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HEALTH

Health insurers caught wasting contributions

A government report released on Tuesday has uncovered huge wastage in Germany's health care system - one state insurer spent €10,719 on detectives to follow someone who may have illegally claimed €15 per day.

Health insurers caught wasting contributions
Photo: DPA

The survey, carried out by the Federal Insurance Office (BVA) and seen by the Bild newspaper, contained several other examples of what it called “gross inefficiency” in the health insurance system.

One insurer rented out 4,700 square metres of office space for ten years at a cost of €96,000 per month – plus an extra €97,500 to install special facilities and furnish the office. It was then found to be only using 40 of the 117 desks, notching up a loss of €13 million.

The BVA also found that insurers were using their members’ contributions to hold parties, complete with catering and entertainment, which contravenes government regulations.

The report even revealed one case of massive fraud, which it said the insurance company itself should have noticed long ago – an employee reportedly transferred a total of €459,000 to her private account – spreading 213 transactions over eight years.

The financial situation of many insurers is currently very good. The most recent figures show the country’s insurance firms collecting €184 billion in 2011, and spending €180 billion.

The BVA has now demanded better internal control systems, but it also underlined that the inefficiency was not systematic. “They are isolated cases,” a spokesman said in Der Spiegel magazine.

The Local/bk

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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