The electronic health card cannot do much

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The new electronic health card can do little more than the old health insurance card

All over Germany, statutory health insurers are currently being asked to send their photos to the health insurance company. The background is the introduction of the new electronic health card (eGK). Up until now, the switch from the old health card to the new health card has cost around 600 million euros. Critics complain that the new chip card can hardly do more than the old one. In addition, there are still technical defects that do not correspond to a high level of data protection. Nevertheless, the distribution on the part of the black and yellow federal government is being pushed with massive pressure.

Hardly any additional functions
Although the new electronic health card has hardly more functions than the old health insurance card, the introduction has so far caused around 600 million euros. The insured must ultimately pay the costs of this undertaking, which has been in the planning phase for five years, with their contributions. The federal government has not made any new funds available for the changeover. The provision of the technical infrastructure in the outpatient medical practices and hospitals alone costs an estimated 156 million euros. The distribution of the electronic health card for all of the 70 million health insurance patients in Germany will cost around 139 million euros, according to some experts. In addition, there are development costs, the cost of adding data, and bureaucratic expenses.

The only visible change to the new card is the passport photo of the cardholder on the front. This is to prevent third parties from stealing health care. With the exception of twins, the illegal use of insurance benefits is made almost impossible. In addition, insured persons can have chronic diseases, blood group, living will or information about allergies saved if they wish. If the idea also contains a willingness to store organ donation, the required majority in the Bundestag, this data can also be transferred to the card in the near future. So far, all other innovations are only declarations of intent. These include, for example, medical reports and diagnoses, MRI or X-ray images that are to be made available on the chip card. When this feature is feasible is still in the stars, because in terms of data protection, there are still inconsistencies at numerous corners and edges despite the encryption technology. During the first test runs, there were considerable delays in the process of retrieving the data because, in some cases, the reading only worked very slowly. Therefore, according to a survey by the Techniker Krankenkasse, two thirds of the doctors surveyed were in favor of making the system stable before the new card was put into circulation.

Long planning phase until implementation
If you look at the timing of the planning and implementation phase, you will find that due to internal inconsistencies, organizational problems and technical difficulties, the introduction of the health card has always been postponed. Because the new card should actually be introduced 3 to 4 years ago. However, in order to speed up the process, the federal government acted and ordered the health insurers to provide at least ten percent of the insured with health cards by the end of the year. Otherwise, the individual health insurance providers face severe fines, which could lead to smaller health insurance companies in particular. The Federal Ministry of Health announced that the distribution should be completed by 2013 at the latest.

Considerable privacy concerns
The Chaos Computer Club (CCC), however, was harshly criticized. According to the initiative, there are "considerable concerns whether the sub-area 'electronic patient record' meets the high data protection requirements that are expected of patients and doctors". In addition, the CCC believes that “building the complex infrastructure is hardly economically viable”. In 2006, the association's CCC experts were provided with evaluation data from the consulting firm Booz / Allen / Hamilton. From this it could be read that the introduction of the card will lead to “no savings” in the health system. "On the contrary, in the first few years the eGK will be a decent minus business for the health insurance companies and thus also for the insured," summed up the CCC in a press statement. Health insurance companies and the federal government are more optimistic. Overall, savings of billions are expected.

Refusal of the insured is futile
Refusal by the insured will be difficult. Even if individuals refuse to give their passport photo, the change is delayed for themselves, but at the latest when the old cards have expired, they will no longer be accepted in clinics and medical practices. Both cards are only to remain valid in one contact time. If there is no medical emergency, doctors can refuse treatment without an insurance card. At the latest, the changeover will be urgently required for everyone. In order to facilitate the sending of the pictures, some large health insurance companies have started to set up special websites on the Internet. Cash register members can upload their passport photos there using a secure connection. Some cash registers even allow uploading via MMS. Ultimately, all of these measures should lead to the implementation being completed on schedule by 2013. (sb)

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