despite recent austerity measures announced by Health Minister Nina Warken (CDU), hospital expenditures are projected to reach a record high of €120 billion next year.. Internal calculations, revealed by the Frankfurter Allgemeine Zeitung and subsequently confirmed by the ministry, indicate that these expenditures will rise by €8 billion, a figure that would have been nearly €122 billion without Warken’s efforts to implement spending controls.
The sheer scale of the increase underscores a growing political and economic tension surrounding the statutory health insurance (GKV) system. Hospital costs now account for almost a third of the GKV’s projected total expenditure for 2026, a substantial shift from 2019 and 2020 when spending was considerably lower, pre-pandemic. Expenditures have steadily climbed since then, reaching €102.2 billion in 2024 and are on track for an estimated €112 billion this year – a near ten percent surge.
Warken’s austerity package, approved by the Federal Cabinet, aims to limit the cost increase for 2026 to 7.1 percent, the lowest rate since 2023. Without these measures, the growth rate would have been closer to nine percent. The planned savings of €1.8 billion are initially limited to the upcoming year and rely heavily on temporarily suspending the “most favorable clause” which currently guarantees hospitals a certain level of reimbursement. This move, intended to curb rises in supplementary GKV contributions, is proving deeply contentious.
The controversy stems from the potential consequences for hospitals themselves. Industry representatives are vehemently opposing the suspension of the clause, warning of significant revenue losses and exacerbating the already precarious financial situation facing many institutions. They argue the short-term savings will lead to long-term instability in the delivery of care.
The government counters these concerns by pointing to financial support measures already in place, including a commitment of €4 billion in “immediate transformation costs” from the Infrastructure Special Fund for 2025 and 2026, intended to address cost increases and investment gaps from 2022 and 2023. Furthermore, Berlin highlights the provision of €6 billion in energy relief packages between 2022 and 2024, with hospitals already claiming €5.1 billion.
However, critics suggest these supporting measures are reactive band-aids rather than addressing the underlying systemic issues driving escalating healthcare costs. The reliance on temporary suspensions and one-off injections of capital raises questions about the long-term sustainability of the GKV system and the potential for future political backlash as the inevitable consequences of these temporary fixes materialize. The debate underscores a critical juncture for Germany’s healthcare landscape: balancing financial responsibility with the vital need to maintain a robust and accessible healthcare system for all citizens.