Doctors demand Bundesrat block health insurance savings package as Bundestag prepares to vote
As the Bundestag prepares to vote on a controversial health insurance savings package, the German general practitioners association calls on the Bundesrat to halt the legislation, warning of a 'fiasco' for patient care.
Legislative process and the reform
The Bundestag will vote on the black-red coalition's health insurance savings package on Friday. The reform is designed to relieve statutory health insurers of sharply rising costs in 2027 and head off fresh contribution hikes. It imposes spending limits on doctors' practices, hospitals, pharmacies, and the pharmaceutical industry, while also raising co‑payments for medicines and restricting free co‑insurance for spouses. The package advanced after the Federal Constitutional Court on Thursday rejected emergency appeals by two opposition MPs against the legislative process.
Doctors' fierce opposition
The Hausärztinnen- und Hausärzteverband, representing general practitioners, has sharply condemned the plan. Its chair, Nicola Buhlinger‑Göpfarth, called on the Länder to intervene: “Spätestens der Bundesrat muss diese Irrfahrt stoppen.”
If the savings law comes as planned, that is an outright fiasco for GP practices and their patients.
She warned that the reform would “noticeably worsen patient care”, predicting longer waiting times, less time for treatment, and the erosion of local coverage. The association described the measures as a “Kahlschlag” – a clear‑cutting of primary care infrastructure.
Constitutional Court clears path
On Thursday (9 July), the Federal Constitutional Court in Karlsruhe rejected emergency applications filed by Green health expert Janosch Dahmen and Left Party politician Ates Gürpinar. They had challenged the legislative procedure after the governing factions introduced sweeping, last‑minute amendments spanning 278 pages. Dahmen said he respected the ruling, while Gürpinar maintained the “catastrophic health reform” remained poorly crafted. The decision removed the final legal obstacle before the Bundestag vote.
- Federal Constitutional Court rejects emergency appeals against the legislative process.
- Bundestag votes on the health insurance savings package.
- Bundesrat may consider the bill; it could block the law or call the mediation committee.
Measures affecting patients and doctors
The package caps fee increases across the healthcare sector and raises the manufacturer discount for pharmaceutical firms to 15.5 percent. For patients, the cost‑sharing for medicines will climb, and the previously free co‑insurance of spouses will now require a contribution – reduced from an initial 3.5 to 2.5 percent. Finance Minister Lars Klingbeil (SPD) has agreed to contribute €1 billion, up from €250 million, towards covering basic income support recipients.
Another flashpoint is the mandatory sick note from the first day of illness and the abolition of telephone sick leave. Green politician Ricarda Lang called the provision a “Schnapsidee” (crazy idea), arguing that practitioners expect it will increase, not decrease, sick days.
Gestures of concession and uncertain fate in the Bundesrat
Health Minister Nina Warken (CDU) acknowledged the burden the reform places on stakeholders, saying: “Ja, es ist eine Zumutung.” She stressed, however, that without the package the system would face collapse. While a Bundestag majority is considered certain, opponents are now raising pressure on the Länder. After the Bundestag vote, the Bundesrat could block the law outright or refer it to the mediation committee. It remains unclear whether the Länder will even place the bill on its agenda for final deliberation on Friday.
Yes, it is an imposition. But if we keep up the current spending dynamic, sooner or later we will be heading for a system collapse.
