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In the 18th electoral term, the Committee on Health has 37 members: 18 from the CDU/CSU parliamentary group, 11 from the SPD parliamentary group, 4 from the Left Party parliamentary group and 4 from the Alliance 90/The Greens parliamentary group. The Committee is chaired by Dr. Edgar Franke (SPD), with Rudolf Henke (CDU/CSU) serving as deputy chairperson. The chairperson prepares, convenes and presides over committee meetings.
In general, the chairperson consults the spokespersons of the parliamentary groups on the Committee when planning its meetings, except on routine matters. The spokespersons are the main representatives of their parliamentary groups on all procedural matters. Each parliamentary group appoints one spokesman or spokeswoman. The spokespersons of the parliamentary groups on the Committee are Maria Michalk for the CDU/CSU, Hilde Mattheis for the SPD, Birgit Wöllert for the Left Party, and Dr. Harald Terpe for Alliance 90/The Greens.
The parliamentary groups also appoint health spokespersons, who represent the working groups set up by the parliamentary groups on this subject. The health spokespersons of the parliamentary groups on the Committee are Jens Spahn for the CDU/CSU, Harald Weinberg for the Left Party, and Maria Klein-Schmeink for Alliance 90/The Greens. In the case of the parliamentary group of the SPD, Hilde Mattheis serves as spokeswoman of the parliamentary group on the Committee and as the group’s health spokesperson.
Health is one of the biggest policy areas. Around one tenth of gross national product is spent in the health sector, one in ten workers are employed in this sector, and around 90 per cent of the German population is insured under the statutory health insurance scheme. This is therefore a sector with a correspondingly diverse range of stakeholders. Patients want to receive high-quality medical care, health professionals want to receive an appropriate income, and insured people want the contributions they pay to remain within reasonable limits. Health policy needs to strike a balance between these different concerns. It seeks primarily to guarantee high-quality medical care while limiting the cost of health services. As a result, there is a constant need for political action and regulation. Over the past two decades, the Committee has dealt with at least one major health reform in almost every electoral term. The core issues dealt with by the Committee are the financing and services of the statutory health insurance scheme, as well as relations between the health insurance funds and service-providers. Other important areas of regulation include legislation on medicinal products, hospital financing and long-term care insurance. However, health policy goes beyond these fields to take in subjects such as legislation relating to the health professions, pre-implantation genetic diagnosis, and organ donation and transplants.
The 37 members of the Committee have a heavy workload. In order to properly consider and take decisions on the vast number of motions and bills referred to it by the Bundestag’s plenary, the Committee draws on a range of information sources. For example, it regularly requests in-depth briefings on subjects of its choice from the Ministry of Health and other ministries, and often receives follow-up briefings at a later date. The Committee also invites scientific experts and representatives of the self-regulatory bodies in the health system to expert consultations in order to obtain a comprehensive and, as far as possible, independent picture of the subject under discussion. On most subjects, the Committee makes use of its power to hold public hearings, to which it invites representatives of groups in society affected by the planned regulations and a range of scientific experts. The number of associations invited varies significantly, depending on the substance of the bill under discussion. Depending on the complexity of the subject, a hearing might last just an hour, but on occasion it might last six hours or more – spread over several days, in some cases. The information obtained in direct discussions with the experts and the – often lengthy – written statements forwarded to the Committee by associations are taken into consideration in the Committee’s deliberations. The conclusion of the Committee’s deliberations on motions and bills, which sometimes take many weeks, takes the form of a recommendation for a decision to the plenary and a report on the course of the Committee’s deliberations. On this basis, the plenary then takes a majority decision on the item in question.
In addition to bills and motions relating specifically to health policy, for which the Committee on Health is the lead committee, it is also asked for its opinion on items of business which fall within the remit of other committees, if they touch on aspects of health policy. In such cases, the Committee on Health submits its opinion to the lead committee for the item in question.
The Committee also deals with other topics falling within its remit, making use of its right to take up issues on its own initiative. For example, it can call on the Federal Government to provide briefings on its health-policy initiatives, within the framework of parliamentary scrutiny of the government’s work. The Committee also holds talks with the Federal Minister of Health and other ministers.
The Committee also engages in international dialogue with the aim of sharing experience. Talks with politicians from other countries who specialise in health policy often provide ideas for reform projects in Germany. For this reason, the Committee sent delegations on eight trips in the 17th electoral term, to France, Israel, the Netherlands, the United States, Sweden and Finland. This allowed the Committee to gather information about current developments and national reforms in these countries and learn lessons which can be applied to future developments in the German health system.