the potential rationing of medical services.. Thomas Lemke, CEO of the Sana hospital group, has issued a stark warning, highlighting a growing trend of patients privately funding quicker appointments and improved care, a development he argues is indicative of a systemic crisis.
Lemke’s concerns aren’t isolated. Numerous hospitals are struggling with precarious finances, forcing a difficult reckoning with the concept of access to care. He suggests that if the current trajectory isn’t altered through substantial structural reform, providers will increasingly cater to those willing to pay out-of-pocket, leaving a diminishing pool of resources for the broader population. This isn’t a guaranteed equitable distribution anymore.
The unspoken truth – that Germany’s principle of equal access to medical care is already under strain – is becoming increasingly visible. Long waiting times for appointments, treatments and surgeries are a common experience for many, despite official pronouncements guaranteeing equitable service. The current grand coalition government, comprised of the CDU and SPD, has signaled a health reform agenda, but progress has been frustratingly slow.
Health Minister Nina Warken’s recent announcement of temporary cost-cutting measures aimed at averting a further rise in statutory health insurance contributions offers only a brief respite. The underlying problem remains: yearly expenditures on therapies and pharmaceuticals are rising at an alarming rate – eight to twelve percent – far outpacing inflation. This unsustainable trajectory threatens the viability of the entire system.
Lemke advocates for a broader examination of international models, pointing to countries where access to certain medical procedures is tied to specific requirements and greater patient responsibility. The Netherlands, where patients can wait up to two years for a knee operation, provides a cautionary example of societal acceptance of rationing. While Lemke insists Germany should strive for a more equitable approach, he warns that failing to address the core issues will inevitably lead to a form of rationing, albeit a less transparent and acknowledged one. The critical question now facing policymakers is whether they have the political will to confront this reality and enact the profound reforms required to safeguard the future of German healthcare.
