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The federal government's planned reform of statutory health insurance is currently causing massive dissatisfaction. The managing directors of the East Hesse hospitals see this as a massive threat to medical care.
Fulda – Dr. Thomas Menzel, spokesman for the Fulda Clinic, speaks of a “serious time” and a special situation. He has never experienced that he and his colleague Michael Wilhelm as well as the managing directors Michael Sammet (Herz Jesu Hospital Fulda), Thomas Faust (Eichhof Hospital Lauterbach) and Sebastian Mock (Hersfeld-Rotenburg Hospital) invite people to a joint press conference.
However, the situation is also more precarious and critical than it has been in the past 30 to 40 years. Hospital managers agree on this.
Clinic bosses sharply criticize the planned health insurance reform
Wilhelm describes Federal Health Minister Nina Warken's (CDU) project with the awkward term Statutory Health Insurance Financial Stabilization Act as a savings law that amounts to an uncontrolled withdrawal of funds from hospitals. Wilhelm and colleagues also complain about immense uncertainty in the health sector. Warken's bill comes at an inopportune time – just during the hospital reform.
The managing directors unanimously admit that continuing the health system as it has in previous decades will not work. It cannot be denied that structures would have to be changed in view of increasing investment and cost pressure due to inflation, higher collective wages and energy costs. On the other hand, the managers complain that the clinics are not allowed to increase the prices for their services to the same extent.
A number of clinics are already on the verge of collapse. Sammet – like Menzel, Vice President of the Hessian Hospital Society – provides figures: “15 percent of clinics are already at acute risk of insolvency. If the law comes into effect as intended, we will have a rate of 30 percent at the end of the year. And according to current studies, the whole thing will expand to half of all clinics by 2030.” For the Sacred Heart Hospital alone, Sammet expects future revenue losses of 500,000 euros due to the cancellation of care-relieving measures. In addition, support that the federal government provided to the clinics for a limited period of one year is expiring. For St. Vinzenz gGmbH this amounts to two million euros less.
Clinics in East Hesse are demanding more security and less bureaucracy
Wilhelm also calls up numbers: 60,000 patients contacted the emergency room last year, By 2024 there had been more than 50,000. This year, 64,000 to 65,000 contacts are expected in Pacelliallee – and the trend is rising because outpatient care is also being cut and patients are going straight to the emergency room. 70 percent of cases are not admitted to hospital at all. For comparison: Before Corona there were just 35,000 contacts in the emergency room every year.
Menzel reiterates: The clinic strives not to rely on the support of the sponsor – i.e. the city of Fulda. However, the Statutory Health Insurance Contribution Stabilization Act creates additional uncertainty here. After a deficit of 13 million euros with 360 million euros in sales in 2024 and expected red numbers for 2025, the clinic plans to be in the black again in three to four years.
Menzel, Wilhelm and Mock, who represent municipally run clinics, complain that the draft law involves redistribution – ultimately at the expense of taxpayers because the municipalities would be burdened more heavily. However, financing health care is not their original task.
Sammet and Faust, however, even see a competitive disadvantage for the clinics that are run by independent, non-profit organizations. “For us, the provider cannot inject money. We have to see how we can finance ourselves independently,” says Faust, and Sammet specifies: In the Aschaffenburg area, for example, he is observing how municipal providers try to finance the clinics in other ways, for example by making savings on other social services.
The clinic's managing directors emphasize several times that the German Hospital Association has already submitted proposals for restructuring. However, Health Minister Warken did not listen to them. At least they see themselves supported by the states and hope for an intervention in the Federal Council. The clinics' demands are clear: more security, less bureaucracy and adequate financing instead of redistribution. Otherwise, they fear that hospitals will not die in East Hesse, where the clinics work well together. However, they still see the quality and professional range of medical care under threat.
