Bureaucratic madness in Germany: 1 orthopedic surgeon - 1000 contracts

Before an orthopaedic surgeon can start working, he first has to spend © hours dealing with contracts Horst Rudel/imago

Actually, a health reform in 2007 was supposed to strengthen competition between health insurance companies. The result is a bureaucratic monster that makes life difficult for orthopedists.

Munich – The skilled trades in Germany are facing major challenges. These include a shortage of skilled workers, rising prices and energy costs or supply bottlenecks. But excessive bureaucracy also makes life difficult for companies. "Bureaucracy is now strangling us," said Crafts President Jörg Dittrich at the Crafts Fair in Munich at the beginning of March.

Orthopedic technology and office file madness: New law increases the number of contracts by a factor of forty

The extent to which bureaucracy can take on is shown in an article in the Deutsche Handwerks Zeitung (DHZ). According to this, health workers such as orthopaedic technicians usually do not receive their money from the patient, but from his health insurance company. Currently, there are 96 statutory health insurance companies and more than 1000 contracts with an average of 100 to 150 pages for the supply of orthopedic aids. Before the 2007 health care reform with the Competition Strengthening Act, there were only 25. The aim of the law was actually to stop the rising costs in statutory health insurance and to strengthen competition between providers.

One consequence is that, according to an industry survey, orthopaedic technicians spend a third of their working time on bureaucratic and documentation obligations. Because before he can start working, he must first deal with these contracts: What services does the health insurance company of the affected patient cover at all in the case of his clinical picture? Then a cost estimate must be submitted to the cashier.

Orthopaedic technology and office file madness: Regulations are not clear

To make matters worse, it is not clear what the cash register will cover. Section 12 of Book V of the Social Code only states that the benefits must be "sufficient, appropriate and economical". "But what is sufficient today?" quotes the DHZ Michael Schäfer, deputy head master of the Bavarian state guild of the Federal Guild Association for Orthopaedic Technology (BIV-OT). In the case of prostheses, the spectrum ranges from wooden legs to high-tech prostheses for 50,000 euros. Technologies continued to develop, but financial pots stagnated.

For a reduction in bureaucracy and the introduction of transparent standards, the BIV-OT has presented reform proposals together with the alliance "We supply Germany" (WvD). For example, lead contracts are intended to reduce the number of more than 1000 individual contracts. In addition, the documentation requirements are to be revised in order to reduce the disproportionately high administrative burden.

But it's not just orthopaedic surgeons who complain about the bureaucracy in the healthcare system. Clinic operators also despair of the high bureaucratic effort.