The head of Germany’s largest statutory health insurance (GKV) association, Oliver Blatt, has stated that German hospitals are adequately funded, cautioning against the potential for overfunding should the recently implemented hospital reform be altered. In an interview with the “Frankfurter Allgemeine Zeitung” Blatt expressed concerns that revisiting the reform could inadvertently solidify existing, potentially inefficient, structures rather than fostering necessary change.
Hospitals are slated to receive approximately four billion euros in immediate aid in 2025 and 2026, alongside 3.5 billion euros annually from 2026 onward, drawn from a federal infrastructure fund to support modernization efforts. Blatt emphasized the importance of careful management of these funds, warning against an uncontrolled disbursement that would impede progress.
Currently, one-third of all GKV expenditures flow to hospitals, a total exceeding 100 billion euros annually, a sum Blatt believes should be sufficient. He highlighted the increasing costs associated with nursing care budgets, noting that there are currently no limits on spending in this area.
Blatt voiced support for the core principles of the hospital reform, which aims to concentrate inpatient services, enhance quality through standardized performance groups and incorporate fixed payments alongside case-based remuneration.
However, he cautioned that pressures from regional governments resisting facility closures, coupled with the new Federal Minister of Health Nina Warken’s willingness to reconsider the reform, pose a risk of dilution. Blatt asserted that not every locality requires a hospital and expressed fear that reopening the reform could compromise its effectiveness.
He warned against prioritizing regional politics over the quality of care and urged against deviating from standardized performance groups intended to ensure quality. Furthermore, he insisted that fixed payments must be allocated based on actual care needs, not distributed indiscriminately.
Beyond hospital funding, Blatt ruled out performance cuts and the reintroduction of a co-payment system. He did however, endorse the coalition government’s proposed introduction of a primary care physician system for outpatient care, recognizing its potential to improve access.
Blatt pointed out that while sufficient specialists exist in certain disciplines, access and allocation remain problematic. He cited the example of readily available psychotherapists yet long wait times for appointments, alongside instances of patients inappropriately utilizing emergency services.
The head of the GKV association characterized such misallocations as wasteful, socially unfair and potentially dangerous. He advocated for improved patient guidance as a means of enhancing care quality, saving money and avoiding service reductions. He stressed, however, that a functional primary care system required an independent appointment service capable of prioritizing care based on urgency, irrespective of a patient’s insurance status (statutory or private).