Germans go soft on claims of medical kickbacks

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The Independent Online
GERMAN health insurers yesterday presented details of a dozen alleged cases of bribery and fraud in German heart clinics, with talk of paid-for Caribbean holidays and substantial payments into third- party accounts. But, apparently wary of legal action, they backed away from claiming that the practice of offering kickbacks is standard in Germany today.

Horst Seehofer, the German Health Minister, said he believed there was no reason to suspect 'overall' corruption. But he suggested 'there must be more transparency' in the finances of the German health services.

Gert Nachtigal, the head of the country's biggest health insurance company, retreated from direct allegations of widespread corruption. At the same time, he insisted that the problems were serious. 'We may only have 12 cases. But 12 out of 50 clinics is 25 per cent,' he said.

Public insurance companies have claimed that heart clinics paid inflated prices for cardiac valves, passing the cost on to the insurance companies. The implication was that the difference between the proper purchase price and the price paid to the manufacturer went towards free holidays, cars, and other gifts for the heart surgeons involved.

The claims of foul play came from the insurance companies, which seemed eager to blow the lid off a problem that has been stewing for some time. They first mentioned the problems to Mr Seehofer more than a year ago. But it has taken until now for the apparent scandal to explode.

Karsten Vilmar, the head of the main German doctors' association, complained this week of 'slander' and 'lynch justice'. But the critical response of the Suddeutsche Zeitung was not untypical. 'One would like to know how (Dr Vilmar) is so sure that these accusations are slanderous. Wholesale accusations may lead to unacceptable exaggeration. But wholesale exoneration is often mere stupidity. It seems clear that there were heart surgeons whose behaviour was demonstrably wrong.'

Under the existing system, the billing for the standard health insurance schemes is carried out directly, without the patient ever seeing the bills. Ellis Huber, an outspoken doctors' leader in Berlin, says he 'would be happy' if only one in 20 doctors are involved in corrupt practices. There were suggestions this was merely the 'criminal tip of a legal iceberg'.

The scandal involving the cardiac valves has focused attention not just on the corrupt billing of a presumed minority, but also on the cosy relationship between the pharmaceutical industry and the medical profession. The Frankfurter Rundschau suggested yesterday: 'Not everybody is frightened by crossing the pain threshold to straightforward bribery.'