German Health Minister Nina Warken (CDU) defended her proposals for reforming the care insurance, acknowledging in a guest article for “Welt am Sonntag” that the changes involved “unavoidable hardships.” According to Warken, the care insurance is currently facing its greatest challenge since its introduction, labeling the system a “sanitation case with a warning.”
The fundamental problem, she explained, is a massive financial shortfall. With annual payouts reaching approximately €70 billion, a deficit of €7.5 billion must be bridged. Warken attributes the escalating crisis partly to the shift in the definition of dependency that occurred in 2017. This change was implemented despite scientific recommendations, significantly easing access to benefits. Consequently, Germany ranks disproportionately high internationally regarding the number of people requiring care.
The number of individuals needing assistance has surged dramatically; since the 2017 reforms, there has been an average growth of well over 300,000 people annually. With over six million affected within the country, the total has nearly doubled over the past decade. Warken stated that this trend has been known for several years, but political hesitation allowed the situation to worsen.
To mitigate costs, she argues that certain areas must be targeted, particularly where there have been significant, sudden increases in spending recently. Specifically, she defended the plan to reduce pension contributions for family caregivers and the proposal to increase the out-of-pocket payments for nursing home residents, asserting that the trends of recent years leave little room for deviation in either case. These costs are mounting rapidly: the number of family caregivers has quadrupled since 2016, and subsidies for nursing home residents are set to more than double between 2022 and 2025 to over seven billion euros.
However, Warken stressed that the reform is not merely a cost-cutting measure. Instead, she characterized it as a paradigm shift in care provision. The goal is to move away from simply managing the needs of dependent individuals and instead focus heavily on prevention. This foundational shift involves establishing a right to professional care support even in the early stages of need, aiming to prevent or at least significantly delay the onset of long-term dependency.
