Guest patient dispute

Vienna City Council now at loggerheads with Mikl-Leitner

The dispute over guest patients between Lower Austrian Governor Johanna Mikl-Leitner and Vienna politicians is entering the next round. City Councilor for Health Peter Hacker does the math in the "Krone" newspaper.(Bild: Krone KREATIV/ NLK Khittl/Imre Antal/)

Vienna's Health Minister Peter Hacker (SPÖ) is not willing to accept Lower Austria's Governor Johanna Mikl-Leitner's threat to reclaim several million euros for the treatment of guest patients in Vienna; he explains his calculations in the "Krone" newspaper.

The conflict between the federal states over guest patients continues to escalate: after patients from Lower Austria were to be placed at the back of the treatment list or even turned away in Vienna, and a lawsuit against the federal capital was therefore being prepared, Governor Johanna Mikl-Leitner threatened to demand several million back: "If Lower Austrians are no longer treated in the federal capital, then Vienna should repay the money provided for in the fiscal equalization scheme," she told the "Krone," referring to her compatriots, who generate around 20 billion euros in gross value added in Vienna.

However, Vienna's City Councilor for Health, Peter Hacker, is not willing to leave it at that: "We understand that all Lower Austrians would like to be treated in Vienna's state-of-the-art and well-equipped hospitals in cases that can be planned, but the proportion of guest patients and the compensation for this must be brought back into an adequate balance."

The dispute over guest patients between Lower Austrian Governor Johanna Mikl-Leitner and Vienna politicians is entering the next round. City Councilor for Health Peter Hacker does the math in the "Krone" newspaper.(Bild: Krone KREATIV/ NLK Khittl/Imre Antal/)

How much guest patients cost
Lower Austrian guest patients would have incurred treatment costs of €1.115 billion in all federal states in 2024, of which a total of €879 million would be attributable to Vienna. This compares with 242 million euros incurred by guest patients from all other federal states in Lower Austria. "Viennese guest patients incur costs of only 92 million euros in Lower Austria," the Krone explains. The bottom line is that Vienna is left with 788 million euros in costs.

Guest patients: Vienna versus Lower Austria

• Lower Austria accounts for 44 percent of all guest patients in Austria.
• At the same time, Lower Austria treats 13 percent of all guest patients in Austria.
• Vienna accounts for 8 percent of all guest patients in Austria, while at the same time treating 40 percent of all guest patients.
• Lower Austrians account for 80 percent of guest patients in Vienna, compared to Burgenland residents, who account for 12 percent of guest patients in Vienna.

Insisting on four health regions
"The number of guest patients is clearly unbalanced – and we need to resolve this. Vienna naturally treats all emergency and acute cases, regardless of where they live. We remain open to discussion and want a solution that benefits all patients," assures Hacker, who is very receptive to his mayor Michael Ludwig's proposal to create four health regions: "Four health regions would be a good framework for jointly planning, financing, and managing healthcare across state borders." Now is not the time to unsettle patients, "because Vienna still treats almost 20 percent of guest patients. Now is the time to work together on solutions that are in the best interests of patients."