Overview

• Health Minister Nina Warken raised on ZDF the prospect of charging patients who go straight to specialists instead of following a GP-first pathway.
• Union figures floated tougher options, with Albert Stegemann reportedly suggesting a €200 charge per bypassed referral and CSU’s Stephan Pilsinger urging full-cost liability for such visits.
• The reform aims to route most care via general practitioners to coordinate treatment, curb insurer spending and reduce specialist backlogs, with a proposed appointment guarantee.
• The Hausärztinnen- und Hausärzteverband backs the shift, citing lower per-patient costs and fewer hospital days in existing GP-centered models, while government estimates point to roughly €2 billion in savings by 2028.
• Exemptions discussed include ophthalmology, gynecology and emergencies, and critics warn fees could burden chronically ill and vulnerable patients given the poor results of the former Praxisgebühr.