Personal Health

Should put the policy on Prvention?

The German health system is one of the most expensive. Nevertheless, people are not gesüas in other Lächange. Für Prävention is, by contrast, spent very little money. Why the ächange should

A heart für Prävention? The hits für, the German health care system currently is not – even if to save a lot of money ließe

Three times as häfrequently as Sweden, and almost twice as often as all of the EU-Bücitizens on average: About ten Times in the year, German patients go to the doctor, compared to that of the organization für economic co-operation and development (OECD). Nevertheless, the Bundesb&uuml die;trouble in the cut früas, for example, the Scandinavians, and spend a total of less healthy years. Almost 80 percent of the Swedish adult schäappreciate your a Are as very good or good, in Germany only do almost two-thirds. 

At the same time, our health system is one of the most expensive in the world. In 2017, the costs were high as never before: On almost 375 billion euros schäthe Federal office f&uuml tzt;r statistics, keep all the health expenditure of the state, private households and companies. The goods for the first time, more than one billion euros per day and 11.3 per cent of gross domestic product. All States außthe USA and Switzerland spend proportionately less.

Hardly f&uuml expenditure;r Präprevention in our health care system

"Supply and Verfüavailability in an international comparison the Federal Republic of very gut", OECD health analyst Michael M&uuml says;ller. Gesüthe Germans, however, are not so. How ließe the ächange? How ließen expenditure-reducing and results improve? Für many experts is clear: more needs to be done to prevent diseases. Currently le&shy be omitted;dig­lich 3.3 per cent of all health expenditure in Germany to prevention.

"Smoking, obesity and alcohol year f&uuml cause;r year, several dozen billion follow-on costs. PräventionsansäParking spaces are a huge lever to senken&quot these costs;, Dr. Tobias Effertz from the Institute f&uuml says;r law of the economy in Hamburg. And Professor Ulrich John, Director of the Institute für social medicine and Prävention of the University of Greifswald, erklärt: "Our average life span erhöht all four, füfive years to one year. With successful Maßto be taken against Smoking, Drinking, unhealthy Ernäcurrency and too little exercise wüwould that number double."

Alcohol, Smoking, Fast Food: German life unhealthy

However, many Bundesbütrouble life consistently unvernüin the future. Eleven litres of pure alcohol, the average German drinks per year – two liters more than in all OECD Lächange in section. Üabout 20 percent of adults smoke f&uuml, ;nf percent more than in Sweden. The last Report "Health in Deutschland" the Robert-Koch Institute, the German food is increasingly burgers, ready-made pizzas and other Fast Food. The H&auml: Not even;half of the adults doing a lot of sports, as recommended by the world health organization.

Üabout 50 percent of the Bundesbütrouble is ümountain important, almost a quarter are obese. Also these are with the höthe highest values in comparison to other States. And the trend is rising. The consequences of this lifestyle: Almost seven million Germans are diabetic, up to 30 million käfight with high blood pressure. "In the case of antidiabetic drugs and blood-pressure-nuclear-gehört Germany to the international Top-Usern", OECD expert M&uuml says;ller. The most Bundesbücitizens are dying of a chronic illness – häoften the one Suffering, by präventive Maßtook hinausz&ouml prevent, or at least;like to can.

In the year 2015 450&thinsp were in this country;000 people because of the consequences of Smoking were treated in a hospital. Diseases of the cardiovascular system number one cause of death and caused, according to the Federal statistical office, alone 2015 health spending of around 46 billion euros. Scientists from the University of Hamburg and to quantify the consequential costs of Smoking, Drinking, unhealthy Ernäcurrency and to the lack of movement on 180 billion euros per year. "A very rough Hochrechnung", Professor Hajo Zeeb from the Leibniz-Institute f&uuml judge;r Präprevention research and epidemiology in Bremen, Germany. "But helpful to the discussion."

Policy or Bütrouble is: Who is responsible?

Social physicians, Ulrich John, and other Prävention experts consider it für, that üabout 90 percent of all spending in our health care system on the supply already Diseased target. Professionals preaching for years the immense potential of Prävention and stress, among other things, the importance of health literacy in the Bevöaging of the population. Just educated groups are in the stästrongest of chronic diseases affected. "This pushes the patients to the Black Peter zu", criticized by health researchers Hardy Müller by the Scientific Institute of the techniker Krankenkasse.

Economic expert Effertz looks, especially the legislators responsible: "Numerous studies show that Just by höhere taxes, less Informa­tion, reduced the consumption of tobacco, alcohol and unhealthy foods effectively." The criticism, in order wüit s the people patronize and in their freedom, lässt Effertz not apply. This is the only way wüwould the cost of the event by spätere disorders fair priced. This bill can rise, shows the view in other Lä.

In Scandinavian Lächange policy Maßtook

"Sweden, Norway and Finland for decades, particularly active against tobacco and alcohol vor", Public Health specialist Ulrich John reported. Liquor is not expensive, beer and wine in the supermarket and also not around the clock, tank liquor and cigarettes d&uuml, High;may very eingeschränkt are advertised. The consumption has since declined dramatically. According to studies, a decline in the Smoking percentage has a very positive effect on the heart and Gefäßhealth Bevöaging of the population. "The success stories are all bekannt", Effertz says.

But so far, German politicians reject Steuererhöhungen or another Einschrälimitation of Verfüavailability of nicotine and alcohol. Meanwhile, Germany is the only EU country that still Außenwerbung für tobacco products allowed. Many Bücitizens take the government in a duty. In a repräsentativen GfK survey conducted on behalf of the apotheken Umschau almost 90 percent of the politicians in the debt-to-für the rising cost of healthcare. The HöHey your Krankenversicherungsbeiträge more than 44 percent of Germans now hold für inappropriate.   

Health care: German genießen many Vorzüge

At the same time, Anspr&uuml are;che of the Insured. Üabout the Hähalf of respondents of the survey, alternative healing methods, such as Homöto homeopathy or acupuncture is not completely self-pay, in order to save costs. Almost 77 percent wüauthorities do not want to renounce on innovative and expensive therapies, almost 90 percent is not their free choice of doctor. The Latter is a performance, the patients in the other europäof Lächange is usually not or only eingeschränkt.  

Generally speaking, genießthe German en many Vorzüge health care. So düyou may, at some to plan for a second expert opinion, interventions to obtain. According to the OECD, müonly a few patients from financial Gr&uuml shot;the forego necessary treatment. And with eight hospital beds per 1000 inhabitants 70 percent &uuml Germany;about the OECD average. But some of these supposed benefits of expert values is critical.

Case-fülisten to unnötransparent operations and therapies

"The Krankenhäuser a Infra­structure, the führt, you wird&quot used extensively;, OECD Analyst M&uuml says;ller. So wüauthorities minor procedures such as an almond-OP in other Lächange successfully durchgef&uuml on an outpatient basis;hrt. "In Germany station&auml happens the most;r", M&uuml says;ller. In addition, the number of hospital admissions f&uuml was;r some chronic diseases höas in many other States, such as für Diabetes. Generally speaking, köcould OPs and therapies so because of economic incentives durchgefüwill hrt – and not because they are medically necessary. Want to work for a clinic to be profitable, zäselect high numbers of patients.

"Since treatments are billed with flat rates, suffers from the Qualität medical supply to part erheblich", erklärt Ulrich John. With the Ökonomisierung of medical services you’ve miscalculated. Systematic disincentives to reward those Ädoctors, the many treatments durchfüdo – not necessarily those of the Bedüneeds of the patients are really, says Professor Gian Dome­nico Borasio. He has the Interdiszipli­näre the centre für palliative medicine at the Universität MüMunich and is now head of the Department für palliative medicine at the Universität Lausanne.        

A third of the cost at the end of life

This Einschäup stützt is a result of the pharmacies Umschau-survey. Almost 40 percent of the respondents stated: "I once had the Gefühl, that I offer medical vöcompletely überflücasual was." A tendency to Überversor, which is, according to Borasio, particularly at the end-of-life significantly: "About a third of all costs are spent in the last two to three years of life. The are between 40 and 60 billion Euro per year." A Großpart of it was, in his opinion, Übertherapie.

A good example of dafür cancer patients, according to Borasio. Many chemo therapies wübodies whose life is only a few weeks verlängern– in the worst case, accompanied by violent side-effects. A treatment durchgef&uuml should;be hrt if you are Suffering a lot, probably only verläextended? "Palliative care provides the uncomfortable question of whether you should do anything just because it kann", Borasio says. 

Rising costs in medikamentösen tumor therapies

The cost für tumor therapies have recently risen dramatically, especially because of the innovative treatments are often extremely expensive. Wäwhile a medikamentöse treatment in 2011, has cost on average per Patient 4686 Euro, it was 2015 already 6458 euros. A cost increase of üabout 40 percent of the medicines report of the health insurance company Barmer calculated. The prices medikamentöser – and very successful – Skin cancer therapies have, and even eight-fold. In the interest of the patient, pharmaceutical manufacturers erklären such cost explosions with their high spending für research and development. Critics hold für price gouging at the expense of the entire field of health care and of the sick.

"Patient-hörende medicine wäre automatically ressourcensparender", palliative physician, Borasio says. A science höthe ruling policy wäit re also. In both Fäcases benefited the Insured – also, financially. Effertz: "More Prävention würde a triple dividend: a gesüother Bevöpopulation, höhere Produktivität, höhere tax revenue. And at the end of köcan potentially ­even the Krankenkassenbeiträge can be reduced."

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