Wild dispute over money – health care reform on the brink

Some countries feel provoked by smoke and see an election campaign maneuver because the minister plans a press conference after the meeting without consultation. “This is a strange thing to do. The minister apparently wants to be celebrated,” an insider told “Krone”. In fact, ÖGK chairman Andreas Huss, who is leading the negotiations for the fund, is currently on vacation.

Ministry downplays conflicts
The ministry is trying to downplay the conflict. “Tomorrow’s goal is to pass health care reform.” The amounts have already been determined with the financial equalization, now it is about “creating a set of rules: how can you use the funds, which projects are taken into account, what evidence is there?” you must provide information about the expenditure of funds, etc.’, the department said at the request of the ‘Krone’.

Five billion will flow in the coming years
This will amount to approximately one billion euros per year over the next five years. At the last meeting of the Federal Target Management Commission at the end of April, at which measures should have been laid down, all items were postponed.

This is reflected in several areas: Among other things, an additional 90 million euros has been agreed for vaccinations. According to the states, the federal government wants to include the corona and flu vaccinations, which were previously paid for by the federal government, in these amounts. In the future, a third of these vaccinations would be paid for by the federal government, the states and the health insurance fund. This would save the federal government money. “But we want to use the money to make all currently recommended vaccinations free,” the city of Vienna said.

Pass on the costs to others?
There are also discussions about the use of MRIs. Although the number of devices in Austria is high, the number of studies is even higher. With 159 examinations per 1,000 inhabitants per year, Austria is the leader in Europe. From 2015 to 2021, the number of MRI examinations in hospitals remained virtually unchanged. In the private sector it has increased by 60 percent.

ÖGK chairman Huss wants to make more intensive use of the devices in hospitals. That, in turn, would mean more costs for the states as they finance the hospitals. As a result, states are pushing for more cash-funded MRIs. In many private practices these would be of little use. The states reject the health insurer’s considerations for having MRI examinations performed by a doctor.

Time is of the essence due to the upcoming National Council elections
In implementing the reform, the overall focus should be on expanding the provision of statutory health insurance and primary care units. The payment flow is linked to the implementation of the reforms. If there is no agreement, there can be no money for the states. Time is of the essence, as the National Council elections at the end of September and the subsequent formation of the government make a decision for this year difficult.

Rauch admits that nursing reform has failed
The current dispute shows once again how difficult it is for Austria to implement reforms in some areas due to federalism. The situation is similar when it comes to healthcare. Rauch recently admitted the failure of nursing care reform and called on the federal government to combine its powers. “The central problem we have is that we have failed to achieve common financing in a fragmented system. That’s right. We have now done it with a crutch, namely financial equalization. But if you ask me, the next administration will probably have to talk about whether we can finally implement federal reforms,” Rauch said.