Three years ago, Nicole Blaum had a stroke and has not seen a doctor since. She does not even take the vital blood-thinning medication. It is not that the woman simply does not have enough money - including for health insurance and medication, reports the public media ZDF.
However, she is welcome at the clinic “Caya” (from the English “Come as you are”), we learn from the publication. Julia Isselstein is one of 25 doctors who work there on a voluntary basis. On this day, she works not in her own office, but in “Caya” and devotes time to the seriously ill woman. There, Nicole Blaum receives the same treatment as in any normal clinic.
“Some people don't dare to go to the doctor because they are afraid that they will be turned away if they look different from others. If they live on the street, they often can't take a shower, and in that case the smell also plays a role,” Isselstein told ZDF.
Those affected are probably in the hundreds of thousands
“Kaya” has been around for three years. The small clinic is located in a container on the outskirts of Cologne, near one of the places known as a drug distribution center. “Kaya” was founded by Professor Mark Jote, who was the head physician at a Cologne clinic. He emphasizes: “Someone has to take care of people without health insurance”.
According to him, scientific data shows that the life expectancy of homeless people is less than 50 years. And this is simply unacceptable for Germany.
At the same time, it is known that the number of people without health insurance is growing, writes the German public media. According to official statistics, in 2023 only about 72,000 people in Germany were without insurance, but this is probably just the tip of the iceberg. It would not be surprising if the number turns out to be significantly higher, since many people do not appear in the statistics. In this regard, some experts speak of up to 800,000 people, or about 1 percent of the country's population, the publication points out.
Why do people remain without health insurance?
Health insurance has been mandatory in Germany since 2009, ZDF recalls. But there is no systematic control, as Jürgen Wasem, professor of medical management at the University of Duisburg-Essen, pointed out to the media.
He lists the reasons that can lead to the loss of insurance: for example, termination of family insurance, studying, starting an independent entrepreneurial activity or accumulating outstanding contributions. Often such people are homeless or avoid contact with the authorities.
In an emergency, they can turn to a hospital that is obliged to serve patients, otherwise they are subject to sanctions. However, hospitals are often not reimbursed for the costs of treatment. Wazem also points out another problem: those who have been outside the system and want to get their insurance back must pay the premiums retroactively. And this naturally repels many.
Mobile office
“Kaya" is financed only by donations. The project costs 150,000 euros per year, the German public media reported.
The publication also presents Mark Jote's latest idea - a small van, equipped accordingly, which will function as a mobile office. This will expand the options for patients who do not live in Cologne and cannot go to the clinic themselves.