The proposal by the German Association of Statutory Health Physicians (KBV) to introduce a new per-visit fee of three to four euros for patients has ignited a fierce backlash from across the political spectrum and patient advocacy groups. The suggestion, championed by KBV chairman Andreas Gassen as a mechanism to curb perceived unnecessary doctor visits, is being widely condemned as regressive and ineffective.
SPD health policy spokesman Karl-Heinz Pantazis sharply criticized the concept, describing it as an outdated “health policy concept from the 2000s” that fails to advance the German healthcare system. He emphasized that such a charge disproportionately affects vulnerable populations – individuals with low incomes, those suffering from chronic illnesses and the elderly – effectively erecting financial barriers to essential care. “This doesn’t deter ‘unnecessary’ visits; it deters those who need it most” Pantazis stated.
The push for a patient fee represents a reversal of prior coalition agreements. The SPD and its coalition partners had previously rejected what Pantazis termed a “malus system” opting instead for structural reforms centered around a streamlined primary care system with improved referral processes and guaranteed specialist appointments. This alternative approach, he argued, is “more effective, fairer and alleviates strain where it’s truly needed without imposing new financial hurdles.
Eugen Brysch, board member of the German Foundation for Patient Protection, intensified the criticism, accusing physicians and hospitals of prioritizing profit over patient well-being. He suggested the proposal wasn’t about directing care but about “making money”. Brysch further lamented the existing system’s tendency to reward mediocre performance with substantial payments, leaving patients underserved.
The Green Party has unequivocally dismissed the proposal, with health policy spokesperson Janosch Dahmen branding it a diversionary tactic. Dahmen argued that the proposed fee would generate only additional bureaucracy, straining already overburdened practices and failing to address the fundamental cost challenges within the healthcare system. He warned against burdening patients and transforming them into “scapegoats for political failings”. Dahmen advocated for better care coordination, reformed emergency and primary services and transparent pricing and quality standards, rather than punitive measures targeting vulnerable individuals.
Left Party parliamentary group spokesperson Ates Gürpinar echoed the concerns regarding social equity, asserting that the fees would simply exclude poorer and sicker individuals from the solidarity-based healthcare system. He proposed an increase in the contribution assessment limit as a more equitable solution, shifting the financial burden toward higher earners to resolve funding issues in a socially just manner.
Criticism is intensifying the pressure on the government to address the systemic challenges within the German healthcare system, with calls for a shift away from proposals that disproportionately impact patients and towards solutions rooted in fairness, efficiency and a genuine commitment to universal access. The debate highlights a growing tension between cost containment measures and the fundamental principle of healthcare as a social right accessible to all.
