Sixty-six Ways to Fix Germany’s Costly Health Care System

A panel of specialists unveiled multiple suggestions aimed at reducing the escalating costs of Germany’s health care system. However, the success of these measures hinges on the government’s ability to enforce them. On Monday, the group released a 66-point plan designed to cut the continuously rising health insurance fees that citizens contribute to the system.

Germany’s health care system ranks among the most expensive globally, with public insurers alone allocating about €1 billion daily to medical services. This figure is anticipated to grow further in the coming years. Meanwhile, insurance premiums for state-run providers have climbed by an average of 3% this year, following a 2.5% increase in 2025. Despite these hikes, the expenses of public insurers are surging faster, creating a widening gap between income and outlay.

At a press briefing, the commission displayed a chart from the state insurers’ association, the GKV, illustrating how the disparity between revenue and spending would balloon from €15.3 billion in 2027 to €40.4 billion in 2030 if current trends continue. To view this video, enable JavaScript and upgrade to an HTML5-compatible browser.

66 Recommendations for System Reform

The 66 recommendations, outlined in a 480-page report, seek to not only bridge this financial shortfall but also generate additional savings. The 10-person commission, composed of economists, medical professionals, and social law specialists, was tasked with proposing an extensive list of options. The rationale was that the government might struggle to implement all of them due to political considerations.

“I’m thankful the commission has given us a comprehensive toolkit, from which we’ll select the most effective solutions,” stated Federal Health Minister Nina Warken of the Christian Democratic Union (CDU). “It’s crucial to stress that no reform will solely target the insured. We won’t undermine the core principles of a solidarity-based healthcare framework.”

Brysch, head of the German Patient Protection Foundation (DSP), noted that the 66 proposals likely reside in the archives of various healthcare institutions. Yet, he emphasized the government must adopt a cohesive strategy. “It’s time for the government to take a firm stance,” Brysch said in a statement. “The financial imbalance requires action. Sustainable insurance can’t be achieved through a financial commission alone—only by the government with a unified vision.”

Brysch warned that the suggestion to have the government subsidize health insurance for the unemployed could spark debate within the coalition government. To view this video, enable JavaScript and upgrade to an HTML5-compatible browser.

Germany operates a dual healthcare model, with contributions from both employees and employers. Health insurance is compulsory for all citizens, and state insurers, covering roughly 90%, cannot deny coverage. Around 10% choose private plans, often for broader benefits. Critics have long argued that hospitals and doctors may encourage costly, unnecessary treatments, increasing pressure on public insurers and premiums.

Health Minister Warken assured that the proposals would be swiftly reviewed, with her department drafting a bill for cabinet approval by summer.