False Economies

Abstract

At last, someone has made the effort of drawing attention to the “forgotten disease” that is tuberculosis, especially to the global catastrophe of increasing drug resistance. At the district hospital in Parsberg—the only closed quarantine hospital for TB in Germany—we have been treating recalcitrant TB patients for more than 40 years; in the past 10 years we have increasingly recorded a substantial increase in the MDR/XDR (multidrug resistant/extensively drug resistant) forms of TB. Since 2008, Germany’s federal states have been contributing to the treatment costs (costs of isolation treatment) because this is state responsibility under the Infection Protection Act. Since then, inpatient occupation has dropped by 50% and the number of TB cases by 70%. My question is: where are these patients being treated now (the incidence has stayed roughly the same)? Or has a penny pinching mentality spread among the health offices and states and false economies applied that would put us all to shame in view of the billions invested in saving the banks? The medical service of the health insurers also examines almost each and every case and increasingly refuses inpatient treatment for such patients (who are difficult to deal with on a personal level as well as from a medical perspective). The demise of our hospital is therefore merely a question of time. But if specialist hospitals, such as ours, with their in-depth knowledge of how to treat drug resistant TB are abolished and the public health services sacrifice their careful approach on the altar of cost savings, the global catastrophe will rapidly become a national catastrophe—albeit a self inflicted one.