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MediNetz Jena: between consultations and politics

7 Februar 2015 No Comment

Das Logo des medizinischen Dienstes

There are 34 independently operating medical networks (MediNetz) in Germany, aiming to help people who are not covered by the health insurance system. In Thuringia, there is only one of these  medical networks: MediNetz Jena e.V. is situated in Jena, Wagnergasse.

by Jan

Last year, we came upon a tragic case in Thuringia. A man without passport approached us, looking for help. He was suffering from cough and respiratory distress. For fear of deportation he hadn’t dared see a doctor beforehand. One of the female doctors we cooperate with examined him – and diagnosed a manifest tuberculosis of the lung,” says Jakob from MediNetz Jena e.V. “In Germany, the disease has been all but defeated, not least due to its curability in earlier stages. Despite this our patient died in hospital, as he came to seek help too late. It would have been possible to prevent his death, if only the legal circumstances weren’t so inhumane.”

This specific case has been one of the most severe that the MediNetz Jena e.V. staff has experienced during the organisation’s as of yet short existence. The association was founded approximately three years ago, emerging from an initiative of students of IPPNW (“International Physicians for the Prevention of Nuclear War”) and from the student council of medical studies of the University of Jena.

Cooperation and Mediation

The different medical networks aim to offer treatment to people who, for different reasons, are either not medically insured, or not fully insured – in the end, anyone can fall ill. MediNetz offers complete and anonymous medical care to whomever needs it. The different associations are not nested under a parent organisation, and elsewhere are called MediBüro (medical office) or Medizinische Flüchtlingshilfe (medical refugee relief). Along with 33 other locations, the MediNetz Jena operates independently. Nevertheless, the different networks cooperate with one another, even sharing experiences at annual federal meetings. This year’s federal congress will be organised by MediNetz Jena and will be held from 22/05/15 – 25/05/15. They also support each other with the placement of patients with insufficient health care coverage.

There is a large group of students from diverse fields of studies volunteering at MediNetz Jena e.V. They meet in Wagnergasse, in the rooms of the association Refugio Thüringen e.V., the self-conception of which is one of a psychosocial centre for refugees. There is an option for personal and by-phone consultations; each case is discussed in plenums and the numerous tasks are assigned.

Robert, a helper at MediNetz Jena, informs us that they “are simply the first contact for the patients.” He elaborates that “we cannot treat them, but we arrange further treatment. We can draw from a network of doctors, psychotherapists, midwives and nurses. Over the course of the last three years we have contacted 5,000 resident doctors. Furthermore, in specific cases we will address the doctors explicitly.” The main task is to find doctors willing to cooperate. “We establish contact between them and the patients. The doctors support us with their work – especially in that they work inexpensively and, above all, anonymously,” explains Robert.

Help for the Underinsured

Volunteers from MediNetz Jena e.V. often accompany patients to their appointments, and a translator will be taken along if need be. Donations are the key to financing the work, ensuring that the doctors, working on an honorary basis, can be compensated for lab costs and expenditures for material.

According to the MediNetz team from Jena, it seems a fundamental flaw in the German health insurance system is its policy to offer only limited medical care to specific groups of people. This leads to a systematic underprovision, often resulting in severe health issues for the people not in this category. For example, according to the Asylum Seekers Benefits Act, applicants for asylum are merely entitled to emergency care. Non-obvious or chronic illnesses are neither being taken into account nor treated, one example being dental issues. Tooth repairs are often expensive and cumbersome, and they are commonly removed instead. Additionally, in case of sickness, the patients in question first have to apply for treatment. In the end, social assistance clerks are left to assess the necessity of treatment, and a slimmed down one at that. Illegalised people, such the term coined by MediNetz Jena to refer to people without valid residence permit, face possible deportation even when on a regular doctor’s visit. It is easy for their personal data to find their way to the foreigners’ registration office, as – depending on the legal conception – the social office is subject to circulation obligations. While all doctors are sworn to professional secrecy, costs of treatment for under- or non-insured people are accounted for via the social office. The ambiguous legal situation forces the clerks to decide how to proceed with the information.

“Another major group making use of the association’s help are European citizens whose domestic health insurance is not recognised in Germany,” Jakob adds. He goes on to explain that even German citizens who failed to pay for their insurance may be affected. They too only have limited treatment at their disposal, comparable to that of applicants for asylum, until they have squared their debts with their insurance in total.

The association’s representatives decline to tell us the exact numbers of the people looking for help. It has been obvious nevertheless that there is a great need for the organisation’s offerings.

Jan, working at MediNetz as well, tells us that “this situation contradicts article 25 of the Universal Declaration of Human Rights, the right to medical treatment.” It is for this reason that the association engages in political activism alongside its daily work with doctors and patients. One of the favoured solutions to the situation would be a fundamental reformation of the German health and insurance system. “Our main goal is to effectuate the right to comprehensive medical care,” Jakob closes. “In a best case scenario we would become obsolete.”

Every Monday, personal consultations are being held in the rooms of Refugio e.V., Wagnergasse 25. For those who do not want or cannot come in person, there is the possibility to get in touch with the association via telephone, daily between 4 and 6 p.m. If need be, there will be a return call. The number is: 0157/ 87623764. It is equally possible to write an e-mail to medinetz@listserv.uni-jena.de.

Further information can be found on the internet: www.medinetz-jena.de.

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