In principle, it is to be welcomed when Karl Lauterbach now recommends that homeopathic and anthroposophical services be deleted from the statutes of statutory health insurance funds. “Services that have no proven medical benefit must not be financed from contributions,” the “Spiegel” quoted from a new paper by the Federal Health Minister.
Especially now, when people with statutory health insurance are waiting a little anxiously to find out whether their fund will increase their contributions from 2024 due to a deficit, it is difficult to understand why scarce money is being spent on "alternative" treatments whose benefits have not been convincingly proven. The doctors are already a little ahead of the Minister of Health: Due to a lack of evidence, the German Medical Association voted in May 2022 to remove the additional medical title homeopathy from further training. Most regional medical associations have now followed this decision.
Health insurance companies, on the other hand, have so far been allowed to list even controversial "alternative" treatments in their statutes - as additional services with which they can stand out from the competition in order to attract insured persons who may be willing to change. At least that could soon be over according to Lauterbach's plans.
However, the Federal Minister's proposals should still leave room for homeopathy at health insurance costs: insurers should be allowed to continue to offer additional tariffs for alternative medicine. Homeopathy would then remain part of the statutory health insurance system - which actually always wanted to advertise that it only finances things that are proven to be effective, so-called evidence-based medicine. Soft exception rules for poorly proven treatment concepts undermine the credibility of the solidarity-funded medical industry.
The direct savings effect of fewer globules on health insurance costs should be manageable: According to the Federal Association of the Pharmaceutical Industry (BPI), statutory insurers spent just under 7.2 million euros on homeopathic medicines in 2022 - that is 0.01 percent of drug expenditure in the health insurance market. The largest part of the homeopathic business is paid for out of private wallets: according to the BPI, around 534 million euros in sales were generated in pharmacies and mail order in 2022.
Another problem: Even with the new health insurance rules, homeopathic medicines continue to be traded as medicines that are only available in pharmacies and are thus scientifically ennobled. Pharmacies are thus retained as a kind of “scientific setting” for a therapeutic approach in which, in some cases, no active ingredient can even be detected in the highly diluted preparations.
It will now be interesting to see to what extent Karl Lauterbach will not only put globules, but also homeopathic doctor's consultations on his savings list in the future. So far, health insurance companies are still allowed to conclude special contracts with homeopathic doctors and then also partially pay for their “anamnesis discussions”. These are significantly better rewarded than discussions in a practice that does not offer homeopathy.
Even savings on alternative medicine sessions are unlikely to plug the financial holes in the health insurance companies. But they could focus on the question of how much money the important and often even healing conversation between doctor and patient is worth to us, the contributors, regardless of specific treatment options.
Not least because the discussions between evidence-based doctors have not yet been rewarded so generously by the health insurance companies, a doctor's meeting in this country only lasts eight minutes on average. Then you have to get out of the consulting room again. Those who suffer most are patients who, during this time, are often unable to first explain their symptoms and then understand the potentially complex therapy they are supposed to undergo. This urgently needs to be improved – through better remuneration for all “talking medicine”. But a few million euros saved through homeopathy won't be enough.