German health minister announces billions in cutbacks

Germany's Health Minister Nina Warken, of the ruling conservative Christian Democrats (CDU), on Tuesday outlined key features of the government's planned reforms to the country's ailing healthcare system. Warken's draft legislation, to be passed this summer, aims to prevent further increases to the health insurance contributions. "We simply cannot spend more than we take in," Warken said at a press conference in Berlin on Tuesday. Health insurance in Germany is mandatory, with 90% paying into the income-dependent public insurance (Gesetzliche Krankenversicherung or GKV). Contributions are roughly 14.5% of income shared evenly between employer and employee, plus a small additional premium depending on the provider. Health insurance contributions by Germans who pay into the public health insurance system rose by an average of 3% this year, on top of a 2.5% rise in 2025. Meanwhile, public insurers' expenditures are increasing even more rapidly. Without the cost-saving measures, Germany's public health insurance funds face a budget shortfall of over €15 billion ($17.7 billion) by 2027. Health care in Germany: Inside a system at breaking point To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video Germany has one of the world's most expensive healthcare systems. In March, a commission of experts presented a list of 66 cost-saving proposals to help curb spiraling costs. Warken has now announced which of these will be implemented. The measures include: Patients will have to pay between €7.50 and €15 for prescriptions, up from the current €5 to €10. Mandatory second opinions to approve expensive hip or knee surgery from doctors who do not benefit financially from the procedures. From 2028, spouses without their own source of income who are currently insured free of charge, will have pay a flat rate of 3.5% of their spouse's income. This will be lower for low and middle-income earners and includes exemptions for those caring for children under seven, parents of children with disabilities, caregivers and pensioners. Homeopathy will no longer be covered by health insurance. Increased mandatory discounts for public health insurance funds from the pharmaceutical industry. New limits on fees for health insurance executives, as well as their administrative and advertising costs. Extra-budgetary payments for family doctors for services such as walk-in consultation hours and referred patients will be eliminated. The environmentalist Greens have criticized the plans, calling them "a real disappointment." "Minister Warken is disproportionately shifting the burden of stabilization onto employees and employers — while she doesn't dare to confront influential lobbies on the expenditure side," Green Party health policy spokesperson Janosch Dahmen told German news weekly Der Spiegel. The chairman of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) Oliver Blatt said in a statement that he "expressly welcomed" the health minister's announcement that revenue will serve as a benchmark for health insurers' expenditures. Berlin under pressure to fix pensions, health care and taxesTo view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video "The statutory health insurance funds currently spend over €1 billion per day on the care of the 75 million citizens insured under the statutory health insurance scheme. That is a lot of money, and it has to be enough. However, in the last year alone, hospital expenditures rose by almost 10% expenditures for doctors by almost 8%, and expenditures for medications by around 6%," the statement said. The reform package does not include the commission's one recommendation with the greatest potential for savings, namely for the health insurance costs for welfare recipients to be paid out of state coffers. The commission estimated this could save the insurers €12.5 billion in 2027 alone. Warken appears to have bowed to pressure from Finance Minister Lars Klingbeil, of the center-left Social Democrats (SPD), who threatened to veto such a move. The proposals will now become a draft law, which is scheduled to be passed by the cabinet at the end of April. The Bundestag and the Bundesrat — the legislative body representing Germany's 16 federal states — and a vote is expected before the summer recess. Edited by Rina Goldenberg