“Why must they do that?”

The criticism was clear: Hardly a good hair of the Federal court of auditors in April 2018 at the orthodontics. Although the statutory health insurance funds spend more than a billion euros a year for teeth straightening, there is much no transparency: It is missing Numbers on how many children and adolescents are treated in exactly, how long and with what result. As a consequence, the Federal Ministry of health ordered a second report (PDF) – and is silent since then.

In this case, the second opinion confirmed the gaps in knowledge, which had denounced the Federal court of auditors. Also here is the balance: The Benefits of dental braces is unclear and needs to be better explored, as the representative of IGES-Institute. “With so many uncertainties, you must clearly reluctant to be in therapy and diagnostics,” says orthodontist Alexander Spassov from Greifswald, and has published several research papers. “And the Insured should be informed about this ambiguity.” How Spassov critics are now calling for consequences.

The Ministry of health expressed

But then it looks at the otherwise bustling Federal Ministry of health currently. At the beginning of January, the Ministry had informed that they would be needed, “the organizations involved in the research and further recommendations for action discuss”. At the request of the LEVEL it is now, these talks are to last until the summer. Due to the poor study situation in the “technical and conceptual questions were not answered ( … )” and “without the technical Knowledge and the supply is close to the dental profession and health insurance companies.”

However, the audit Committee of the Bundestag has set Spahn already a time limit: Up to 30. August 2019, we expect a report of the Federal Ministry of health “about the implemented or planned measures”. The Committee also requested the Ministry already in the previous may, to have an opinion on the long-term effects of braces create.

In 2001 and 2008, there had been criticism of the two institutions at the orthodontics. “With so much Inertia of an entire profession, one has to ask: Why may?” patient representatives Gregor Bornes says. You treat mostly children, and without any serious scientific evidence about the Benefits, risks, and side effects. “Orthodontists earn well above the average, in the System of the statutory health insurance Fund, and expected private benefits,” says Bornes. The health insurance companies played the game for years and the policies have moved in the really important questions so far, nothing: “no one knows whether straightened teeth last longer, or are healthier, or how many teeth by the treatment harm,” criticized the Patient protection.

The Federal court of auditors had already expressed clear recommendations and downtime suspected: The Federal Ministry of health has not investigated the Point to these abuses “for years” and could not “remain in relation to the undisputed findings of the Federal court of auditors, idly and on the actors in the statutory health insurance hope”. The Ministry may instruct, according to the social code book, for example, the Institute for quality and efficiency in health care (IQWiG) directly.

On the demand of the MIRROR, as they wanted to the recommendations of the Federal court of auditors to implement, the Ministry of unspecific. These aspects “are all the subject of ongoing discussions”, this one could not tire “unfortunately, the front yard”.

One of the recommendations that namely independent of the number of patients, services are information just to Themselves, is in favour of at least the top Association of statutory health insurance funds, and suggests, “to extend the health information of the IQWiG to the field of orthodontics”.

Sale conduct scientific study

Achim Kessler, Chairman of the group of The Left party in the health Committee of the Bundestag, is not enough. His group had already made in October of 2018, a Small question to the “effectiveness and transparency in orthodontics” to the Federal government. “We can well imagine, to investigate the behavior of the orthodontist when you ‘Sell’ your services scientifically,” says Kessler. Also orthodontist should have offered additional services to the cash register.

This proposal of the Federal court of auditors has flagged for the Ministry already. “Whoever rejects this, is the accusation that they want to conceal,” says Kessler. “We will follow up at BMG, and to take further steps to urge.”

“The Federal government has looked away for too long,” also criticized Kirsten Kappert-Gonther, Chairwoman of the Green party in the health Committee. “The Ministry of health must protect the patients and patients prior to surgery with questionable Benefit.”

The Ministry of health shows but on the other: The benefit assessment of treatment methods was “not a state responsibility”, the Federal Joint Committee (G-BA) to be responsible. This is not formally correct, only the Minister of health Spahn holds for other issues, changes to this rule.

On demand of the G-BA, however, remains vague and does not want to tire the talks front. “If not, the orthodontics directives of the G-BA correspond to the current state of medical knowledge”, said Josef Hecken, the impartial Chairman, in front of the MIRROR, “will review the G-BA this policy.”