Linke on health and care

The Left wants hospitals funded according to need and quality and wants to replace per-case flat rates with a cost-covering system. It also calls for legally required, fully funded staffing levels for all hospital professions.

Today hospitals get money for each treatment case. The Left wants to change that. Hospitals should get the money they really need. A law should set how many staff are needed.

The platform speaks of taking economics out of hospital care: profit and cost pressure should not shape treatment. It notes that the number of hospitals in the state has fallen from 72 to 44 since 1991 and that many face insolvency. The party accuses the state of not covering enough investment costs and health insurers of saving on operating costs. University hospitals would continue to carry out their mission in research, teaching and care independently.

The Left wants to found a group of municipal hospitals with a permanent state stake and bring private hospitals back under public ownership. In the party's view, private operators run their hospitals for returns and close sites when returns fail to appear.

Many hospitals in the state belong to private companies. The Left wants to bring them back into public hands. Municipal hospitals should join together in one group. The state should take a share and provide money.

The group would act as a holding company handling overall business management and credit management, and would receive equity and loan guarantees. Medical and administrative leadership of each site would stay with the municipalities. Possible members named include the hospitals in Magdeburg and Dessau and the Harzklinikum, plus the state-owned SALUS clinics. As an incentive, the platform holds out partial relief from old debts. Private operators would lose their care mandate if they can no longer guarantee care. In addition, municipal care centers would combine outpatient, inpatient and emergency services.

The Left wants an emergency room at every hospital site except psychiatric hospitals. Rescue and emergency room staff would also get mandatory training on rare diseases.

Every hospital should have an emergency room. Only psychiatric hospitals are left out. Rescue workers should learn more about rare diseases. Emergency ID cards should be respected the same way across the state.

Depending on their mission, sites would specialize in certain fields as basic or specialized providers and network with each other. Planning for equipment such as X-ray or MRI machines would take nearby outpatient care into account. For paramedics, emergency physicians and emergency room staff, the platform calls for regular mandatory training on rare conditions relevant in emergencies. Uniform statewide standards would govern how emergency ID cards are recognized and followed. The party cites an Addisonian crisis as an example of a life-threatening situation.

The Left wants to improve pay and working conditions in health and nursing professions and bring wages up to the western German level. It backs the unions in pushing for collective agreements across the sector. The platform attributes staff overload to past austerity policies.

The Left wants better pay in hospitals and in care work. Wages should be as high as in western Germany. Collective agreements should apply to everyone. A collective agreement sets pay and working hours. Nursing training should also get better.

Collective agreements are to be declared generally binding wherever possible. For nursing training, the platform calls for flexible start dates, part-time options and more varied practical training sites; training is to be paid and, over time, moved to university level. For hospitals it lists more staff, reliable rosters, higher shift bonuses and good staffing ratios. In long-term care, the Left also demands mandatory collective bargaining coverage and reliable staffing standards.

The Left wants to reduce prejudice in health care toward people with HIV and other sexually transmitted infections, people with mental illness, and trans people. To that end, medical staff in particular are to be educated, and prevention, counseling and treatment services expanded.

Some sick people face prejudice at the doctor's office. The Left says this affects people with HIV, people with mental illness and trans people. The Left wants to change that. Doctors and nurses should be better informed. There should be more free tests and more counseling.

According to the platform, treatment is sometimes refused or symptoms are too quickly blamed on mental health. The Left wants to expand and fund free testing. Psychological harm caused by stigmatizing behavior from medical staff is to be prevented, treated and legally sanctioned. The health needs of people in sex work are also to be taken into account.

The Left calls for a state rescue fund of 300 million euros for hospitals. It is meant to make up for missing investment funding and prevent further insolvencies and closures. The state is to meet its obligation to finance hospital investments.

The Left wants the state to rescue hospitals with money. It wants 300 million euros for this. This should stop more hospitals from going bankrupt or closing. The state should also invest in hospitals regularly.

As examples of insolvencies, the platform names the Ballenstedt lung clinic and the hospitals of the Pfeiffersche Stiftungen. The Left wants the federal government to help with investments, for instance through an annual lump sum of up to 2.5 billion euros for new equipment, renovations and modernization. Care is to remain reliable in the north of the state as well; the platform promises emergency and basic care for Havelberg, Genthin and for children around Gardelegen.

The Left wants outpatient and inpatient care to be planned together and linked, especially in rural areas. Hospitals are to become combined outpatient-inpatient centers and later health centers covering both sectors. That way they could also replace doctors' practices that disappear.

The Left wants to change hospitals in rural areas. They should also do the work of doctors' offices. This creates health centers for the region. Sick people get help there even when doctors' offices are missing. The state and towns should be able to become co-owners.

Hospital planning is to serve as a steering tool for cooperative care across the whole state. In coordination with the association of statutory health insurance physicians, hospitals are to be allowed to offer outpatient services for a limited time where specialists are lacking locally, without needing special permits. The state, counties, cities and municipalities are to be able to take stakes in the centers. Dental care, nursing facilities and local pharmacies are to be included. The Left expects the federal government to provide sufficient funding and the legal basis.

The Left wants to fund municipal care centers as central points of contact and secure accessible outpatient care in cities and rural areas alike. To counter the doctor shortage, it relies on additional rural-doctor quotas, more medical school places and broader powers for other health professions.

The Left wants enough doctors everywhere in the state. Towns should get their own health centers. More young people should be able to study medicine. There should be reserved places for future rural pediatricians and dentists. Rural pharmacies should also stay open.

The centers are to combine outpatient treatment with emergency medicine, psychotherapy, nursing and other therapies. Care districts are to be drawn smaller and defined by states and municipalities. Planned measures include a state quota for pediatricians and one for dentists, relaxed grade-based admission limits, and more support for students from the state. Professions such as nurses, midwives and paramedics are to treat and advise patients more independently. Mobile practices (Medimobil), telemedicine, medical care centers for Genthin and Havelberg, and adequate pay for pharmacies round out the list.

The Left wants to prevent private capital companies, especially private equity firms, from buying into nursing facilities and medical care centers (MVZ) on a large scale. Instead, it wants to support MVZ that are run by their owners.

Some companies buy medical centers and nursing homes to make a profit. The Left wants to stop this. It wants to support medical centers owned by the doctors themselves. Big corporations should not come first.

The platform describes such investors as gearing facilities toward returns and then reselling them at a markup. Owner-run MVZ are to take priority over corporations, investors and the expansion of branch practices. The demand ties in with the goal of care in public or nonprofit hands.

The Left wants it to be mandatory that abortion services are available close to where people live. In addition, the topic is to become a fixed part of medical training.

Women should be able to end a pregnancy near where they live. The Left wants to make this a requirement. Future doctors should learn about it in training. That should be required too.

The platform places the demand within outpatient medical care, especially in rural areas. It sets out two obligations: abortion services near where people live and inclusion of the topic in the medical school curriculum.

The Left calls for federal long-term care insurance that covers all care-related costs, so that out-of-pocket payments disappear. To pay for it, the income cap on contributions is to be scrapped and capital income is to be subject to contributions as well. The platform argues that care costs push many people into poverty.

Care in a nursing home costs people a lot of their own money. The Left wants to change that. Care insurance should pay all care costs. People with high incomes should pay in more for this. Contributions should also be due on income from investments.

According to the platform, the out-of-pocket share for a nursing home place has nearly doubled in six years and is well above the average net pension in Saxony-Anhalt. In home care and day care, too, those affected have to cover growing gaps themselves. The contribution assessment ceiling is the income level above which no further contributions are charged; it is to be removed. The Left regards care as part of public services.

The Left wants to introduce a state care allowance (Landespflegegeld) of at least 1,500 euros a year in Saxony-Anhalt. The state is also to cover the investment costs of nursing facilities in full. Nursing facilities are to be transferred to public or nonprofit ownership.

The Left wants state money for people who need care. It should be at least 1,500 euros a year. The state should also pay for building and equipping nursing homes. Nursing homes should no longer belong to private companies.

According to the platform, about 200,000 people in Saxony-Anhalt have an official care level and about 58,000 work in care. Nursing homes' investment costs are no longer to be passed on to residents. By moving facilities into public or nonprofit hands, the Left wants to end privatization; in its view, health should not be an object of speculation.

The Left wants to draw up a state strategy for digital health care. In the platform's view, digital services should ease the shortage of medical care in rural areas and the strain on the health system.

Rural areas often have too few doctors. So the Left wants more appointments by video or phone. At least every second family doctor's office should offer this. Clinics and doctors' offices should be able to share data better.

Digital consultations are to be expanded in at least half of all family doctor practices. The party wants to establish data-exchange standards through the conference of health ministers, the conference of digital ministers and the IT Planning Council. Health facilities are to be networked with one another to improve care. The platform also names a secure electronic patient record as a possible source of relief.