A month ago, the Bavarian Red Cross (BRK) opened a clinic for people without health insurance in the center of Augsburg. The practice is open every Wednesday between 9am and 11am, and the BRK is pleased with the demand so far.
Two or three people always attended the free weekly consultation hours in the uninsured practice in Augsburg, says Reinhard Eder.
Serious cases also come into practice
Eder is a retired general practitioner and internist. He supervises the practice on a voluntary basis in cooperation with the BRK. So far, it has been possible to help patients, prescribe medication or refer them to other doctors. Most people aged 60 and over would have sought help from the practice with a wide variety of complaints, such as post-heart attack care.
Now a 69-year-old man presented to Eder with a hernia. The man wants to remain anonymous, but gives a little insight into his story: The 69-year-old lives in a mobile home, works as a craftsman and has never had health insurance: “I never needed it. And that’s how long I’ve been I didn’t think of that there. This is the first time I’ve had this problem. I was hoping to get some help here now,” he says.
Ambulatory surgery saves hospital costs
Eder quickly realizes that the man needs an operation, but the operation plus hospital stay would cost a good 2,600 euros, too expensive for the patient. Eder calls a friend’s surgeon without further ado. “Now I have put him in touch with a surgeon who operates on an outpatient basis. The patient has few savings and can spend up to 1,000 euros on the operation. And next week he goes to the surgeon and introduces himself. That is relative, it is done with little effort and the patient can return to normal life,” says Eder.
People without insurance are embarrassed
Eder wants to help his patients pragmatically and without bureaucracy. One thing is that they often cannot afford medical treatment. The other thing is embarrassment: many people without insurance find it difficult to go to the doctor. An estimated 60,000 to 80,000 people in Germany don’t have health insurance, says Eder.
Most of the people coming in now are so-called old cases. “We have compulsory health insurance since 2009. And it is partly the case that these families have not had health insurance for generations, for example in the agricultural sector. And they continue to live as they used to. And now they are old and now the problem often manifests itself.
No benefits due to lack of insurance contributions
Other patients, on the other hand, used to have health insurance, but could no longer afford their insurance premiums. “In such a case, the insurance is suspended and the person is no longer entitled to insurance benefits,” explains Eder. It is the same with Rudi, 60 years old. He used to have private insurance, then statutory insurance, and now she is in Augsburg uninsured practice for the second time. Rudi seems very nervous. “I have a urological problem and it hasn’t been treated for a long time,” he says.
Eder arranged for a blood test, which an Augsburg laboratory took care of free of charge. Eder has bad news: there is an urgent suspicion of a malignant change in the prostate. “So we urgently need a first and second urologist, and above all a financier. And now he will go to the employment office and see if he gets Hartz IV, that he is at least insured and that further treatment can be taken over by the insurance company.” Health insurance”.
Uninsured practice relies on donations
Eder visited other practices for the uninsured, for example in Mainz or Hamburg, and observed the processes there. The “Practice without Borders” in Hamburg, for example, is of a completely different size: More than 60 people work there on a voluntary basis, covering many medical fields.
Eder can only dream of this: Everything remains very simple in the Augsburg practice: there are two tables and a patient sofa in the treatment room. But soon there will also be ECGs, pulmonary function devices and ultrasounds, used medical devices, for example, from practice closeouts. They must be financed by donations.
In the long term, funds should also be set aside to be able to pay for medicines and necessary operations for patients. Eder also looks forward to colleagues who can replace him in the uninsured practice, or who can care for one or another patient or provide specialist advice.