Germany’s statutory health insurance providers are demanding a sweeping €50 billion austerity package to avert a projected surge in contribution rates over the coming years, according to a report released by the reform commission appointed by Health Minister Nina Warken (CDU). The comprehensive 77-page document, obtained by the Redaktionsnetzwerk Deutschland, outlines over 50 specific measures aimed at curbing escalating healthcare costs.
The commission warns of a potential contribution rate increase from the current 17.5 percent to as high as 18.1 percent in 2027, reaching 19.1 percent by 2030 and a staggering 22.7 percent by 2040. To mitigate this trajectory, the health insurance providers argue for a fundamental overhaul of the current system, focusing on eliminating “economic misincentives” and dismantling “inefficient structures”. Full implementation of the proposed measures could potentially reduce contribution rates by approximately 2.5 percentage points.
The proposed austerity measures target significant sectors within the healthcare system – hospitals, private practitioners and the pharmaceutical industry. Regarding hospitals, the commission advocates for capping currently unlimited expenditure on in-patient care and limiting the automatic pass-through of annual inflation-linked tariff increases to insurance funds. Furthermore, they propose eliminating the “fast-track” bonus payments currently incentivizing quicker appointment slots for patients seeking immediate consultations with private physicians and reinstating budget caps for family doctors and pediatricians.
Regarding pharmaceutical costs, the commission calls for stricter price regulation and demands an increase in compulsory discounts from the pharmaceutical industry to be applied to insurance premiums. This move is likely to face strong opposition from the industry.
However, the health insurance providers are not solely placing the onus of financial responsibility on the healthcare sector. They are actively challenging the government’s role, arguing that the state must assume greater financial responsibility for healthcare costs previously borne by the insurance funds. Specifically, they reiterate their demand that the federal government fully fund the contributions of Bürgergeld (unemployment benefit) recipients and cover the full cost of training healthcare professionals through public funding. The providers describe this as creating a “politically congruent financing” of societal tasks. Furthermore, they are advocating for a reduced Value Added Tax (VAT) rate for pharmaceuticals, aligning Germany with the practices of many other industrialized nations. This policy shift underscores a growing discontent with the current funding model and raises questions about the government’s commitment to maintaining an equitable and sustainable healthcare system.