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Plans to introduce a law in Germany that would force doctors to notify a patient's health insurance company if medical treatment is for a complication of a beauty operation or piercing have been heavily criticised by doctors and welfare organisations.
Health insurance companies, the law says, would have to deny covering the entire costs for complications of such unnecessary treatments. This would save some €50m (£35m; $72m) in healthcare costs, the German health ministry says. However, its main intention is to strengthen the personal responsibility for health.
At the moment, patients have to pay the costs of medically unnecessary cosmetic treatments themselves (BMJ 2007;335:114 doi: 10.1136/bmj.39279.367662.DB). But complications are still covered by their health insurance company. Doctors usually report diagnoses to the patient's health insurance company but not the causes unless they are because of occupational disease, trauma, unintentional injury, and injuries or complications from vaccinations or malpractice.
The president of the German Medical Association, Jörg-Dietrich Hoppe, criticised the government's plan and called it an attack on doctor-patient confidentiality.
“Patients will not be able to trust their doctors any more if the doctors are trying to sound them out and blow the whistle on them to their health insurance companies,” he said.
The chairman of the German Hospital Doctors' Society, Frank Montgomery, also demanded a change to the law and suggested that additional self inflicted health costs could be covered by higher taxes on tobacco and alcoholic products.
The Sozialverband Deutschland which represents old and chronically ill patients in Germany, said it feared that further self inflicted diseases, for instance caused by tobacco or alcohol consumption or obesity, might also be included in the request for notification.
The Germany health ministry was surprised by the public outcry. “We are just implementing health reform,” said spokeswoman Dagmar Kaiser and pointed towards the already existing obligations for notifying the insurance companies. However, the health ministry will carefully review the passage of the proposed law, she said.