Social legal self-administration - How we patients can be active - Part 1

This article deals with the topic of self-administration under social law, regulated in §§ 43 ff. SGB IV - Further articles on this topic will follow

Social elections, what is it anyway?

Some of you may still vaguely remember a letter from the health insurance company from 2017, which offered the possibility of social choice. Many asked themselves about the meaning and purpose, just as many did not participate because the meaning did not immediately become apparent. If you take a closer look, the very concept of social choice doesn't sound particularly “sexy”. “Social” may still work, but there are likely to be ambivalent feelings about elections in general.

Why can this be of great importance to us?

In the social elections, it is determined who sits on the decision-making bodies of the social insurance carriers (health insurance companies, German pension insurance, professional association) and has a say in decisions. This concerns decisions about preventive measures, rehabilitation measures, claims for benefits, e.g. B. in the Board of Appeal. Board of Appeal? Anyone who has already submitted a claim for benefits to their health insurance fund knows roughly what the appeal committee is. The latter makes the final decision on the claim for benefits. If this is positive, the contradiction is remedied. If this turns out to be negative, legal action must be taken or the matter abandoned.

When it comes to many things, we often say: It's no good anyway. However, we often give up too quickly here. Admittedly, with our illness we already have to spend some time “on the cheek”, but - without wanting to act like a senior teacher here - women can do something.

Social choice and the German hunting association

The readers of this blog might think: now it's getting bizarre. What do I have to do with the German Hunting Association? The German Hunting Association has 243.628 members (as of 2016) and is in 2017 started for social election. If you also know that the principle applies in many constituencies: voting without voting (!), Then things get interesting. That means:

There are not enough people who make themselves available to vote, so not enough passive electorate.

Our number of patients is estimated at 3,5 million women in Germany, the number of unreported cases is far higher. All of this may just be a number game, since it is based almost exclusively on estimates, I would ask you to look up this inaccuracy. From a statistical perspective (source: Statista), around 2017 million people were privately insured in January 8,77; If one subtracts about 50% as the proportion of women (4,35 million) and takes 10% as an estimate of those affected by lipedema, ie 435.000 women, there are still 3 million women left as potential voters and candidates for election.

As I said, please look after these number games with their high inaccuracy.

Social self-administration - how does it work?

Those insured by the statutory health insurance funds (including the German pension insurance and the employers' liability insurance association) can join forces to form so-called free lists. Depending on the insurance company - what z. B. applies to each individual health insurance company - up to 2.000 supporter signatures must be brought together (so-called quorum).

The representatives elected from the group of insured persons are then active in the self-governing bodies of the insurance carriers after the elections.

One advantage: You don't have to fit into a party corset.

Is it really that far away?

The next social election will take place in 2023. That still seems a long way off. Perhaps by then liposuction for lipedema will already be part of the service catalog? It should be noted here that many studies took longer than expected. In addition, decisions are to be expected in 2022 at the earliest, more likely in 2023 or later. We must also not forget that to date we have only had symptomatic treatments available; a causal treatment of our disease - as it is genetic - does not yet exist. All the more a reason to ensure that interests are represented.

Do you feel too small and too powerless? I throw the following question around: Who of you has ever had a mosquito in your bedroom?

With this in mind, more about this and many other topics on this blog,

best regards,

Your Ruth Leitenmaier