• Z Evid Fortbild Qual Gesundhwes · Jan 2009

    [General legal conditions for prioritisation within the scope of the German Statutory Health Insurance system].

    • Felix Welti.
    • Hochschule Neubrandenburg. mail@felix-welti.de
    • Z Evid Fortbild Qual Gesundhwes. 2009 Jan 1; 103 (2): 104-10.

    AbstractIn setting health care priorities the law, and in particular the constitution, has to be obeyed. The social constitutional state must guarantee minimum access to health care. Members of the Statutory Health Insurance (SHI) shall have access to health care services protecting their life and ensuring their participation in society. They shall not be discriminated according to gender, race and ethnic origin, language, disability, age and sexual orientation. Essential decisions will have to be made by the legislator. Within the EC the right to access health care services in another EC member state may be an obstacle to prioritisation on the national level, e.g., to waiting lists. The exclusion of health care services on the basis of the social security law may be too simplistic an approach. Administrative discretion needs priorities, but it is unclear whether these are set to meet political priorities and real needs. The decisions of the Federal Joint Committee (Gemeinsamer Bundesausschuss) are sophisticated enough but have to respect the rule of law. There are deficits in research on the prioritisation effects of health care law. Diminishing these deficits is a prerequisite for turning political priorities into effective legal provisions.

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