- Budget Caps: Fee cuts in specialties like cardiology and orthopedics are driving doctors to consider private-pay models for faster appointments.
- Political Pushback: Federal politicians and public insurers sharply rejected the plan, warning of a three-tier healthcare system.
Andreas Gassen, head of the National Association of Statutory Health Insurance Physicians (KBV), told the Redaktionsnetzwerk Deutschland that practices cannot maintain current operations as financial cuts continue.
He said that practices have no infinite service obligation, pointing to revenue drops for several specialist groups.
„Niemand kann erwarten, dass die Praxen angesichts der Kürzungen einfach weiter machen wie bisher“, said Gassen, head of the National Association of Statutory Health Insurance Physicians. He added, “Ich gehe davon aus, dass es Angebote in der Privatsprechstunde geben wird, da wird ja jeder Termin vergütet.”
According to Gassen, statutory insurers and social associations reacted with outrage to the prospect. Gassen argued that this is the only way to finance the costs of extra cases beyond existing budgets.
Gassen said that honorarium cuts totaling three billion euros heavily impact ear, nose, and throat doctors, orthopedics, cardiology, radiology, and rheumatology. He warned that if specialty groups lose up to 25 percent of their revenue, it creates an existential threat.
Federal politicians swiftly rejected the proposal, with Vice Chancellor and SPD leader Lars Klingbeil making clear during an event in Potsdam that such a suggestion is unworkable for his party.
Janosch Dahmen, health policy spokesman for the Green parliamentary group, told the Deutsche Presse-Agentur that the model threatens to introduce a new payment barrier. He warned that individuals who pay out of pocket are seen within hours, while those relying on health insurance must wait, creating a medically and socially problematic paywall medicine.
„Ich warne eindringlich davor, dass sich in Deutschland neben der bestehenden Zwei-Klassen-Medizin eine neue Drei-Klassen-Versorgung etabliert“, Dahmen said.”
| Stakeholder Group | Stance on Proposal | Primary Concern |
|---|---|---|
| KBV (Gassen) | Defensive / Proposed Option | Budget cuts up to 25 percent threatening practice viability |
| SPD / Greens (Klingbeil, Dahmen) | Strong Rejection | Creation of a three-tier healthcare system and payment barriers |
| GKV / SoVD (Stoff-Ahnis, Engelmeier) | Sharp Criticism | Patients held hostage; severe disadvantage for low-income and chronic patients |
Harsh criticism also emerged from the National Association of Statutory Health Insurance Funds (GKV).
„Hier werden gesetzlich Versicherte, die einen Arzt brauchen, in Geiselhaft genommen, damit Ärzte ihre Honorare steigern können. Dies ist ein skandalöses Verhalten“, said Stefanie Stoff-Ahnis, deputy GKV board chairwoman. She added that doctors in statutory practices average over 200,000 euros annually.”
The Social Association Germany (SoVD) dismissed the initiative as highly unsolidary and socially unjust. Michaela Engelmeier, chairwoman of the SoVD board, said that the move would disproportionately harm low-income earners and chronically ill individuals who rely on dependable medical care.
Eugen Brysch, board member of the German Patient Protection Foundation, emphasized that the associations of statutory health insurance physicians hold a legal guarantee to ensure care. He urged Health Minister Carsten Linnemann to establish clear statutory regulations to ensure the financial burden is distributed fairly without making medical access solely dependent on a patient’s wallet.
