The suggestion by CDU health policy spokesperson and addiction commissioner Hendrik Streeck to reconsider the allocation of exceptionally expensive medications to elderly patients has ignited a firestorm of criticism and condemnation, exposing deep fissures within Germany’s healthcare system and raising profound ethical questions.
Sören Pellmann, parliamentary group leader of the Left party, denounced Streeck’s comments as a direct assault on social cohesion. “Such thought experiments from a CDU health politician are simply shameful” Pellmann stated in an interview with the “Rheinische Post”. “To open this debate further undermines societal solidarity. Streeck needs to explicitly outline his stance: at what age does life, in his view, cease to be worth protecting – 85, 90, 95?
Pellmann’s critique highlighted the existing inequalities within the German healthcare landscape, observing that individuals from lower socioeconomic backgrounds already experience significantly shorter lifespans than their wealthier counterparts. He questioned whether these already vulnerable populations should now be further disadvantaged by the denial of life-extending treatments. Instead, Pellmann advocated for capping the pricing of new pharmaceuticals, which he described as having “exploded” in recent years and criticized the government’s failure to hold the pharmaceutical industry accountable. He pointed out that the industry continues to generate “massive profits” while the conservative CDU party actively opposes leveraging it to stabilize the public health insurance system (GKV).
Streeck’s initial proposal centered on whether particularly costly medications should routinely be prescribed to individuals in advanced age. He argued for the development of “clearer and binding guidelines” within the medical self-governance sector to restrict the automatic trial of certain pharmaceuticals, suggesting that there are distinct phases of life where such interventions may be inappropriate.
While the medical establishment itself is divided, the German Federal Medical Association (Bundesärztekammer) cautiously welcomed the ensuing public discussion. President Klaus Reinhardt, commenting to the “Tagesspiegel” emphasized the significant ethical responsibility borne by physicians when making treatment decisions for elderly or terminally ill patients. He stressed that societal and medical consensus must constantly reassess what constitutes “medically sensible and simultaneously humane” care in the final stages of life. Reinhardt firmly stated that treatment decisions should not be contingent on age or financial burden, but rather on individual patient preference, prognosis and quality of life.
Reinhardt further criticized the increasing rigidity of Germany’s healthcare system, arguing that it progressively hinders physicians from engaging in patient-centered, individualized decision-making. He warned that excessive medical interventions ultimately disadvantage both the patients involved and the healthcare system as a whole, fueling concerns about resource allocation and the potential for unintended consequences. The debate exposes a fundamental tension: balancing technological advancements and life-extending therapies with the principles of equitable access and sustainable healthcare funding.