Hospital representatives have again warned of hospital insolvencies and called for quick financial aid even before the major hospital reform planned by the traffic light. “The hospitals are in the shock room of the emergency room, and many clinics will not survive the political therapy of waiting and waiting,” said the CEO of the German Hospital Society (DKG), Gerald Gass, in Berlin.
He referred to increased costs due to inflation and spoke of monthly deficits of 740 million euros. “If nothing happens, we will be at minus 15.6 billion euros by the end of 2023.”
Representatives of healthcare associations, experts and healthcare politicians discussed the topic at an industry meeting in Berlin. At the annual “hospital summit” organized by the DKG, Federal Health Minister Karl Lauterbach (SPD) said: “The hospitals are in dire need.” He assumes that many hospitals will be at risk of bankruptcy. He promoted his major clinic reform, which is to be launched this year.
Majority of clinics in bad shape
DKG boss Gass was basically open to this, but initially called for “a preliminary law to secure the economic security of the hospitals”. This is the only way to prevent clinics from going bankrupt before the major hospital reforms.
According to a survey conducted in February and now published by the DKG, 71 percent of general hospitals (excluding psychiatric clinics) rate their current economic situation as bad or very bad. Every second house (51 percent) expects to have to reduce the range of services in the next six months, for example by temporarily closing stations. Many clinics name “unrefinanced cost increases”, such as energy costs, and the shortage of skilled workers as causes.
Lauterbach: No prospects without reform
Lauterbach did not address the demands for short-term financial aid in his speech and explained his reform plans. According to him, the key points for a law should be available by the summer break. However, there are indications that the legislative process will be difficult. The three federal states of Bavaria, North Rhine-Westphalia and Schleswig-Holstein want to have Lauterbach’s reform checked for its constitutionality by means of a legal opinion. They want to know whether the reform goes too far into the competence of the federal states in hospital planning. Lauterbach appealed to the states to participate. Without the reform, he sees no prospects for many clinics.
The plans provide for a nationwide uniform division of clinics into three levels, with appropriate funding: clinics close to home for basic and emergency care, houses with “regular and priority care” – i.e. other services – and “maximum care providers” such as university clinics. Greater specialization is also being sought within the clinics. In addition, the so-called case flat rates are to be reduced. Clinics receive a flat rate per patient or case of treatment.
According to Lauterbach, the packages lead to a “hamster wheel effect” of carrying out as many treatments as possible. Decreasing flat rates are intended to reduce incentives, for example to install knee prostheses where it may not be necessary. To compensate for reduced flat rates, the clinics should receive so-called advance payments: Fixed amounts for the provision of staff, an emergency room or necessary medical technology.
In Germany there are around 1900 hospitals with more than 480,000 beds.
