[Strained relations between federal health insurance and the public health service]

A close cooperation between all partners according to section 20 IV SGB V is basically welcome. However, in times of financial straits in public budgets, attempts have to be avoided to shift tasks and financial burdens to statutory health insurance (SHI). A series of examples shows that because of the different responsibilities-related to the insured persons on the one hand, and the general population on the other-tendencies to shift burdens to SHI are observed. However, such measures are neither adequate nor without problems (e.g. protection by vaccination). Public health service is requested to improve its epidemiological capacities and the qualification of its doctors. Furthermore, the service should be re-orient to a modern citizen-oriented service organization. Communities and provincial ("Land") governments have to provide the financial prerequisites.