Why Germany is shutting hundreds of clinics

Admin I Sunday, October 20, 2024

 

BERLIN – The controversial hospital reform is intended to reduce financial pressure and also achieve greater specialisation. What does this mean for the network of hospital locations?

Federal Health Minister Karl Lauterbach expects clinics to close as a result of the hospital reform. ‘It is quite clear that we will have a few hundred fewer hospitals in ten years at the latest,’ the SPD politician told Bild am Sonntag. And that is the right thing to do. ‘We don’t have the medical needs for these hospitals.’ Every third bed is already empty and there are too few staff. Hospitals are likely to be closed, especially in large cities in western Germany. At the same time, he emphasised that hospitals needed in rural areas would receive additional funding in order to survive.

Lauterbach added on Sunday that the reform would ensure comprehensive care and improve quality. ‘Hospitals in rural areas will be preserved. But several hundred clinics – especially in large cities in western Germany – will no longer be able to continue operating as before. They will be rededicated or will no longer be able to offer all services.’ He was sure that the federal states would plan this responsibly. ‘The reform will help to prevent uncontrolled hospital closures.’

What is planned with the hospital reform

The reform passed by the Bundestag is intended to put the financing of hospitals on a new footing and lead to more specialisation for more complicated interventions. It is planned to change the current remuneration system with flat rates for treatment cases in hospitals. In future, they are to receive 60 per cent of the remuneration for providing certain services. This should reduce the pressure to treat as many cases as possible.

According to the Ministry of Health, Germany has the highest density of hospitals and beds in Europe with around 1,700 hospitals. Many clinics are in the red. Lauterbach therefore also sees the reform as an emergency brake: without changes, there is a risk of hospital insolvencies, poor treatment and long journeys. The reform will be finalised in the Bundesrat. It does not require approval, but the chamber of the federal states could send it to the mediation committee and put the brakes on it. The reform is due to come into force on 1 January 2025, with the new structure to be gradually implemented by 2029.

Lauterbach: No increase in health insurance contributions for 2026

After the predicted increase in health insurance contributions in 2025, Lauterbach does not expect any further increases for the time being. He does not believe that health insurance contributions will have to be increased again in 2026. ‘With the reforms we have already made, which are now starting to take effect, and the reforms we are currently making, this increase in contribution rates will actually come to a halt.’

Lauterbach had called the increase in contributions forecast by experts this week historic. Experts from the so-called estimation circle had calculated a mathematically necessary contribution rate increase of 0.8 points to 2.5 per cent of contributory income for the 2025 federal election year.

However, this figure is theoretical. Each health insurance fund decides for itself how much the contribution rate will increase.

Without the hospital reform, the contribution rate would not have risen as much as is now expected, said Lauterbach.

‘The hospital reform is now costing something in the short term, putting pressure on the contribution rate.’ The costs of the reform have been criticised by the opposition.

“CDU health politician Tino Sorge wrote on Platform X that Lauterbach was falsely portraying himself as the ‘cheapest health minister’ ‘in view of the historic explosion in contributions’.