Lump sum for health instead of paying for treatment?

July 3, 2019, 3 pm

Capitation is a lump sum payment system for health care services provided by clinics or physicians for a specified period. The model already applied in Switzerland, Great Britain and the United States rewards quality of care and preventive measures. Although even one in ten Germans do not know "capitation", 75% agree that patients should be helped to stay healthy as long as possible.

The better the state of health and the younger the respondents, the higher the approval. Nine out of ten Germans would also be willing in principle, in cooperation with their doctor, to take measures to preserve their health. This is the result of a representative survey conducted among 1,000 people of the Toluno Institute on behalf of Asklepios Kliniken.

Recently, the Association of Private German Clinics has proposed such a compensation model for rural areas in order to adapt medical care to the needs of patients.

"The capitation model is still largely unknown, but offers new opportunities for which apparently many people are open as soon as they are aware of it," said Kai Hankeln, CEO of Asklepios Kliniken GmbH & Co. KGaA.

Is the fault in the system or at the doctor?

"On the one hand, resources could be used more flexibly in care," added Hankeln, "a second benefit is the incentive to prevention, which is supported by nine out of ten respondents." According to 93% of respondents want closer cooperation between individuals and businesses. Specialists and clinics to improve the quality of treatment, demand more money for health care for respondents in priority.

Only one in two people agree with the statement that doctors are actively looking after the health of their patients. On the contrary, 82% believe that doctors benefit sick patients more than healthy patients. Three-quarters of them complain that doctors tend to be concerned only with acute illness and not with the cause, and 58% sometimes even think that doctors prescribe unnecessary treatments.

Women and the elderly are better prepared for prevention

On a capitation model, 38% hope that unnecessary treatments will be avoided and 30%, it will focus on the well-being of the patient – but 37% fear that this is done to the detriment of the chronically ill. The fear is particularly pronounced with 44% of respondents who feel that their own health is "bad".

The aperture to the capitation model decreases with age: while 85% of the under 30s expect more positive effects, the over 60s account for only 65%. Two-thirds of respondents also suspect that capitation is of particular interest to health-conscious people. 36% consider above all people with higher education as a target group and 35% seniors – but even as mentioned, they are rather skeptical.

At 60%, women are clearly more willing than men (45%) to be "in any case" active in prevention. Only a minority of 7% of women and 10% of men would "do not want" or "not at all". The propensity for prevention increases significantly with age: while the under-30 age group confirms it at 47%, it is 62% in the 60-year-old generation. 61% believe that the influence of the doctor on the motivation is rather large or very large.

Health checks, vaccinations and preventive back training are the most popular.

Free health check-ups, vaccinations, preventive back training and personal nutrition counseling are considered particularly appropriate for improving the health of the population. Even massages enjoy a certain popularity. There is less interest in conferences, organization of meetings and addiction counseling. After all, every second indicates that he himself would take preventive training.

In any case, women who show greater interest in prevention would be much more willing than men to submit to health checks, massages and relaxation procedures. Although addiction counseling is very low, at least 38% of smokers would be interested in weaning classes. With 72%, a clear majority sees the competence for preventive measures at the family doctor.

More than every second pays attention to a healthy lifestyle

Younger people also see a competence of hospitals here. In total, 61% of respondents say they pay special attention to a healthy lifestyle, but in Hamburg they are significantly lower (54%). While half of respondents reported playing sports at least twice a week, many complain of regular back pain.

Although 41% on average report regular stress, the younger the respondents, the more numerous they are. There are up to 58% of people under the age of 30, while only one in four seniors report it. In Hamburg, the average with 47% is even higher and the extreme age difference (68 against 21%). Women also feel much more stressed (57%) than men (36%).

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