Closing the gaps!

Enable doctor visits for people without health insurance

When Erika holds her insurance card in her hands today, she is overjoyed. Because she can go to the doctor again and her health has improved now. For many people, this is something that goes without saying - but not for Erika. In her early 50s, she loses her job. Her application for unemployment benefit II was rejected because she lived with her partner and they were considered a community of needs. However, she had to finance her health insurance herself - family insurance was not possible. Without her own income, Erika could not pay the contributions and after a few years she owed 12,000 euros to the insurance company. As she suffered from severe coughing and frequent shortness of breath, Erika went to a free consultation for uninsured people in Munich in 2019, where the respiratory disease COPD was diagnosed and treated. In addition, with the help of the offer's staff, the contribution debt was reduced to around 3,000 euros. For Erika, this is a huge relief and gives her hope for a better future.

Background

According to the UN International Covenant on Economic, Social and Cultural Rights, all people have the right to freely accessible and affordable health care (UN, 1966). In addition there has been compulsory health insurance in Germany since 2019. Nevertheless there are many people in Germany who have no or insufficient insurance cover. This also affects many Germans who can no longer pay their contributions due to insolvency, loss of income or loss of employment as in Erika’s case. But apart from the financial aspects there are other barriers such as the rejection of homeless patients in regular medical practices. Especially people without regular residence status or domicile often experience discrimination. Often these barriers are mutually dependent (Bundesministerium für Gesundheit, 2023; dbb, 2023). What they all have in common is that they prevent adequate medical care. The patients of Doctors of the World’s domestic projects are in extremely precarious living conditions. A large proportion of them do not have secure housing (81.9%), live without a regular residence status (16.1%) and have to get by on an income below the poverty risk threshold (98%). Many of them worry about their existence, live in an everyday life that is characterised by little stability and security. They often have no functioning social network and are excluded from social participation. This affects their physical and mental health. At the same time, the majority of patients do not have sufficient access to health care (87.7%). As a result, diseases are often discovered and treated far too late. The chances of success of medical and psychotherapeutic treatment are severely limited by these conditions (Ärzte der Welt, 2021 & 2022).

The good deed

With the help of your good deed today people without sufficient access to health care can receive medical and social advice and treatment from the open.med teams. Similar to a normal family doctor's practice, medical examinations are carried out here with the support of doctors and the patients' illnesses are treated. The treatment spectrum ranges from acute infections and chronic diseases to prenatal care. In addition, social counselling is offered. The aim is to help the people to be reintegrated into mainstream care. The use of the Medmobil provides an additional mobile component to the project so that patients for example in the Bayernkaserne or in the area of the main railway station can also receive basic medical care on site. The teams help to ensure that every person has the right to appropriate medical care.