Versorgung: Bremsen die Länder die Notfallreform aus?

Germany's federal states are forming resistance to the Bundestag's reform of the emergency healthcare system, which aims to better match patients with appropriate treatments. The Bundestag's leading Health Committee and Interior Committee recommend sending the law to the mediation committee, to be discussed in the November 20th session of the Land Chamber. The outcome will decide whether to accept the committees' positions.

This reform would slow down the implementation of budget cuts for stable health insurance premiums in the new year, attached by the black-greener coalition to the law. For instance, spending restrictions on psychotherapists are set to be relaxed starting early 2027. Clinics are expected to receive an additional €550 million compared to initial plans. A previously dropped obligation for health insurance companies to inform members about premium increases will be reintroduced.

The objections from the Bundestag's committees are not against these points but against the overall emergency reform itself. The Interior Committee raises concerns about the federal government's competence in regulating emergency services, which generally falls under state jurisdiction. They argue that such rules should be limited to "the necessary and constitutionally permissible". The Health Committee emphasizes that state authorities can decide on location decisions for hospitals.

The emergency reform aims to better direct patients with urgent complaints to appropriate treatment options, preventing overcrowded hospital emergency rooms. This will be achieved through central points of contact in hospitals and a nationwide telephone hotline. Integrated emergency centers will be established at selected clinic locations, where patients receive a preliminary assessment and are directed to either the emergency room or a nearby emergency practice based on the urgency.

Some states, like Niedersachsen, have voiced concerns to the German Press Agency. Andreas Philippi, the Lower Saxony Health Minister, stated that planning safety for hospitals depends on the states deciding where the emergency centers are located. He also warned that taking over the refinancing of rescue services would result in a significant quality loss, particularly in air rescue. As chair of the Health Ministers Conference until the end of the year, Philippi stressed the importance of addressing these concerns.