House doctors demand savings in health insurers' administrative costs

Markus Blumenthal-Beier, head of the German house doctors' association, calls on statutory health insurers to cut their administrative costs. He proposes halving them mid-term rather than restricting patient care. CSU politician Klaus Holetschek advises seeking cooperations and mergers.

Amid debates on rising costs in Germany's statutory health insurance, Markus Blumenthal-Beier criticizes the insurers' administrative expenses. «Health insurers could ask their members what they prefer to pay contributions for: finding a house doctor's practice in future or financing 90 insurers», he told the Rheinische Post. He demands: «It's time for insurers to apply the red pen to themselves, not just to their insureds' care». Administrative costs should be halved mid-term. There are currently 93 statutory health insurers in Germany, down from 1,815 in 1970 and 420 at the millennium. Klaus Holetschek, CSU parliamentary group leader in Bavaria's state parliament, advises insurers to «seek synergies, expand cooperations and initiate mergers proactively – before legislators act». Last year, insurers recorded a surplus after contribution hikes, but expenses rose sharply. Health Minister Nina Warken (CDU) states that since 2024, spending on hospital treatments, medicines and practice services has outpaced revenues. An expert panel will present stabilization proposals by late March, with broader reforms by year-end. This addresses a projected multi-billion euro funding gap for 2027.

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Press conference photo of health insurance chief Andreas Gassen calling for abolition of voluntary services to save 1 billion euros amid 12 billion euro gap.
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Health insurers' chief demands abolition of voluntary services

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Andreas Gassen, chairman of the Kassenärztliche Bundesvereinigung, calls for the complete elimination of voluntary additional services provided by statutory health insurance funds to achieve savings. He estimates the potential savings at nearly one billion euros per year. This comes amid a looming financing gap of twelve billion euros in the statutory health insurance system.

Following coalition negotiations and a December 2025 mediation effort on her stalled savings law, Federal Health Minister Nina Warken (CDU) received a major boost on Monday as a government-appointed commission of ten scientists presented a 480-page report with 66 reform measures for statutory health insurers in Berlin. The proposals aim to close a projected 15.3 billion euro deficit next year and generate over 40 billion euros in short- to medium-term savings, preventing contribution increases.

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Following recent coalition consultations, Federal Health Minister Nina Warken expressed optimism about her savings package to ease pressure on health insurance funds. The mediation committee meets on December 17 to resolve the stalled law, averting potential contribution hikes for millions in 2026.

The CDU economic council has proposed tax cuts and reductions in social benefits in its "Agenda for Workers," including removing dental coverage from health insurance. The plans face sharp criticism from politicians and associations, who label them unsocial and harmful to creating a two-tier medical system. Even within the CDU, there is discontent.

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On the coming Monday, many pharmacies across Germany will close all day to protest for higher fees. Statutory health insurers criticize the action, accusing pharmacies of false claims since fees have risen since 2013.

The black-red coalition plans a comprehensive modernization of the social system to reduce bureaucracy and digitize processes. A commission with representatives from the federal government, states, and municipalities has developed 26 recommendations, which Federal Social Minister Bärbel Bas will present on Tuesday. Planned are fewer authorities, merged benefits, and automatic child benefit, without cuts to social assistance.

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A health ministry panel in Japan has approved increases in hospital medical care costs to enable higher staff wages, address inflation, and expand telehealth services. Patients will face higher charges for hospital visits covered by the public health insurance system in various ways. The government aims to keep overall health care costs relatively low while meeting new medical needs.

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