The head of the Sana hospital group, Thomas Lemke, has issued a stark warning about the potential for rationing of medical services in Germany, directly challenging a long-held political taboo. Lemke’s comments, delivered to Capital magazine, highlight a deepening crisis within the German healthcare system, exacerbated by political inertia and unsustainable financial pressures.
Lemke’s primary concern centers on the burgeoning trend of individuals paying out-of-pocket to expedite appointments and secure preferential treatment. He argues that if the government fails to enact substantial structural reforms, healthcare providers will increasingly cater to this demand, systematically reducing available services for the broader population. “If nothing is done” he stated, “providers will adapt to this demand first. Then, increasingly less supply will be available for large parts of the population.
The warning comes amid a precarious financial situation for many hospitals, pushing the sector towards a precipice. Lemke explicitly warned of a future where medical care is distributed based on waiting lists rather than need, a scenario he believes is unavoidable without immediate and decisive action. This prospect fundamentally undermines the officially enshrined principle of equal access to healthcare for all German citizens.
While the grand coalition government of CDU and SPD has pledged healthcare reforms, progress remains frustratingly slow. Health Minister Nina Warken’s recent announcement of short-term austerity measures, intended to avert impending deficits within statutory health insurance funds and prevent further contribution increases, is seen by many as a mere temporary fix. The fundamental problem remains: healthcare expenditures, particularly for therapies and pharmaceuticals, are escalating at rates of eight to twelve percent annually, significantly outpacing inflation.
Lemke draws a troubling comparison with European counterparts, pointing to countries that have implemented restrictions on access to medical services, tying them to specific conditions and emphasizing greater individual responsibility. He cites the Netherlands as an example, where patients reportedly face wait times of up to two years for knee operations – an arrangement that has seemingly been socially accepted.
While acknowledging that Germany’s approach should rightfully differ, Lemke cautions against a silent descent into rationing. “If we don’t address the problem” he concluded, “rationing will come anyway, but secretly”. His blunt assessment forces a vital, albeit uncomfortable, conversation about the long-term viability of the German healthcare system and the political will required to confront its existential challenges.