Germany’s federal audit office, the Bundesrechnungshof, has issued a stark warning regarding the escalating financial challenges facing the statutory health insurance system. A recently released report, shared with the Bundestag’s budget committee and reported on by Politico, details a growing disparity between income and expenditure within the system.
The audit office projects an annual gap of six to eight billion euros, potentially leading to a rise in additional contributions to 4.05 percent by 2029 – a development it suggests could hinder economic growth. The report criticizes the federal government for delaying necessary corrective measures.
A primary driver of increasing expenditures, according to the audit office, is the removal of cost-containment regulations. This is compounded by technological advancements and Germany’s evolving demographic landscape. An aging population is exacerbating the structural deficit, as reduced contributions from retirees are expected alongside rising healthcare costs.
The auditors are now calling for decisive action to address the financial instability. Their report emphasizes the need for short-term measures impacting all relevant service areas, particularly those experiencing significant cost increases.
Delays in implementing reforms are seen as particularly damaging, with the ongoing hospital reform highlighted as a critical area for attention. The audit office stresses that core elements of the reform, aimed at improving efficiency, shifting care towards outpatient settings and enhancing quality, must not be diluted. Furthermore, the removal of fixed budgets in certain areas of outpatient care requires further scrutiny.
