The proposal by the German Association of Statutory Health Physicians (KBV) to introduce a new per-visit fee of three to four euros for patients has ignited a firestorm of criticism, raising concerns about equity and the long-term viability of the nation’s healthcare system. The suggestion, championed by KBV chairman Andreas Gassen, aims to curb what proponents describe as “unnecessary” doctor visits and alleviate financial strain on healthcare providers. However, the plan has been widely denounced by opposition parties and patient advocacy groups as a regressive measure that disproportionately burdens vulnerable populations.
The SPD’s health policy spokesperson, Guy Pantazis, sharply condemned the proposal, labeling it a “classic throwback to outdated healthcare concepts from the 2000s” with little prospect of genuine improvement. He emphasized the potential for the fee to discourage access to care among low-income individuals, chronically ill patients and the elderly population. The coalition government, comprised of SPD and other parties, had previously rejected similar measures in negotiations, opting instead for “structural solutions” such as a strengthened primary care system with clear referral pathways and guaranteed access to specialists.
Beyond parliamentary opposition, concerns surrounding the KBV’s initiative are echoed by patient advocates. Eugen Brysch, board member of the German Foundation for Patient Rights, accused the medical community of prioritizing profit over patient welfare. He argued the proposition wasn’t about optimizing care but about “cashing in”, further stating that low-quality care was currently being overcompensated.
The Green Party adopted a categorical rejection, with parliamentary member Janosch Dahmen dismissing the proposal as “a diversionary tactic” from the underlying issues contributing to the cost crisis. Dahmen pointed out the administrative burden such a fee would create, exacerbating the challenges faced by already overloaded practices and generating unnecessary bureaucracy. The sentiment resonated throughout the political landscape, with Left party parliamentary member Ates Gürpinar arguing the plan would effectively “push poor and sick people out of the solidarity system”. He insisted on raising the income threshold for social security contributions as a more equitable solution.
Pantazis’s remarks further underscored the growing demand for accountability within the healthcare sector, urging all stakeholders to identify and contribute to the stabilization of the system rather than shifting responsibility onto patients. He warned against a “constant passing of the buck” to those seeking care, a practice he deemed both “un-solidaristic and unsustainable for the future”. The escalating debate underscores the deep divisions within Germany’s healthcare system and the urgent need for systemic reforms that address funding challenges without compromising equitable access to care.