What you should know about hedgehogs

Füindividual health services (IGeL) müshot patients self-pay. Why you with such Offers, Benefit, and harm better good abwägen

Individual health services cost extra – and often not a little

Every second register a patient in Germany knows it now: being a doctor offers him zusäadditional benefits, such as the Früdetection of diseases. But there’s a catch: patients müshot numbers of these so-called Individual health services (IGeL) out of their own pocket. And many patients do it. Almost three-quarters participated in such offerings, and spent about a billion euros dafür. The hedgehog Report 2018, a survey of the Medical service of the Central Federal Association of health insurance companies.

The Bundesämedical Board describes IGe-benefits General: "Hedgehogs are ämedical services which are not financed by the statutory health insurance funds and, therefore, the Insured will be paid mü." You should außerdem äcertificate.recommended, or at least &auml…certificate is acceptable. Today there are several hundred IGe services. How many are there exactly, weiß you do not. A uniform and mandatory list them all aufzählt does not exist. And it st&auml come;fully new. Really häoften, only a few are offered.

The top tab is the measurement of the eyes are currently inside pressure and ultrasonic examinations of the breast and the Eierstöcke. To the self-pay services gehören, however, not only Screenings. They include, for example, sports-medical examinations, consulting services and travel vaccinations. Some komplementär used therapies from alternative medicine will be provided as IGe services. At the dentist heißen IGe-benefits often "private Zusatzleistungen". In principle, mean the same thing. The professional tooth cleaning, for example, is one of the hämost common durchgefüdisabled-Owned services.

Why not pay cash?

Medical examinations and treatments müshot both necessary and economical. If this is the case, the Central decision-making body in the German health care system: the Federal Joint Committee (G-BA). Representatives of the sickness funds, the Krankenhäuser as well as the Ädoctors and Zahnädoctors advise here darüber, which benefits the statutory health insurance funds pay mü. Patient representatives have an Advisory and proposal rights, but no voting rights. Rejects the G-BA for an investigation or treatment, münot have to reimburse the funds. Such services are then häoften as a hedgehog offered.

In the case of the private health insurance (PKV) is different. Here It is: hängt from the respective contract of insurance, whether the insurance paid for a performance. Top rates usually cover most of the IGe-services. The benefits of a basic tariff and differ very little from those of the statutory health insurance funds.

The G-BA rating since the 1990s, according to the strictly scientific Maßstäben of evidence-based medicine. If a treatment or examination is rejected by him, lässt either their Use or their cost-effectiveness can not be proved. The heißt: it was found Either in studies, no significant efficacy or there aussagekr&auml missing;future studies of a performance. Or but there is already a günstigeres procedure, the äsimilar is good. This applies für the Großpart of the offered hedgehogs. In addition, the hedgehog, the sense k&ouml there are;can, but not to the supply scope of the statutory health insurance funds gehören – such an examination of diving fitness.

Some Ädoctors offer, for example, Traditional Chinese medicine (TCM), or osteopathy in the Form of a hedgehog to – because you üare assured that in the individual case, be helpful köhumans, or at least not harm, even if the General Benefit is not scientifically proven.

Wunscherfüllende medicine

In the case of some medical services, it’s more about the Erfüadjustment of Wüwant – planning, self-realization and self-improvement. The distance from Tätowierungen, cosmetic procedures, tooth whitening or desire of births by caesarean examples daf&uuml are cut;r. Accordingly, the patients acceded to their doctor gegenüber rather than the customer, if you such hedgehog wüin accordance with your wishes. Ask for the treatments and müyou should pay for it.

But this is the exception rather than the rule. In most Fäcases, the &Auml it;doctors who suggest their patients with IGe-services. In four of fünf Fäcases, there are benefits to Früdetection and Prävention.

IGe services köcan also damage

The use of hedgehogs can also have disadvantages. An example hierfür: the ultrasound of the Eierstöcke to Krebsfrüevaluation. Studies see it as of no Use, if Äon doctors this examination in asymptomatic patients without suspicion of or a particular risk für ovarian cancer (ovarian cancer). The mortality of this cancer ließ this Früherkennungsmaßtaking not lower. In some women however, due to a auffädigit ultrasonic findings, a cancer is suspected, although the Eierstöcke are healthy. In the worst case, the f&uuml can;do that as a result of this false alarm, the Eierstöcke will be removed.

The more important it is that Ädoctors ausfüdangerous and factually über möpossible advantages and disadvantages of a hedgehog. Patients should demand this information and a picture of their own make. A decision to help give möcontempt, for example, the IGeL-Monitor, a patient-information page of the top Association of Statutory health insurance. Under www.igel-monitor.de* doctors and scientists are now two-thirds of the major IGe-services.

The ultrasound examination of the Eierstöcke to Krebsfrüdetection without suspicion about &quot is;negativ" rating. Project Manager Dr. Christian Weymayr says: "There can be no two opinions. I wüwould be an unsafe patient on the recommendation of the ämedical guideline notes that says: don’t Make it." But Weymayr also clear: the reviews of IGeL-monitor, it comes to Information. Patients should the Benefits and the möadjusted damage of a hedgehog individually abwägen. "We don’t want to talk about the people and nothing to you excuses, but rather open-ended." On its website, the Team of the IGeL-monitor to consider: "Truly objective reviews, there is not, because the Abwägen of Benefit and harm value judgments are based. It may be that you come to a different conclusion."

The rules of the economy in health care

The philosopher Professor Matthias Kettner hält hedgehog für zwiespävalid. He teaches at the Universität Witten/Herdecke and beschädeals there intensively with the so-called Ökonomisierung of the health care system. Ökonomisierung says that, in addition to the medical logic of healing in an economic logic of cost-Benefit Abschäup everything that is medically feasible is Not a place, it is also financed by the solidarity-organized insurance system in Germany. The legislator obliged the health insurance funds to operate economically. You köcan not spend more than you by the Beiträge of their members.

This is becoming more and more difficult. The people live, on average, läViking and have häsingle-stage chronic diseases. You now make a Großpart of the costs in the health system. Modern, expensive therapies raise the cost zusäin addition, in the HöHey. In the last decades, the policy continued, therefore, among other things, on market competition. This is to prevent the costs explode in the healthcare sector. This competition will also get the established Ädoctors to spüren says Kettner. You mücompanies to understand their practices as a business. "Actually, mübiggest be politically to ensure that can be good business to sell without the senseless medical services. But this is not guaranteed."

Hedgehogs are a burden on the Verhärelationship between the doctor and the Patient

Right here is a danger f&uuml is;r the trust Verhärelationship between the doctor and the Patient. The doctor takes gegenüber of his patients, a double role: on the one Hand, the physician unabh&auml to;this depends on the advice, what services do in an individual case sense. On the other hand, these benefits increase to the private account of his sales.

Längst not all Ädoctors to cautiously go with the theme of hedgehogs. Some of them advertise the services active. According to IGeL-Report 2018 fühlt, more than every third Patient with IGeL offers bedrängt. Many are not sure whether you für or against a hedgehog and decide to. "There are even Ädoctors, the Fund benefits from IGe-services abhäregardless machen", weiß Dr. Christian Weymayr. "If the Patient buys, for example, no professional tooth cleaning, it will not be treated further. Or if he does not intraocular pressure measurement lässt for glaucomafrüdetection, he gets the nänext appointment in a year’s time."

If Ädoctors behave in the same, hurt you clear your vertragsämedical obligations. Patients as something widerfährt should the Landesämedical Board darüabout inform, advise both the IGeL-Monitor as well as the Bundesämedical Board and Kassenämedical Confederation.

Hedgehog: right

If your doctor offers you a hedgehog-power, you should not agree better. Christian Weymayr weiß: "Often wänot during the physician visit, the nerve or the courage supposedly awkward questions. That’s why I say it is probably easier to üit consider me." He rät, make sure the following points with your doctor to klären:

1. Why should I do that? What wäre my Use?

2. What wäre the consequence of für therapy? The simpler, cash-funded procedures is not enough?

3. Insist on a written contract with a verstäfinal cost estimate and a detailed invoice.

4. Ask your doctor for time to reflect and learn zunäfirst of all, for yourself.

5. If you are at home: Inform, for example, the IGeL-Monitor www.igel-monitor.de*. For this purpose, köyou can take quiet time. IGe services are – with the exception of travel vaccinations – rarely a matter of urgency.

6. Ask your cashier whether the offered hedgehogs will be paid in your case. Möperhaps you are a risk patient, and have a claim on it. Or your cash üassumes the cost, in whole or in part, as an additional service.

If you know what you für your money k&ouml get;you can decide: is it worth it to me – or not. You may then come to the offer of your doctor zurück.

Advice and information on hedgehogs on external websites

– Assessment of 49 IGe-services (may 2018) by the Medical service of the Central Federal Association of health insurance funds e.  V.: www.igel-monitor.de*

– Broschüre "Individual Gesundheitsleistungen" the Federal Ministry für consumer protection: www.bdz-bw.eu/baden/downloads/igelbroschuere.pdf*

– Broschüre "Self-pay?" the Bundesämedical Board and the Kassenämedical Confederation: https://www.patienten-information.de/checklisten/igel-checkliste*

– Consumer centers of the Bundeslä, addresses www.vzbv.de*

– The cancer information service in Heidelberg informed to hedgehog in cancer therapy:



Kettner M: unity and difference of curative and wunscherfüto be provided by medicine. In: D. Wrestling, H. Wittwer (Hg.): What medicine is? The concept of medicine and its ethical implications, Freiburg MüMunich, Verlag Karl Alber 2018: 19-41

Medical service of the Central Federal Association of health insurance funds e. V. (MDS): IGeL-Report 2018. The results of the insurance survey. Online: https://www.igel-monitor.de/fileadmin/Downloads/Presse/2018_05_03_PK_IGEL-MONITOR/18_05_03_IGeL-Report_2018_Ausfuehrlicher_Bericht.pdf* (Accessed on 27.11.2018)

Windeler J: Individual health services – A balancing act between the market and the medicine. In: GGW 2006,6: 17-27. Online: http://wido.de/fileadmin/wido/downloads/pdf_ggw/wido_ggw_aufs2_0406.pdf* (Accessed on 27.11.2018)

Gerlinger Th: competition and privatization. Üon the change of health systems. In: A. Nassehi (Ed.): Gefäendangered healthy price-to-book 175), Hamburg 2013: 170&ndash fixes (;182

*www.apotheken-umschau.de is not responsible for and üno liability f&uuml assumes;r the content of external Internet sites

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