Heini Und Luise
The Austrian Medical Association is preparing to do battle with the government over planned reforms to primary healthcare provision
Servus!
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Readers of this newsletter may remember the old “Harry and Louise” ads that ran on American television in the early 1990s. The campaign, funded by the Health Insurance Association of America, was part of an effort to torpedo the Clinton health care plan of 1993, which would have restructured the American health insurance market. In one ad, the couple sits at their kitchen table, hunched worriedly over a stack of bills. “That was covered under our old plan,” Louise bemoans. “That was a good one, wasn’t it,” Harry replies wistfully, before Louise says: “Having choices we don’t like is no choice at all.” The tagline: They choose, we lose.
I was reminded of Harry and Louise when I read in the paper over the weekend about a campaign, this time from 12 years ago, put out by the Ärztekammer, the Austrian Medical Association, in the context of a debate about the digitization of medical data via a system called ELGA. As described: “The adverts showed a naked older woman with an affected look, whose figure was far removed from that of a standard model body. ‘ELGA exposes you in front of others,’ was written above it: ‘Do you really want to be in public with your health data in public?’”
Andrea Kdolsky, a former health minister from the conservative People’s Party (ÖVP), told the Standard that the Austrian Medical Association has tried to block every attempt at healthcare reform in Austria. The Austrian Medical Association, meanwhile, see themselves as the system’s defenders, and now the group is gearing up to do pitch battle with the government once again as it gets ready to finalize and publicize the details of its planned package of healthcare reforms this week. The Standard further reports the has €10 million in campaign funds at their disposal to fight them.
The Austrian healthcare system at present does not suffer from a funding crisis as much as access and personnel issues. Especially in rural areas, it is becoming harder for people to get appointments with a Kassenarzt, a GP who accepts state insurance. In such Kassenarzt deserts, Austrians have two choices: pay out of pocket to see a GP privately and hope their state insurer will reimburse part of the cost or show up at a hospital for treatment at a walk-in or outpatient clinic. Both options demonstrate the existing system is failing, and the latter option leads to outpatient clinics becoming overloaded by people who shouldn’t be there in the first place.
The government’s proposed solution to these crunches is to establish new central Primärversorgungseinheiten, primary care units, which, in addition to having longer opening hours compared to GP practices, will offer a wider range of services: from psychotherapy to social work. By improving access to preventive care in this way, so the government argues, primary care units will take a load off of overrun outpatient clinics, saving the healthcare system money in the process. Critics of the Austrian Medical Association believe their opposition to primary care units derives from a fear that they represent competition to GP practices and that cutting GPs out of the primary care process will lead to the body’s disempowerment.
The Austrian Medical Association counters these planned reforms constitute cuts that will lead to a deterioration in the availability and quality of primary care. “We doctors want services to be expanded and modernized. We want to have time for our patients in our surgeries,” the body states. “That is why we are committed to maintaining our tried and tested healthcare system.” The Austrian Medical Association has often been the boy who cried wolf when it comes to healthcare reform. But what if they’re right this time? After all, it’s one thing to open primary care units, but without more personnel to staff them and having failed to make being a Kassenarzt more attractive, has the government really solved the issue of Austrians having to turn to the private sector to seek primary care?
Bis bald!
Work Starts At ‘Hitler House’
Construction work is underway at the house in which Adolf Hitler was born in Braunau am Inn. The federal government, which owns the house, plans to convert it into a police station, though building work has thus far been confined to the house’s adjacent car park.
Down With A-Levels
Vienna mayor Michael Ludwig has proposed abolishing grades for secondary school and sixth form pupils as part of reforms to Austria’s education system. Ludwig also said he favored ending the Matura, the Austrian equivalent of the A-level, in its current form.
No To Swiss Highway
Residents of Lustenau have voted against construction of the Bodensee Schnellstraße, a proposed highway linking the western state of Vorarlberg to Switzerland. 77.4 percent of Lustenau residents rejected the proposal in a local referendum held Sunday. Turnout was 30.2 percent.