Clientelism

Medical association rehearses rebellion against parts of the reform

Health insurance reform yes, but not at the expense of Vorarlberg, rumbles the Vorarlberg medical profession. State Health Councillor Martina Rüscher (ÖVP) is - unsurprisingly - joining in the criticism of Health Minister Johannes Rauch's plans. 

Once again, it's all about money: the representatives of the Vorarlberg medical profession are particularly critical of the plans for flat-rate remuneration in the planned health insurance reform. "This reform step could lead to a step backwards in office-based care in Vorarlberg," argues Medical Association President Burkhard Walla.

By way of explanation: there are currently different remuneration systems for panel doctors in the federal states, based on state-specific service catalogs. "If fees are set at a flat rate, there is a risk that, for example, complex examinations, which are currently paid for separately, will no longer be carried out in surgeries and patients will instead be referred to the already overcrowded hospital outpatient clinics," adds State Health Councillor Martina Rüscher (ÖVP).

Cost of living not taken into account
The doctors are particularly annoyed that a standardization of fees would hardly take into account the different costs of living in the provinces. "In addition, a flat rate would not be based on the upper limit of the existing fees, but would rather mean a leveling down," Walla is annoyed. All of this would mean that Vorarlberg's panel doctors would earn significantly less than before after this reform step.

One possible consequence: a number of doctors could terminate their contract with ÖGK and migrate to the elective doctor system, and the health insurance system would be further thinned out. If Walla and Rüscher have their way, ÖGK should use the 300 million euros it has received from the federal government for the expansion of the private practice sector to increase the attractiveness of health insurance fund positions.

However, neither the Chamber nor the regional health councillor seem to have internalized the idea of saving money. Instead of suggesting how the system could be made more cost-efficient, they are practising pessimism and transparent clientele politics.

What is most irritating, however, is how compliant Provincial Councillor Rüscher is in allowing herself to be harnessed to the medical profession. Her "loyalty to the line" is well received by the lobbyists, and she has even been awarded the Medical Association's Golden Aesculapian Snake prize. In contrast, her predecessor Dr. Christian Bernhard, who was often critical of the professional group's proposals, regularly received nasty remarks in the Chamber's own magazine.