Peter McDonald warns
ÖGK boss: “Not all hospitals will survive”
The debate about guest patients is "undignified" and highlights how urgently the Austrian healthcare system needs to be reorganized, says Peter McDonald, who resumed his position as head of the ÖGK in January. In an interview with the "Krone" newspaper, he makes it clear that hospital closures will be unavoidable.
"Access to top-quality medical care on the E-Card cannot depend on your house number," says Peter McDonald, referring to the dispute between Vienna and Lower Austria over guest patients. "Vienna's Ketzergasse is the best example of this: people with even house numbers are treated in Vienna, but people with odd numbers are from Lower Austria and don't get an appointment. Thinking in terms of borders destroys trust in the security of Austrian healthcare," McDonald warns, calling for an end to the tiresome debate.
Around 7.6 million insured persons and their employers pay into the health insurance fund throughout Austria, which means they should all receive the same level of care everywhere. "Planning, management, and financing of the healthcare system should therefore be in one hand. This undignified debate clearly shows the need for fundamental reform. A constitutional amendment is needed to bring healthcare under federal jurisdiction," McDonald says plainly.
"We need fewer hospitals"
More and more older people in the population need more and more medical care. At the same time, the number of contributors is steadily declining due to demographics, part-time work, and unemployment. "To secure care for the future, we must act now, not only for financial reasons, but also for reasons of quality of care. Medicine is becoming more decentralized and closer to home, which means that fewer hospitals will be needed in the future."
Pumping additional money into the overburdened system is not the solution. "We are a high-tax country. We cannot continue to increase taxes and non-wage labor costs; we must use the money more efficiently throughout Austria. At the same time, we need to depoliticize healthcare, with planning and control at the federal level based on quality and efficiency, more expert-oriented and less policy-oriented," says MacDonald.
For scheduled surgeries, it is not particularly relevant if I have to drive half an hour longer to a hospital.
Peter McDonald
Hospitals must specialize
"We need hospitals to focus on specific areas and specialize. The more often operations are performed, the better they are carried out. For planned surgeries, it is not particularly relevant if I have to drive half an hour longer to a hospital, as long as the quality is right. There will always be emergency structures," said McDonald. McDonald does not want to give specific figures on how many hospitals could be closed; ultimately, the aim is to ensure regional care and relieve the burden on existing hospitals.
The restructuring of the healthcare system will have to be discussed in the course of future planning. If we want to strengthen the digital and outpatient sectors, there is no way around it. McDonald is convinced that constitutional reform is possible because there is great pressure on politicians from experts, the population, and the financial sector.
Over the past 25 years, the number of people over 65 has increased by more than 50 percent. "And people over 65 need twice as many services as younger people," explains the ÖGK chairman. This puts pressure on the healthcare system. "So far, we have been able to compensate for this well, including through stable economic growth, but we have just come through the third year of recession and the proportion of people over 65 will increase by another 50 percent over the next 25 years."
Borders don't get us anywhere
McDonald is not particularly enthusiastic about Ludwig's proposal for four health regions. That would mean having these boundaries again and talking about guest patients, "a term that, in our opinion, should not exist." "We need an Austria-wide solution and a dismantling of borders in the healthcare system. Regions don't get us anywhere, of course. Austria is just small enough to be able to manage this centrally and nationally. That's why we need a major breakthrough in the reform partnership."
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