[Individual healthcare services in the ambulatory sector]

Even in Germany where the majority of the population is insured under the Statutory Health Insurance system (SHI), there is an increasing need for taking more personal responsibility for healthcare services and more private participation in healthcare costs, which is due to continuously stagnating contributions to the German Statutory Health Insurances. "Medical services on individual demand" (IGeL) is the term used to denote a special choice of healthcare services that are available to SHI members, but not reimbursed by the SHI system. Despite the growing demand private healthcare services in the form of "medical services on individual demand" are not generally accepted, neither by all patients nor all physicians. Opponents criticise that "medical services on individual demand" are of less or no benefit to the patients. In 2006, the German Medical Assembly adopted a policy statement including ten basic principles that are intended to help doctors distinguish between useful and unnecessary private healthcare offers, and avoid conflicts with the professional code of conduct.