Increased monetary contributions remain under consideration
The healthcare sector in Germany is facing a series of challenges, with rising expenses and dwindling reserves putting pressure on insurers and the government.
At the beginning of this year, the average additional contributions rose to 2.9 percent, exceeding the expected increase of 0.8 percentage points to the official orientation value of 2.5 percent. This surge in contributions was followed by a surplus of 2.8 billion euros for the insurers as of the end of June. However, the insurers must use this surplus to replenish their low reserves, currently standing at 4.6 billion euros, equivalent to 0.16 months' worth of expenditures.
The problems are worsening due to rising billion-dollar expenses for care. Hospital treatments increased to 54.5 billion euros in the first half of the year, a 9.6 percent increase from the first six months of the previous year. Outpatient medical treatments also saw a significant rise, increasing by 7.8 percent to nearly 27 billion euros.
The ruling factions and the coalition committee have reaffirmed their goal of keeping contributions as stable as possible after the recent significant increases. The upcoming consultations on the 2026 budget will focus on finding concrete solutions.
However, suggestions for solutions have been met with criticism. Loans are not considered a solution as they only shift the problem into the future, according to Michaela Engelmeier. The employer associations have suggested a patient contact fee to reduce unnecessary doctor visits, but this has been widely criticized as socially unfair and counterproductive.
The Federal Audit Office (Bundesrechnungshof) and the GKV-Spitzenverband have made proposals for swift measures to combat rising healthcare costs, emphasizing the need for structural reforms in hospitals and focusing on pharmaceutical expenditures. The German National Association of Statutory Health Insurance Physicians (KBV) opposes expenditure freezes and calls for budget removal for specialist doctors to improve outpatient care.
Jens Baas, CEO of Techniker Krankenkasse, suggested applying the reduced VAT rate to medicines as a quick-acting measure to stop exploding costs. The head of the German Foundation for Patient Protection, Eugen Brysch, accused the government of reality denial and warned that without funds from taxes, the health and care insurance system's lights will go out. Michaela Engelmeier, head of the German Social Association, suggested paying insurance-foreign services from tax funds instead of risking new contribution increases.
Despite these challenges, Health Minister Nina Warken (CDU) is aiming to avoid contribution increases starting in January. Pharmaceuticals increased by 6 percent to 28.9 billion euros, and the Association of Local Health Insurers (AOK) warned against a "policy of wishful thinking" and criticized waiting for money to appear in the federal budget.
Each health insurance fund sets the specific additional contribution based on its financial situation for its insured. The goal is to meet the calculations of the "estimators' circle" for the average additional contribution in the following year. The problems in the healthcare sector are complex, and finding a solution will require careful consideration and cooperation from all parties involved.
