Bernd Hontschik

Bernd Hontschik (2009)

Bernd Hontschik (born December 11, 1952 in Graz ) is an Austrian surgeon , author and a columnist for the Frankfurter Rundschau since 2007 .

Life

Hontschik attended school in Frankfurt am Main and graduated from high school in 1971 at the Goethe grammar school there . He studied medicine at the University of Frankfurt am Main and completed his specialist training as a surgeon from 1978. He received his doctorate in 1987 with a paper on unnecessary appendix operations in Frankfurt am Main. Until 1991 he practiced, most recently as a senior physician , at the Frankfurt-Höchst City Clinics and then until 2015 in his surgical practice at the Konstablerwache .

Memberships and functions

Hontschik was a board member of medico international from 1982 to 1988.
From 1998 to 2013 he was a board member of the Thure von Uexküll Academy for Integrated Medicine.

Prizes and awards

In 1989 Hontschik received the Hans Roemer Prize from the German College for Psychosomatic Medicine (DKPM). The Board of Trustees of the Hans Roemer Foundation annually awards a prize for the best work that promotes the integration of psychosomatic issues into general medicine or the clinical disciplines of medicine, with preference given to works in which the relationship between psychosocial factors and somatic processes is empirically based or work that has tested models for integrating psychosomatic care in clinics, practice and training.

Positions

In his columns, Hontschik often criticizes grievances and undesirable developments in the health system, in Germany and in institutions that operate around the world.

Flat rates per case

The flat rate system that Hontschik assigns to Agenda 2010 rewards "actions and interventions", but allows births that last too long to turn into negative business. A midwife reported that it was not an isolated case that she often had to look after up to five women giving birth at the same time. Hontschik complains about the "deformation of medicine", which becomes apparent, among other things, in the change from daily rates to flat rates. The time-based system was replaced by a diagnosis-based system based on the Australian model between 1999 and 2002. The economic link between medical activity and diagnosis with the level of payment is fatal.

“As the diagnosis alone generated the hospital's income, it became the central target of economists. Thousands of coding specialists and medical controllers from the hospitals fought every day with thousands of coding specialists and medical controllers from the health insurance companies for every euro. "

Two-tier system

Hontschik refers to a Bertelsmann study to include all citizens in statutory health insurance. This shows how health insurance in Germany, as in all neighboring countries, can be financed in solidarity. Germany is "the only country far and wide that gives a tenth of its population the opportunity to say goodbye to the solidarity system with private health insurance." The medical incomes would not be in any danger either, because privately insured people could take out additional insurance.

"Pharmaceutical lobby"

In the so-called pharmaceutical lobby , Hontschik sees the risk of increased prices, the overburdening of health insurance companies and injustice in treatment in emergency situations ( triage ). The German health insurance companies would have spent 226 billion euros in 2018, 40 billion euros of which was for pharmaceuticals. Hontschik cites Zolgensma as an extreme example , a dose of which costs two million euros. The astronomical price for Zolgensma does not reflect research costs, but the price that Novartis paid for the takeover of Avexis.

WHO

On January 26th, 2019, Hontschik expressed himself critical of the World Health Organization with regard to financing and dependence on economic interests:

“The original mission of the WHO in 1948 was to define diseases, develop standards for their treatment and disseminate them worldwide. He's finally perverted. First of all, the food companies ensure that obesity, vascular diseases and diabetes spread more and more all over the world, in order to then sell the solutions for them profitably with the pharmaceutical industry. The conquest of the WHO by corporations and foundations allows them double profit, once in the cause of diseases and then in their treatment. "

Gates Foundation

Hontschik sees the origin of the money of the Gates Foundation in fixed assets, especially in Coca-Cola, PepsiCo, Unilever, Kraft-Heinz and other alcohol and pharmaceutical companies. Since the Gates Foundation is one of the main financiers of the WHO through donations, Hontschik sees this as the reason why the WHO is not "resolutely against the aggressive marketing of all these manufacturers of junk food full of sugar, fat and salt".

Financial market speculation and pandemics

In 2019, Hontschik warned of the connection between pandemics and financial market speculation. The international financing of world health depends on "financial market-controlled betting shops", "which count dead and countries free of all morality and humanity".

“While the poorest of the poor die, the richest of the rich get richer. It is probably only a matter of time before not only the fight, but the outbreak of epidemics becomes the object of betting and high returns. Nobody far and wide sets limits to the cynical creativity of the financial market. "

The world after Corona

An interview by Stefan Hebel with Bernd Hontschik in the Frankfurter Rundschau as part of the series Die Welt nach Corona caused a stir on May 30th, 2020 . In the interview, Hontschik raises serious allegations against Health Minister Jens Spahn, but above all he outlines the utopia of a health system free of profit interests, which excludes listed corporations oriented towards the common good, which reduces health insurance companies to their actual tasks, which favors the separation between outpatient and inpatient care integrated supply structures and that provides for the curtailment of the "obscene" profits of the pharmaceutical industry.

Publications

Since then, Hontschik has published several books on surgical, social medicine and health policy topics. He is the editor of the now 16-volume paperback series "MedizinHuman" published by Suhrkamp Verlag .

Theory and Practice of Appendectomy (1989, 2012)

In 1989, Hontschik received the Roemer Prize of the German College for Psychosomatic Medicine (DKPM) for his dissertation on appendectomy . It was published in 1994 by Mabuse Verlag in the 2nd edition. This investigation comes to the conclusion that there is no such thing as “chronic recurrent appendicitis ”. This is a widespread surgical indication, especially in German-speaking countries, which particularly affects a large number of girls and young women. The accumulation of this diagnosis on Mondays and the frequent urging of the mothers for an operation (whereby patients and relatives are usually happy if a surgical procedure can be avoided) point to a hidden psychodynamics , namely to conflicts between parents and adolescent daughters striving for independence that came to a head, especially on weekends.

The author presented the topic again in 2012 in his work Short History of Appendectomy. Myths, facts, perspectives .

Body, Soul, Human (2006)

Anyone who thinks about medicine in the 21st century has a big complaint in their ears: Patients feel misunderstood, doctors see themselves surrounded by constraints, while technology and ever new alternative methods make promises of salvation. But how do we really get healthier? After more than 40 years as a surgeon, Hontschik tries to think about his daily work - and beyond - and pleads for a rethink in medicine. The first, and thus also paradigmatic, volume in the MedizinHuman series deals with the wrong ways in advanced medicine and the importance of medical creativity. Why do wounds not heal against all logic? Why do drugs sometimes work and sometimes not? His answer: Man is much more than a "trivial machine" and the art of healing consists in treating him as such: as a unity of body and soul.

Illness harms your health (2019)

Hontschik sees the prerequisites for a very good health system in Germany. But unfortunately, business economists, economists and lawyers have the say. He laments the withdrawal of human medicine and the change from medicine to a commodity. The author sees the separation of the health system from the Ministry of Social Affairs and its integration into the Ministry of Economic Affairs as the political concept of turning the social system into an economic sector.

“It's about replacing the primacy of human medicine with the primacy of profits, of the shareholders. Profit or healing, helping care are incompatible. You have to decide - politically. And in our country the die is falling more and more in the direction of private capital and profit, less and less in the direction of human medicine. "

Hontschik explains this using the example of caesarean section, where the change in the fee schedule shifted the ratio of emergency cesarean section and planned routine cesarean section from 40/60 to 60/40; in back operations, intervertebral disc operations and arthroscopy of the knee joint. At the same time, physiotherapy is stunted: "Since medicine in our country is centered on drugs, operations and technology, physiotherapy leads a shadowy existence." The situation of the hospitals has worsened, the number of hospitals and beds has decreased by around 40% from 1980 to 2010, the length of stay has been halved to one week and over 50,000 jobs in the care sector have been cut.

“.… It's about saving human medicine from access to capital. The whole healthcare ship is headed in the wrong direction. It is high time to stop the neoliberal change of course. The ship would then not have to go backwards, but forwards in the direction of a modern social system that serves the health of all and not the profit-making of a few. "

Private

Hontschik is married to the supervisor Claudia Hontschik and they have two grown children.

Fonts (selection)

As an author:

Appendectomy theory and practice. A historical, psychosocial and clinical study. Pahl-Rugenstein, Cologne 1987.
with Hermann Plagemann: Medical assessment in social law. Deutscher Anwaltverlag, Bonn 1996.
Epilogue to: Max Kirschner: There is a time to cry and a time to laugh. Memories from two worlds. From the American by Ebba D. Drolshagen. Jewish publishing house in Suhrkamp Verlag, Frankfurt am Main 2004.
Body, soul, person. Try on the art of healing. Suhrkamp, Frankfurt am Main 2006.
Affairs of the heart. Medicine can be so beautiful. Weissbooks.w, Frankfurt am Main 2009.
Brief history of appendectomy. Myths, facts, perspectives. Marseille, Munich 2012.
Hippocrates for sale. About the creeping destruction of the solidary health system. Weissbooks.w, Frankfurt am Main 2014.
Illness is bad for your health. Westend Verlag, Frankfurt am Main 2019.

As editor:

with Thure von Uexküll : Psychosomatics in surgery. Integrated surgery - theory and practice. Schattauer, Stuttgart 1999.
Psychosomatic Compendium of Surgery. Marseille, Munich 2003.
with Wulf Bertram , Werner Geigges: In search of the lost art of healing. Building blocks for integrated medicine. Schattauer, Stuttgart 2013.