Free: Services in the healthcare system must be cut - Germany’s Chief of Staff Proposes Sweeping Cuts to Healthcare Benefits
Chancellor Olaf Scholz’s Chief of Staff, Thorsten Frei, has called for major cuts to Germany’s healthcare benefits. He argues that drastic changes are needed to control rising costs in what he describes as the world’s most expensive system.
Frei’s proposals include reducing services, changing how patients access specialists, and preparing for a surge in long-term care needs.
Frei criticised the current system where patients choose their own specialists without oversight. Instead, he wants primary care physicians—usually family doctors—to control referrals. This approach, known as gatekeeping, aims to limit unnecessary specialist visits.
He admitted that cost-cutting measures would face resistance. But he insisted they were unavoidable for the system’s survival. Some benefits, he said, must be eliminated entirely to make healthcare more affordable. Long-term care insurance presents another pressing issue. Frei warned that institutional care will rise sharply as home-based support declines. He described this shift as a 'massive challenge' requiring early planning. To justify his stance, Frei pointed to examples from other countries where similar cuts have been made. Germany, he claimed, can no longer afford its current level of spending without reform.
The proposed changes would reshape how Germans access healthcare. Specialists would see fewer self-referred patients, while GPs take on a stronger role in directing care. Meanwhile, the government must address the growing financial strain of long-term care as demand for institutional support increases.
