[Physicians and politics]

In addition to their original healing-mission, physicians gain more and more responsibility in health politics including most important aspects like education and medical ethics. Recent developments and possibilities in prenatal diagnostics, molecular biology and in-vitro-fertilization demand clearcut positions from the medical staff. Political evaluation of costs in health care systems concerns analysis of the most common factors responsible for the increasing costs. High expectations and demands of the patients are one reason, other are excessive use of new technologies, increase of the aged in the population and growing cost for liability cases. Mechanisms for the down-regulation of costs are restricted. The so called free market in health care such as premium-competition of health insurance point out more theoretical than practical aspects. The Health insurance law (KVG) by increasing the extent of services has contributed to a further increase of costs instead of lowering them. Shifting from hospitalization to out-patient treatment and reducing beds for acute services could lower hospital costs further. AIDS, Drug-politics and environmental destruction, three actual plagues, represent further political challenges for physicians. For the future a reasonable politic involving a better motivated medical corps has to be promoted. To this end first personal structures should be strengthened by help of new ethical view points. Future medicine should be complex, patient-oriented-and remain affordable. Therefore medical responsibility in political development is mandatory.