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  Suggestions For a New Financial Support System in Anthroposophical Medicine

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By: M. Book
New Financial.doc

 (Original title: Anregungen zur Einrichtung eines neuen Kostentraegersystems fuer die an-throposophische Medizin. Der Merkurstab 1996; 49:326-8. English by A.R. Meuss, FIL, MTA.)

Childhood, sickness, old age and accidents are situations where assistance is needed to ensure the continuance of the human race. Provision of this is a basic moral principle by which natural evolution becomes cultural evolution.

The insurance concept is essentially based on this principle, though in our modem civilization this has almost turned into its opposite. Interest in the needs of others conflicted with a desire for personal security, making the risks of life and responsibility for them as far as possible the responsibility of others.

Insurance reforms have thus become a matter of changing attitudes.

Built on and working with the regulatory mechanisms of egotism, our civilization has two ways to achieve the necessary change of attitude, either by:
a) living through and coping with great disasters that cannot be foreseen, or
b) consciously developing community structures that are in accord with human nature, by consistently implementing knowledge gained from the study of man and evolution in the science of the spirit.

Anthroposophy is a cultural stream given to our age to bring about such a change of attitude.

From its inception anthroposophical medicine has sought to support healthy development and healing in mind, body and spirit that is in accord with the essential nature of the human being. It thus goes clearly against current trends that seek to limit natural human development by negating the concept of further evolution.

The modem insurance system is the inevitable product of this trend. Therefore we cannot expect that the inner cultural aims of anthroposophical medicine will be understood, recognized and given the right encouragement in the climate of today's insurance scene. Anyone who has given real thought to the struggle for recognition and understanding of the deeper aims of anthroposophical medicine can see that these are two polar opposites, with compromise solutions usually mere opportunism.

It is remarkable how little those working in anthroposophical medicine have concerned themselves so far with developing a financial support system for themselves.

Such effort depends on finding a view of health among patients different than that which has developed through three generations with the present-day insurance system.

Inner change will have to come from the patients. Today, only anthroposophical medicine is able to give people an insight into the biographical value of illnesses, realizing that they open the way to new states of consciousness and new faculties. These, in turn, lead to the change of attitude that will provide a new moral basis for our approach to insurance. Anthroposophical physicians must work together with an informed body of patients to create an instrument that will meet the needs of both.

How can the three different elements - anthroposophical medical profession, patient body and adequate insurance system - be brought together to be effective in practice? The basic problem to be considered is that of moral attitude. Considered incidental in the context of the anthroposophical medical profession, assumed to be incidental for patients who are interested in anthroposophical medicine, this precondition for such an insurance system must come to the forefront of our thinking.

The consequence for all three elements must be that:
a) the anthroposophical medical profession renounces all claims to financial gain,
b) patients assume a new personal responsibility for services used,
c) with reference to insurance, help is given to enable individual development.

Attitude is an issue that tends to be taboo in our age. It represents the basic concern of both the anthroposophical medical profession and human beings who actively seek healing, having gained understanding of their own nature. The realization of such an insurance system is one of the most important tasks for today. In the sphere of anthroposophical medicine, it can only be implemented with the help of a responsible and informed patient body.

People who are interested in medicine establish regional insurance associations of manageable size. A separate account is opened for every individual. Agreed sums are regularly paid into this account; for example, they may match current insurance rates. When a previously agreed, basic credit level has been reached the monthly contributions get progressively smaller. All services for the individual concerned are debited to his account. When the account goes below a certain level the regular contributions increase again at a rate to meet the need. The insured also stands surety at a socially appropriate level.

Accounts are not allowed to go into the red. Sums required to meet needs not covered by them come from the common fund or, if need be, the sureties stood by others.

The regional insurance associations are managed by the patient body, keeping management costs to a minimum. Every insured person is regularly given both a statement of account and information on the association's assets.

The insured decide, together with their personal physicians and therapists, what insurance-related services are needed. The regional associations make provision for the necessary medical and clinical services. Several regional associations cooperate in providing hospitals and other treatment centers. These institutions are always run as public utilities, with provisions based on actual requirements and regional need. Emoluments for medical staff and therapists are according to the usual rules pertaining to public utilities. Special technologies required may be provided by establishing links with relevant practices and specialist hospitals.

Existing provisions
A bank of similar persuasion may run the accounts of the insured.

Existing anthroposophical medical institutions who accept the above criteria could become part of the developing insurance association on a partial basis to begin with and completely so later on.

The legal conditions for establishing an "insurance association for anthroposophical medical treatment" may be said to be favorable in the present political climate. We shall need the services of legal experts. Patients can be easily informed because contact with anthroposophical medicine and its specific quality is frequent; the patient body is discerning and open, and consistent publicity work should develop this further. Many understand the need for change in our lives, and this opens the way for the change of attitude sought through Anthroposophy.

The efficacy of such an insurance system will be based on a number of special features:
1) Reducing the cost of medical care by:
a) consistently directing medical provision towards preventative and prophylactic measures;
b) educating patients to be conscious, responsible partners in managing their health and destiny;
c) raising awareness of medical aids required for both oneself and other members of the association, making individual concerns relative;
d) consistently matching provision to the needs of all;
e) reducing avoidable long-term aid by helping individuals to become more independent.
2) Reducing the excessive need for insurance coverage by making individuals confident that adequate help will be available if the situation requires it, thus generating trust in the new abilities gained by overcoming illness.
3) Removing commercial pressures from medical care providers by ensuring adequate financial support on a community basis.
4) Keeping administrative costs low through synergistic endeavor on the part of both care providers and receivers and cooperative management.

M Book, MD
Schloss Hambom

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