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Germany’s Top Economic Adviser Urges Higher Patient Cost-Sharing and a Practice Fee to Rein In Health Costs

Insurer surcharge increases for 2026 underscore the financing strain.

Overview

  • Sachverständigenrat chair Monika Schnitzer called for greater self-payment by statutory-insurance patients and backed a low-bureaucracy practice fee collected by insurers rather than doctors.
  • Schnitzer warned the statutory health-insurance contribution rate could rise to 25 percent without efficiency gains and a tighter, evidence-based benefits catalog.
  • She proposed removing services lacking scientific proof, explicitly citing homeopathy and other non-evidence-based treatments from the coverage list.
  • A Verivox review reported that 31 statutory insurers have announced higher supplemental rates for 2026, including the Techniker Krankenkasse rising to 2.69 percent and DAK-Gesundheit to 3.2 percent.
  • Germany’s statutory insurers’ association criticized reintroducing a practice fee as a distraction, pointing to spending projected to climb by about €23 billion to roughly €370 billion next year and urging structural reforms.
  • Separately, Schnitzer urged a public discussion on whether burdensome, high-cost therapies are always appropriate for very elderly patients.