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Germany

Doctors protest lower pay in health care reform package

Thousands of general practitioners shut their offices in protest to plans to reform the German health care system. They warn of declining care and fewer doctors, but the government says it must save money.

Doctor holds mini flag at protest

Just one of many protesting German doctors

Thousands of doctors gathered across Germany on Wednesday to protest a section of the government's proposed health care reform that would lead to less pay for them.

Around 1,000 doctors, together with employees and patients, held a demonstration in the city of Essen, according to union organizers, while around 3,000 were expected at a parallel demonstration in the southwestern town of Sindelfingen. In addition, one in four doctors' practices stayed shut throughout the day, organizers said.

The action comes a week before the German cabinet is to discuss a reform package proposed by Health Minister Philipp Roesler. The reform includes increased fees for patients and savings from insurers, hospitals and doctors, meant to fill the system's 11 billion euro ($14.3 billion) funding gap the government foresees for 2011.

Doctor examines elderly patient

Higher fees are meant to ensure quality care

Rising fees

Under the current contract negotiated between public insurance companies and unions, general practitioners are paid an extra fee for acting as a sort of gatekeeper for their patients - treating them when they are able and referring them to specialists when necessary. The agreement was meant to provide better recognition of higher quality care.

And indeed this agreement has contributed to an overall increase in fees paid to German doctors. Between 2007 and 2009, fees rose by 11 percent, according to a report by Munich-based daily newspaper Sueddeutsche Zeitung. The increase was even greater in certain areas, for example 24.1 percent in Hamburg.

Exodus from Germany

But the German Association of General Practitioners claims its members are still paid far less in comparison with specialists, a fact which is leading to an annual exodus of up to 4,000 doctors and medical students to countries where they find better pay.

“The politicians will wake up when the general practitioner on site is gone,” Dirk Mecking, chief of the Rhineland branch of the association, said at the protest in Essen. “This is war against the doctors.”

Berthold Dietsche, chair of the association's branch in the state of Baden-Wuerttemberg, said the elimination of extra compensation for general practitioners would “stifle an innovative model for out-patient care with minimal bureaucratic costs and equitable compensation.”

GPs at the Sindelfingen protest

General practitioners say they already earn too little

Published salaries

On the same day as the protest, the Central Association of Statutory Health Insurers published current data on doctor compensation. The approximately 150,000 doctors and psychotherapists in Germany are to receive an average of 164,000 euros per year in fees from public insurance agencies, a 22,000 euro increase since 2007.

However, general practitioners indeed earned less than that figure - an average of 116,000 euros in 2007 - while orthopedic surgeons earned 186,000 euros and radiologists earned 264,000 euros in the same year.

Nevertheless, Thomas Ballast, head of the Association of Health Insurance Companies, said the protesting doctors were harming their own reputations.

"General practitioners earned an average gross monthly income of 8,300 euros in 2009, in addition to private revenue," he said. "That's a salary that will give you a very good life."

Author: Andrew Bowen (dpa/apn)
Editor: Susan Houlton

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