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For context: It isn't, and the underlying misunderstanding is fostered by the reporting on what is going on.
The proposed changes are about to what extent all hospitals have to offer treatment types. There's basics that all hospitals have to offer either way, but for some treatments you want highly specialized departments, both in expertise and in equipment. The underlying issue is basically:
Is it better to have a mediocre [something]ology department in every hamlet, with corresponding constraints on quality of care (as well as higher infrastructural redundancies) or is it better to have better equipped specialized centers that have to cover a larger area (with the corresponding issues of having to transport patients across relatively larger distances)?
It's complicated with genuinely important trade-offs to consider, but the minister whose face is associated with it also became a target of right wing weirdoes and newspapers over corona stuff and the cannabis "legalization".
No, in the original proposals they wanted some hospitals to close all inpatient wards or not having them an "On-Duty-Doctor" anymore there during night hours. That's not anymore a hospital in the classic sense anymore.
It's just that the Bundesrat made it abundantly clear that this won't pass, and the hospital planning is their competence, and none of the federal state.
Also for 08/15 diseases in Internal Medicine or General Surgery you don't need big specialized centres. They can handle a Pneumonia, or the usual decompensated heart insufficience just fine. In the big university hospitals there is also a lot of shit going on, which drags down patient care (like stupid internal fights between departments over who is responsible for Patient X or Condition Y, shitty to nonexistent teaching of Assistant Doctors who are getting burned through and learn hardly any practical skills etc...)
We also have already minimum yearly requirements for some procedures where it's clear that more experience in the centre leads to vastly better outcomes
Are you implying more house doctors will make up for it because the opposite is the case for rural areas.
No, that is not what I wrote.