German Doctors Warn Insured Patients May Need to Pay Out of Pocket to Avoid Waits

In brief

• German statutory health insurance patients may have to pay for treatment themselves to avoid longer waits, according to the head of the KBV.
• Gassen expects practices to expand paid private consultations after planned physician fee cuts.
• The cuts are part of a government savings programme to limit rising statutory health insurance contributions, and insurers have criticised the doctors' warning.

Doctors expect a shift toward paid appointments

Statutory health insurance patients in Germany may need to pay for treatment themselves to avoid long waits, according to Andreas Gassen, chair of the Kassenärztliche Bundesvereinigung (KBV), the national federation of statutory health insurance physicians (Ärztechef Gassen: Schnellere Behandlung für gesetzlich Versicherte, die draufzahlen – MDR) (Kassenärzte-Chef erwartet mehr Selbstzahler-Termine für gesetzlich Versicherte – tagesschau.de). He said the planned cuts to physician fees mean practices cannot simply carry on as before.

What the offer would look like

Gassen expects practices to expand private consultation hours, since every appointment in that setting is paid. Patients who choose this route would be treated outside the statutory system, much like privately insured patients, but would have to cover the costs out of their own pocket (Honorarkürzungen für Ärzte: Kassenärztliche Vereinigung rechnet mit mehr Selbstzahler-Terminen – ZEIT ONLINE). He said specialties such as ENT, orthopaedics and radiology would be particularly affected (Ärztechef erwartet mehr Selbstzahler-Behandlungen – MDR).

Reasons behind the cuts

The fee reductions form part of a federal government savings programme aimed at slowing the rise in statutory health insurance contributions, which are paid from employees' wages (Kassenärzte schlagen Selbstzahler-Termine für Kassenpatienten vor – DER SPIEGEL). Physicians have posted notices in waiting rooms warning that patients will find it harder to get appointments if fees are cut.

Criticism from insurers

The statutory health insurance association has strongly rejected the doctors' warning, describing the messaging as a fear campaign. Insurers argue the cuts are necessary to keep contributions in check.

Timing

Gassen has said waiting times for an appointment could grow longer from 2027.