The debate surrounding rising sick leave rates in Germany has intensified, with the country’s association of statutory health insurance physicians, the Kassenärztliche Bundesvereinigung (KBV), publicly backing CDU leader Friedrich Merz’s criticisms. Merz, during a recent campaign appearance, flagged the average 14.5 sick days per employee as excessively high, fueling a broader discussion about potential systemic abuse.
Merz’s comments, which also questioned the efficacy of the recently introduced electronic sick note system, have sparked a political tug-of-war. Former Health Minister Karl Lauterbach (SPD) swiftly condemned Merz’s stance, accusing him of “intimidation of the sick” and warning against the potential overload of general practitioners should telephone-issued sick notes be eliminated. Lauterbach’s concerns centered on the burden increased scrutiny would place on physicians already grappling with significant workloads.
However, KBV chairman Andreas Gassen has countered Lauterbach’s critique, explicitly endorsing Merz’s perspective. Gassen argued that the telephone-issued sick note system is inherently vulnerable to abuse and should be abolished, accompanied by the removal of the mandatory requirement for a doctor’s note within the first three days of illness. He suggested this combination would curtail misuse and genuinely alleviate the pressure on medical practices. Data from the KBV estimates that these short-term sick notes account for approximately 27 million unnecessary doctor-patient interactions annually.
Gassen’s vision extends beyond simple elimination. He advocates for a fundamental overhaul of the current system, proposing that the first three days of illness be regulated through employment contracts, a practice common in many other developed nations. He specifically mentioned considering options such as waiting periods or incentive programs. While reaffirming the importance of continued wage payment for genuine illness, Gassen emphasized that the current system is being exploited for minor ailments, creating a significant strain on the healthcare system and diverting resources from genuine medical needs. The proposals highlight a growing tension between addressing employee rights and the sustainable functioning of Germany’s healthcare infrastructure, potentially signaling a significant shift in policy if adopted.