Source: DPA/Picture Alliance

Jens Spahn may one day become the next chancellor, but he first needs to succeed in his new job as health minister. That means bringing real change to a system that scores well in international rankings but is seen as unfair by many patients. For that, he’ll need Germany’s doctors on his side.

One of Mr. Spahn’s main priorities is addressing an inequality that sees privately insured patients in Germany — around 11 percent of people — get faster appointments with specialists. Doctors tend to earn more from private patients than from the overwhelming majority who are insured under the statutory system.

The 37-year-old, seen as a rival of Angela Merkel’s ally Annegret Kramp-Karrenbauer, also wants to increase the dwindling number of doctors in rural areas and combat a chronic shortage of care personnel, he told physicians at the annual conference of the German Medical Association in Erfurt on Tuesday.

The speech is an attempt by Mr. Spahn to rouse support from the nation’s doctors. The association is a powerful body because it makes rules governing the medical profession. But the association is less enthused with Mr. Spahn and especially his proposal to increase consultation hours for doctors in the statutory system from 20 to at least 25 hours a week.

“I know, of course, that there are debates and that we will wrestle with each other on some issues.”

Jens Spahn, Germany's Health Minister

Yet that did little to deter the Christian Democrat politician from reiterating his plans to present draft legislation that would boost consultation hours before the parliament’s summer break. “I know, of course, that there are debates and that we will wrestle with each other on some issues,” he told the audience of doctors, who gave his speech a somewhat cool reception.

In a bid to mollify the grumbling physicians, he reminded them that his conservatives had averted plans by the center-left Social Democrats to scrap private health insurance all-together and create a single medical insurance system for all. The health reforms agreed to in lengthy coalition talks between the two parties are far less radical than the SPD had wanted.

Predictably, doctors are demanding more money for increasing their hours. They also pointed out that their work consists of far more than seeing patients — they spend many hours analyzing diagnostic findings, making house calls and attending training seminars, bringing their average working week to 52 hours. Mr. Spahn said they will get more money, but didn’t reveal what form the new payment system will take.

Doctors are also skeptical about Mr. Spahn’s plan to expand the network of service centers that help statutory patients secure appointments with specialists. They said many patients don’t bother keeping those appointments and that the system, introduced in 2016, costs more than it’s worth.

Mr. Spahn likewise banged the drum for an increase in the use of telemedicine — remote consultation by phone or online. It’s banned in Germany with a few regional exceptions, meaning that doctors aren’t allowed to make a diagnosis unless they have personally examined the patient at least once. The association is considering softening the ban with a proposal to permit telemedicine in “individual cases” in the future.

“The question is whether Google, Amazon, Dr. Ed or whoever ends up providing this service or if we will organize it together here in Germany,” said Mr. Spahn. He added however that the “gold standard” of medical treatment would remain face-to-face consultations.

Even if the driven politician’s other ambitions fall to the wayside and he only manages to reduce waiting times in Germany, it will be another rung on the ladder he needs to reach and take over Ms. Merkel’s position.

Gregor Waschinski is a Handelsblatt correspondent in Berlin. To contact the author: G.Waschinski@handelsblattgroup.com

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