Catalogue of cures and remedies must be checked urgently

Report of the Barmer GEK

The statutory health insurance companies have had to spend last year for around six billion euros in aid, a remedy for € 4.6 billion. In order for the cost of medicines since 2004 have risen by 14.7 percent. Spending on aid grew by more than 26 percent. These figures come from a report of the Barmer GEK.

Not all remedies hold a scrutiny
     
Devices include wheelchairs, crutches, visual and hearing aids. The term remedy measures such as physiotherapy, occupational therapy or speech therapy are summarized. The Barmer GEK wants to optimize their costs and asks the doctors to rethink when prescribing these agents. For, in the opinion of the deputy chairman of the Barmer GEK, Dr. Rolf-Ulrich Schlenker, the use of auxiliary and remedies often comes too late. If this practice would be changed, so could a number of surgeries, hospitalizations, or medication can be saved. But not only the timing of the regulation is often questionable. The prescription of these agents is often not evidence-based, and also economic aspects appear to play no role for many physicians. Schlenker is of the opinion that there is hardly an area within the health service is in the gap between the economy and the health benefits that far.

Operations could be avoided
As examples, the Barmer GEK-Vice various diseases and their treatment: How can compression stockings help with varicose veins better than surgery, urinary incontinence with pelvic floor exercises can be targeted to make an operation unnecessary. The immediate use of artificial hip and knee joints is controversial for some time. One might initially prescribe physical therapy. The director of the Center for Social Policy in Bremen, study author Professor Gerd Glaeske warns of a change in physician behavior: "The possibilities of physical therapy as prevention are obviously not used enough."

Remedies are used poorly
 Glaeske advocates that the list of remedies is reviewed. For so many applications have a rather dubious benefit. Gerd Glaeske gives the example of the heat and cold therapy for stroke, which he described as completely absurd. Electrical stimulation to treat chronic pain is also somewhat questionable, because the efficacy is as good as not proven. "The same applies to the treatment of patients with spinal electrotherapy. Here there is clearly an over-and misuse." However, it decided to give a few electrical therapies for neurological diseases or in stroke. "Therefore, evidence-based work on the Federal Joint Committee of the remedy catalog," demands Glaeske.

Health insurance is no substitute for education deficits
One telling detail of the report sheds light on the causes of rising costs. The reasons are not only looking at the demographic trends, but also the shortcomings of social policies contribute to this. Among the remedies the costs especially for occupational therapy and speech therapy are greatly increased. Rolf-Ulrich Schlenker sees a general trend, the "cure of childhood." He believes, to recognize here a rather negative and over-zealous cooperation of overburdened parents and educators, too solicitous of occupational therapists and doctors. The statutory health insurance companies can not make up his view, the educational failures.

Scrutiny of the tools required
For all these reasons, demand Glaeske Schlenker and a review of medicines and medical aids. Since the beginning of this year, the benefits of new drugs is reviewed. It is incomprehensible that there are no adequate tools for the benefit assessment, Schlenker. "We also call for a similar instrument for the aid sector." Before new tools are included in the catalog of the statutory health insurance, benefits and effectiveness should be closely monitored.