Construction costs are currently skyrocketing

As I see it, you have no idea about the topic, but at least plenty of it :cool: a) Hospitals do not determine the prices but the negotiating parties (GKV + DKG). InEK creates the DRG catalog. b) The number of nursing staff per patient is legally regulated. Those who fall below pay significant penalties. c) Nursing salaries have climbed to TVöD level through the PpSG, and hardly any hospital can afford to pay less. d) Seven-figure severance payments for board members? I have never seen that in 11 years, let alone read about it in health news. We are not in an investment fund here... e) During the Corona pandemic, the EvB (Ernst von Bergmann Klinikum) in Brandenburg had the biggest hygiene problems (double-digit number of deaths). And that is a municipal hospital. We got through without major problems due to our hygiene precautions. And just imagine if all hospitals were nationalized and managed the same way as other projects like BER, Stuttgart 21 or the Hamburg Philharmonic. The costs would rise significantly in a very short time and who would have to pay for this? Yes, the taxpayer. You would surely be the first to get upset because health insurance contributions would rise enormously...

Well, that is only half the truth. There are also private clinics that have an extremely high level of hygiene (I was just "locked in" at a private clinic for a week). And unlike in the Netherlands, we still do not have mandatory widespread MRSA tests here (or has something changed recently?) How is it to be assessed that especially in the large international corporations (AGs), the profits made in Germany are shifted abroad (of course, not all do that)? And who again wanted the DRGs so badly instead of billing based on services and needs? I am rather in favor of transferring into public hands, but no matter what, as soon as a company is large enough, whether hospital, public administration or private firm, they all behave and react very similarly, namely like a very large ship that is hard to steer. Admittedly, I am not completely into the topic, others here do it, and what I think I have understood is that our health system is good, but there is always room for improvement. Several rather incompetent health ministers as well as demands from doctors and hospital corporations have brought us into this situation (my opinion). P.S. We develop and distribute, among other things, software for hospitals and are market leaders in this special niche ;)

But hospitals do not do this. With the introduction of DRG it was designed this way by the government.

Here are two examples. One old and one current, which will probably be implemented.

Old. DRG system. Whether we as a specialized hospital treat a ventilated patient or a paraplegic patient or whether a general hospital does it, which is not specialized in this, the payment is the same. Quality plays no role in the DRG system.

New. Nursing budget and PPR 2.0. Currently, the government is in the process of introducing PPR 2.0. This is supposed to represent the nursing upper limits. But also the budget limits. That means if I now want to hire more specialists so that not 5 patients are treated by one specialist, but only 4 or 3, I will no longer get paid for it and will be left with the costs. The payment of nursing staff also has its limits. This is represented by the TVöD. Although it is not stated in the law, you can hardly negotiate more than TVöD with the health insurers. And the longer you prolong the negotiation, the more problems you have with liquidity, since you first have to cover the costs…

Private hospitals do not skimp on patients, they just use resources efficiently.

The core of my statement should be that proper health care must be free of charge. I do not blame privatized clinics for wanting to make a profit, that is just normal. The problem is that the rates often do not allow this because disease courses are unpredictable. Therefore, the entire system with the prescribed rates must be questioned. However, this makes privatization absurd.

P.S. Among other things, we develop and distribute software for hospitals and are market leaders in this particular niche ;)

First of all, regarding the P.S. We have ORBIS and eisTIK. They are already the Mercedes among hospital software. Definitely in terms of price :cool:

How should one evaluate the fact that especially in large international corporations (public companies), the profits made kindly in Germany are shifted abroad (of course not all do this)

Shouldn't Amazon, Microsoft, etc. also be nationalized then? And vice versa. I once saw a documentary on this issue that Germany would be the loser in case of a change. Why? Germany is an export country. And the profits of Siemens, Bosch, VW, Mercedes are repatriated to Germany.

And who insisted on having flat rates instead of billing based on performance and needs?

The government introduced it. Who wanted what does not really matter in the end. Politics decide.

I am rather in favor of transferring to public ownership, but no matter what, once a company is large enough, be it a hospital, public administration or private company, they all feel and react very similarly, namely like a very large ship that is difficult to steer.

Public ownership means inefficiency and not necessarily a benefit for the patients.

Admittedly, I am not fully into the subject, others here do that, and what I think I have understood is that our healthcare system is good, but there is always room for improvement. We have ended up in this situation because of several rather incompetent health ministers as well as demands from doctors and hospital corporations (my opinion)

The healthcare system is a money-burning furnace. Starting with the health insurance funds whose administrative burden is enormous. See for example the numerous AOK funds. When a project starts with them, it usually does not take place centrally but at AOK Nordost, at AOK xy, and at AOK wv. All three want something different. This already costs a lot more money. It ultimately ends up with the hospitals. They take whatever they can (all of them). And since the government usually issues blanket support, even those who actually shouldn’t or don’t need it get some... But that’s human. See fuel discount. I have yet to see a millionaire at the gas station say: "I gladly pay the full amount without the fuel discount because I have enough"...

The core of my statement should be that proper healthcare must be free of charge. I do not blame the privatized clinics for wanting to make a profit, that is only normal. The problem is that the rates often do not allow for this, because the progression of illnesses is unpredictable. Therefore, the entire system with the fixed rates should be questioned. However, this makes privatization absurd.

I think you have something like that in Great Britain. And guess how the hygiene is in the hospitals there? Yes, abysmal.

First about the P.S. We have ORBIS and eisTIK. They are already the Mercedes among hospital software. Definitely pricewise :cool:

Our software often has "contact" with Orbis, but this is only for heart/thorax documentation, recently also for cardiology.
Insiders will quickly find out which software this can be ;-)

Wouldn't one then also have to nationalize Amazon, Microsoft etc.? And vice versa. I once saw a documentary about this, saying that Germany would be the loser in such a change. Why? Germany is an export country. And the profits of Siemens, Bosch, VW, Mercedes are paid out in Germany.

Not nationalize, but TAX correctly

The government introduced it. Who wanted what is ultimately irrelevant. Politics decides.

mmmh, first wish for it, then the government implements it, and then one is not satisfied and blames politics – or how should I understand that? ;)

Public sector means inefficiency and not necessarily benefit for the patients.

unfortunately often yes, but not necessarily, with many things in public hands synergy effects can (could) also be utilized

The healthcare system is a money-burning furnace. Starting with the health insurance funds where the administrative effort is tremendously high. See e.g. the numerous AOK funds. If a project starts there, it mostly doesn’t happen centrally but at AOK Nordost, AOK xy and AOK wv. All three want something different. Thus, it already costs much more money. Of course, it ends at the hospitals. They take (all of them) whatever they can. And since the government mostly implements indiscriminate support, even those get it who actually shouldn’t/ don’t need it... But that’s human. See fuel discount. I have not yet seen a millionaire at the gas station who said: "I gladly pay the price without the fuel discount since I have enough"....

Exactly! I often see prices for other KIS, ours (not a KIS!) is a bargain by comparison. I have heard stories that invoices were paid for years for contracts that no longer existed, etc.
Regarding health insurance funds, as the only? country in Europe we allow private health insurance? Along with hundreds? of statutory ones. But executive salaries are really spent there unnecessarily... No idea where the problem lies and whether it would be the absolutely right idea, but what speaks against (really ONLY one) statutory health insurance? (Phasing out private health insurance, other countries have managed that too)

Our software often has "contact" with Orbis, but this is only for heart/thorax documentation, recently also for cardiologies. Insiders will quickly find out which software this could be ;-)

Don't nationalize, but TAX CORRECTLY

mmmh, first you wish for something, then the government implements it, and then people are not satisfied and blame politics - or how am I supposed to understand that? ;)

unfortunately often yes, but not necessarily, with many things in public hands synergy effects can (could) also be used

Absolutely! I often see the prices for other KIS, ours (not a KIS!) is a bargain in comparison. I've heard stories about invoices being paid for years for contracts that no longer existed, etc. For health insurance companies, we are the only? country in Europe with a private health insurance? Plus hundreds? statutory ones. But really unnecessary board salaries are paid out... No idea what the problem is and whether that would be the absolutely right idea, but what speaks against (really ONLY one) statutory health insurance? (Handling private health insurance, other countries have managed that too)

Even though I would very much like to discuss the topic at length... We are OT :cool: