Advance Directives: Private Non-Covered Health Service or Part of Primary Health Care?
DOI: 10.3238/zfa.2012.0087-0093german translation / full article
Summary: Conversations about medical advance directives are of increasing importance in the daily routine of family physicians. Since these conversations are neither curative nor preventive in the strict sense of the word, they are not explicitly listed in the performance catalogue for family practitioners of the German statutory health insurance (quarterly lump sum per patient). Should these conversations nevertheless be viewed as part of the statutory health insurance’s performance package, or is it legitimate to charge patients privately for this service? This article documents a discussion of this question, led in the German family physician web panel “Listserver” in autumn 2011. A subsequent commentary recommends from a political point of view to focus on the sum of family physicians’ lump payments than to the question whether a single performance is covered by it or not. A second commentary argues that the entire discussion misses the point considering the underdevelopment of distribution, relevance, validity and recognition of patient advance directives in Germany.