The German Confederation of Trade Unions (DGB) has strongly condemned proposed reforms to the national healthcare system put forward by the Confederation of German Employers’ Associations (BDA), escalating a contentious debate over the future of social security funding. The BDA’s plan, revealed in a draft paper obtained by the Frankfurter Allgemeine Zeitung, aims to achieve savings of up to €50 billion annually by shifting the financial burden onto patients and dismantling core tenets of the current system.
The employers’ proposal outlines a radical restructuring, including the reintroduction of a €10 co-payment for doctor visits – a measure the DGB dismisses as “a dead horse” – alongside a 50% increase in patient co-payments for medical treatments and the elimination of contribution-free coverage for spouses with low or no income. The BDA claims these measures would reduce contribution rates by up to two percentage points, ostensibly easing the strain on both employers and employees.
However, the DGB argues this represents a dangerous erosion of the solidarity-based principles underpinning the statutory health insurance system. Anja Piel, a DGB executive board member, stated the union would actively resist these proposals, deeming them designed to relieve employers’ financial obligations at the expense of patient access and quality of care. Piel criticized the proposed co-payment as an ineffective bureaucratic burden for medical practices across the country, noting a complete lack of tax revenue generated.
The DGB advocates for a dynamic tax subsidy to ensure societal obligations are not solely shouldered by health insurance contributors. A further demand focuses on the federal government repaying outstanding debts owed to health insurers, accumulated through past interventions that depleted reserves to relieve pressure on the federal budget.
Looking beyond immediate policy debates, Piel emphasized the potential for long-term savings through a well-organized and adequately funded hospital reform, prioritizing the support of strong healthcare providers while avoiding unnecessary duplication of services. The ultimate objective, she asserted, should be a comprehensive emergency healthcare system and accessible network of specialists, streamlined to reduce unnecessary travel, waiting times and ultimately benefit the health of the entire population. The clash between the BDA’s austerity-driven proposals and the DGB’s commitment to social solidarity highlights a fundamental disagreement over the role of government and employer responsibility in maintaining accessible and equitable healthcare provision within Germany.
