Prevention Act

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Basic data
Title: Law to Strengthen Health Promotion and Prevention
Short title: Prevention Act
Abbreviation: PrevG
Type: Federal law
Scope: Federal Republic of Germany
Legal matter: Social law
Issued on: July 17, 2015 ( BGBl. I p. 1368 )
Entry into force on: July 25, 2015;
Art. 2 and Art. 7 on January 1st, 2016
GESTA : M008
Weblink: Text of the law
Please note the note on the applicable legal version.

The Prevention Act (PrävG) is an article law that has been taking effect in Germany since 2016 in the areas of disease prevention (prevention) , health promotion and early detection of diseases .

Germany

The cornerstones of the PrevG were presented jointly by the federal and state governments in September 2004; the draft law by the SPD and Alliance 90 / The Greens was first read in 2005 and should have come into force in 2008. However, the legislative process was delayed by differences within the coalition, then by a change of government and most recently by the 2013 federal election . In autumn 2014, a new draft bill for a prevention law was published, which was discussed until June 2015 and mostly came into force on July 25, 2015.

The main contents of the law, the articles of which consist exclusively of amendments to various other laws (especially the Social Security Code ) plus an introductory formula and the final article on entry into force, are:

  • The social security agencies (health insurance companies, pension insurance, accident insurance, private health insurance companies, federal, state, local authorities, Federal Employment Agency) and the social partners occupy a national prevention conference , which is to develop a "national prevention strategy" (based on the model of the cancer plan ).
  • The care insurance will pay for preventive services.
  • Various measures are intended to promote vaccination , including a. Mandatory advice for parents.
  • Doctors can issue "prevention recommendations" on the services of providers in health promotion such as adult education centers, sports clubs and fitness centers (the media speak of "exercise on prescription"). Prevention courses are subsidized by the health insurances if the courses correspond to the quality requirements of the GKV for § 20 SGB V (see Prevention guidelines).
  • The health and long-term care insurance funds set up prevention programs for community facilities (schools, daycare centers, companies, care facilities) worth € 500 million
  • For self-help groups , the health insurance funds will provide € 1.05 per insured person from 2016, a total of around € 73 million. In contrast to the original draft, this amount was doubled.
  • The Federal Center for Health Education (BzgA) receives an annual subsidy of € 32 million from the health insurers.

According to MP Karl Lauterbach, the total costs amount to € 300 million a year. Greens and leftists rejected the law because it only affects and burdens those insured with statutory health insurance; the Greens also criticized the fact that the municipalities were not getting enough involved. The associations of the health insurance funds complained in particular that the BzgA, a federal authority, is now subsidized with insurance contributions.

In 2019 - as provided for by law - the National Association of Statutory Health Insurance Funds, in cooperation with the associations of health insurers at the federal level, defined the fields of action and criteria for the services of the health insurers in primary prevention and company health promotion , which are binding for the provision of services on site. The types of benefits include individual behavior-related prevention in accordance with Section 20, Paragraph 4, No. 1 and Paragraph 5 of Book V of the Social Code, prevention and health promotion in living environments (such as school, study, sport, etc.) in accordance with Section 20a of Book V of the Social Code, as well as corporate health promotion in accordance with Section 20b and 20c SGB V.

Problems of implementation

Based on previous experience, it is critically noted that the preventive measures remained selective and that neither structure formation nor participation took place. Successful cooperation between the health insurers and with the providers of living environments such as daycare centers, schools, etc. would stand in the way of traditional routines and false incentives. The health insurers are not obliged to cooperate. The fields of action and target groups of prevention are also not sufficiently specific, since the National Prevention Conference presented only a vague system of objectives based on the curriculum vitae: "Growing up healthy", "Living and working healthily" and "Healthy in old age".

As early as 2017, the health insurance companies complained that the law was not effective, since the law in particular did not oblige the states and municipalities to promote health. Except in Lower Saxony there is no single point of contact that enables a cash-wide approach. The National Association of Statutory Health Insurance Funds mainly criticized the (forced) cooperation with the BZgA, to which the health insurances would have to transfer 45 cents per insured person, i.e. 32 million euros, for which the BZgA should develop prevention programs. The BZgA would pass these funds on to subcontractors who, however, did not adhere to the schedules and did not complete the tasks in the agreed quality. Coordination processes and communication are always non-binding or incorrect. Therefore, only just under 3 million euros could be accessed in 2016. The BZgA rejected the criticism, arguing that the health insurance companies would not accept their conceptual proposals. Accordingly, concepts for evaluating the measures are still pending.

Switzerland

In Switzerland, on September 30, 2009, the government submitted a draft law to parliament for a prevention law to be created. The preliminary draft was received controversially in the previous consultation . After approval in the National Council , the draft finally failed in 2012 in the Council of States, despite the majority approval of this Chamber as well, because the spending brake in Switzerland since 1995 would have required a qualified majority of over 50%, which was not achieved. The decisive factor, however, should not have been the costs, but liberal counter-arguments.

Web links

Germany:

Switzerland:

Individual evidence

  1. ↑ BT-Drs. 15/4833
  2. ↑ Federal Council: Prevention Act falls through in the Federal Council. In: bundesrat.de. German Federal Council, September 20, 2013, accessed on July 22, 2015 .
  3. ↑ Procedure and documents in the DIP on the Prevention Act
  4. ↑ Text and changes by the Prevention Act - PrevG ( Federal Law Gazette I p. 1368 , PDF)
  5. ↑ BMG: Bundestag passes prevention law. In: bmg.bund.de. Federal Ministry of Health, June 18, 2015, accessed on July 22, 2015 .
  6. ^ Ärzteblatt -Autor TG: Prevention Act passed in the Bundestag. In: Deutsches Ärzteblatt. June 18, 2015, accessed July 22, 2015 .
  7. ↑ ÄrzteZeitung -Autoren af, fst: Bundestag: Prevention law passed with some changes. In: ÄrzteZeitung. June 18, 2015, accessed July 22, 2015 .
  8. ↑ Prevention guidelines
  9. ↑ Rolf Rosenbrock: Prevention Act 2015 - Challenges of Implementation. In: Public Health Forum, Volume 26, Issue 2, 2018. DOI: https://doi.org/10.1515/pubhef-2018-0004
  10. ↑ So the criticism of the Greens; see. Florian Staeck: The prevention law arrives at Kita & Co. with difficulty, in: www.aerztezeitung.de, October 4, 2017.
  11. ↑ Prevention: Health insurance companies want to push back BZgA. In: Prevention: www.aerzteblatt.de, July 14, 2017.
  12. ↑ Federal Assembly: 09.076 - Prevention Act. In: parlament.ch. The Federal Assembly - The Swiss Parliament, 2012, accessed on July 22, 2015 .
  13. ↑ Katharina Fontana: Prevention Act: The draft is finally off the table. In: Neue Zürcher Zeitung. September 27, 2012, accessed July 22, 2015 .