Rationing health care for elderly Germans

German patients over 85 years old should not receive new hips or dentures, says the head of the youth organisation of Germany's opposition Christian Democratic party. In doing so, 23-year-old Philip Missfelder has re-opened a public debate on the rationing of health care in Germany.

Earlier this year a television report quoted two experts, professor Wiemeyer (Bochum University) and professor Breyer (Konstanz University), who asked the government to abstain from operations for patients older than 75.

Professor Breyer later suggested his real goal was a policy debate that would lead to clear rationing rules decided by politicians, rather than doctors.

Individual doctors or medical institutions should not have to take rationing decisions based on their limited budgets, he argued.

Some experts in Germany warn that rationing – in the form of limited budgets for drugs and hospitals – is already implicit in the system and that it will have to be increased. For instance, a study by a sociology professor from Bremen University found that elderly patients receive less expensive care than younger patients and that the decisions were made mainly by doctors.

The German government has presented a new health reform with the aim of rationalising health care and saving unnecessary costs.

However, experts and politicians agree that a major reconstruction of the entire German social security system is also needed in order to prevent a cost explosion in the closely linked areas of health care, special care for sick elderly people and pension funds, which have to be shouldered by the younger generation.

Source: Annette Tuffs, Germany at centre of rationing row as budget in crisis, British Medical Journal, August 23, 2003.

For text http://bmj.com/cgi/content/full/327/7412/414-g?etoc
For more on Health Care (Rationing Issues) http://www.ncpa.org/iss/hea/

FMF Policy Bulletin/ 16 September 2003