German Health Minister Nina Warken of the ruling conservative Christian Democrats (CDU) has outlined key features of the government’s planned reforms to the ailing health care system.
Warken’s draft legislation, which is on track for passage this summer, aims to prevent further increases in health insurance contributions. “We cannot spend more than we take in,” Warken said at a news conference in Berlin on Tuesday.
Health insurance is compulsory in Germany, with 90% of the population paying into income-dependent public insurance (Rechtliche Krankenversicherung, or GKV). Contributions are also around 14.5% of income shared between the employer and employee, plus a small additional premium depending on the provider.
Health insurance contributions by Germans paying into the public health insurance system increased by an average of 3% this year, on top of a 2.5% increase in 2025. Meanwhile, spending by public insurers is rising even faster.
Without cost-saving measures, Germany’s public health insurance fund will face a budget shortfall of more than €15 billion ($17.7 billion) by 2027.
Germany has one of the most expensive health care systems in the world. In March, a commission of experts presented a list of 66 cost-saving proposals to help curb rising costs. Warken has now announced which of these will be implemented. Measures include:
- Patients will have to pay between €7.50 and €15 (up to €18) for a prescription, up from the current €5 to €10.
- Approving expensive hip or knee surgery requires a second opinion from doctors who do not benefit financially from the procedures.
- From 2028, spouses with no source of their own income who currently have free insurance will have to pay a flat rate of 3.5% of their spouse’s income. It will be lower for those on low and middle incomes and includes exemptions for those caring for children under 7, parents of disabled children, carers and pensioners.
- Homeopathy will no longer be covered by health insurance.
- Increase in mandatory rebates from the pharmaceutical industry to public health insurance funds.
- New limits on health insurance executives’ fees, as well as their administrative and advertising costs.
- Extra-budgetary payments to family doctors for services such as walk-in consultation hours and referred patients will be eliminated.
Environmentalist Greens have criticized the plans, calling them a “real disappointment”.
“Minister Warken is disproportionately placing the burden of stabilization on employees and employers – while she does not dare to confront the influential lobby on the expenditure side,” Janos Dahmen, the Green Party’s health policy spokesman, told the German news weekly. mirror On Wednesday.
Oliver Blatt, President of The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) said in a statement He “categorically welcomed” the Health Minister’s announcement that revenues will serve as a benchmark for health insurers’ expenditures.
The statement said, “The statutory health insurance fund currently spends more than €1 billion per day on the care of 75 million citizens insured under the statutory health insurance scheme. This is a lot of money, and it should be enough. However, in the last year, hospital expenditure increased by almost 10%. Expenditure for doctors increased by almost 8% and expenditure for medicines increased by almost 6%.”
The reform package does not include the one Commission recommendation with the greatest potential for savings, namely that health insurance costs for welfare recipients be paid from the state treasury. The Commission estimates that this could save insurers €12.5 billion in 2027 alone.
Warken appears to have bowed to pressure from Finance Minister Lars Klingbeil of the centre-left Social Democrats, who threatened to veto such a move.
The proposal will now become a draft law, to be passed by the Cabinet at the end of April. The vote is expected to take place before the summer recess in the Bundestag and Bundesrat – the legislative body representing Germany’s 16 federal states.
Edited by: Reena Goldenberg