Risiken der Priorisierung in der Rehabilitation

Abstract

Prioritization, on the one hand, is a necessity in everyday medical practice. On the other hand, a vivid controversy is taking place in particular as to how prioritization can be formalized in order to allocate resources in the German (statutory) health care system in the best possible manner. Some believe prioritization to be just a preliminary stage for rationing resources. Others point out that if human dignity, medical needs, and solidarity within society are taken into account properly, prioritization can contribute to an improvement of distributive justice and quality control in the health care system. With respect to the rehabilitation system this has already been discussed in the late 1990s, when the main rehabilitation carrier--the German statutory pension insurance scheme--had been forced by legislation to implement major cutbacks in rehabilitation spending. In this article, the authors analyze whether the German social code book IX (SGB IX), in force since 2001, has added new aspects to this debate, and consider the question of whether prioritization can be a useful approach in the rehabilitation system.