Dispute over health kiosks: get well once, please

NOf course there are pictures from the day. They show how two black limousines roll through the neighborhood over cobblestones. How police officers secure the pedestrian zone while the Federal Minister of Health explains what a health kiosk is. And then, of course, the press conference inside the counseling center in Billstedt, deep in the east of Hamburg: in front of Karl Lauterbach, the minister, are five microphones from the radio stations. There is only a glass of water in front of the manager of the kiosk.

This is what it looks like when federal politicians leave their government quarters to announce a reform on the spot. It should affect the whole country. Lauterbach wants to build up to 1,000 kiosks nationwide, one for every 80,000 inhabitants. Small institutions run by nursing staff, which are intended to complement the previous system of doctor’s offices and hospitals. It would be a small revolution in the German healthcare system. Something with which Lauterbach could distinguish itself beyond the pandemic and clinical reform. The kiosks, “these are low-threshold access points for those who are otherwise only reached when it’s too late,” said the social democrat during his visit to Hamburg. That was at the end of August.

On the same day, his ministry published the cornerstones of the planned reform. Lauterbach’s kiosks are intended to promote the health literacy of people in problem areas, according to the key issues paper. They should refer the citizens to the right doctors and authorities and take over so-called routine medical tasks, i.e. measuring blood pressure and blood sugar in diabetics. Each kiosk must be managed by a registered nurse. The employees should take care of the wounds of the patients and give injections if necessary.

Comparable facilities have existed in Scandinavia for a long time, but the healthcare systems in the north are also structured very differently than here. Lauterbach’s cornerstones envisage that each municipality decides whether to set up such a kiosk. If she wants that, she only has to bear a fifth of the costs herself. The health insurance companies take care of the rest, with the statutory shouldering the majority and the private only a small part. Neither of them can say no. A total of almost three quarters of all bills would get stuck in the statutory coffers if Lauterbach’s reform came into force.

Pay without having a say? Many insurers do not want to accept that. The AOK Federal Association pointed out that the financial situation of the funds was “precarious”, for the coming year the deficit is estimated at a total of 17 billion euros. Therefore, “at least half of the required funds should be raised from the public sector”, demands the AOK. Another health insurance association emphasized that the kiosks should “also take on public service tasks”. This means that they should be guides through the German supply system, which is often even more difficult to understand than it already is, especially for people with a migration background. And that, according to the criticism, is not the job of the cash registers.