Year:    2009

Author:    Uechtritz, Michael, Weiß, Holger Tobias

Die Verwaltung, Vol. 42 (2009), Iss. 4 : pp. 535–563

Abstract

The provision of Emergency Medical Services (EMS) is a highly important as well as a very costly public service. In Germany, liability for costs of EMS is determined by complex legal rules posing considerable difficulties on the people practising in this field of law. Michael Uechtritz and Holger Tobias Weiß carry out a comprehensive analysis of the relevant laws, covering public emergency law, private law and (social) insurance law. First of all they systematise the legal situation. The authors identify the primary cost bearer (public bodies and private providers) of EMS. Subsequently they analyse the mechanisms for shifting EMS costs onto patients, causers of emergency operations and / or insurance companies. On the basis of this systematisation, Uechtritz and Weiß then deal with the phenomenon of futile rescue operations (“Fehleinsätze”). Futile rescue operations are operations where a dispatched rescue unit renders either incomplete or no rescue services at the site of emergency, e.g. in cases where the patient is only slightly injured, has already died or refuses transport to hospital, or where the EMS provider was (deliberately and maliciously) falsely alarmed. The authors examine to what extent the different legal mechanisms of shifting EMS costs presuppose that rescue services have actually been rendered. They highlight remarkable and problematic discrepancies between the rules that regulate the shifting of costs onto patients and the rules that regulate the shifting of costs onto statutory health insurers. While patients can normally be charged for the costs of a futile rescue operation, statutory health insurers need not – according to the new rulings of the Federal Social Court (BSG) – cover those costs. The authors close with reform proposals.