According to the assessment of the statutory health insurance physicians, publicly insured patients must prepare for longer waiting times for doctor’s appointments from next year. The National Association of Statutory Health Insurance Physicians (KBV) is warning of this. Its chairman Andreas Gassen told the “Bild” newspaper that by cutting funding for outpatient care, the federal government had just eliminated more than 50 million appointments in outpatient care. The remarks were reported on Tuesday, 20 October, by the Tagesspiegel, the Merkur and SPIEGEL, among others.
The KBV names the expanded obligation to report free appointments to the appointment service centres as the second reason. Until now, contract physicians were obliged to report free appointments there but could determine the extent themselves. In future there are to be fixed quotas. Under the reform of emergency care recently passed by the Bundestag, contract physicians are obliged to report to the appointment service centre “appointments to the extent to be determined by the Association of Statutory Health Insurance Physicians in agreement with the regional associations of the statutory and substitute health insurance funds”.
“The appointment shortage will therefore worsen further”
Gassen thinks nothing of this. “The fact that doctor’s practices will in future have to report a fixed number of free appointments will not lead to patients getting appointments faster. On the contrary: if a fixed quota of appointments to be reported is set and these are thus blocked in the practices, they are no longer available to the patients in these practices,” he told the “Bild” newspaper. “The appointment shortage will therefore worsen further.”
The KBV had repeatedly pointed this out, Gassen stressed. “Only if more money is available for outpatient care will there be more appointments. These are comparatively easy-to-understand economic dependencies.” Additional consultation hours cannot be enforced by decree, the Merkur report says. According to Merkur, Gassen had already sharply criticised political appointment guarantees and warned of consequences for publicly insured patients. First policymakers cut the extra-budgetary remuneration for additional appointments, then they tighten the reporting obligation, he had recently criticised, according to the Tagesspiegel.
What the reform of emergency care changes
According to tagesschau.de, the Bundestag passed the reform of emergency care on Thursday, 15 October; it is due to come into force in 2027. Its core is to better coordinate the three care sectors – the contract physicians’ emergency service, hospital emergency departments and rescue services – and to steer patients more precisely. Around 750 integrated emergency centres at hospitals are planned, which are to be reachable around the clock. A telephone or digital initial assessment is to help keep minor cases out of the emergency departments; video consultations are to save travel and waiting times.
The figures show how necessary this is: the Federal Statistical Office announced last December that around 13 million outpatient emergencies were treated in hospitals in 2024 – an increase of five per cent compared with the previous year and the highest figure since records began in 2018. According to a survey published in April by the German Society for Emergency Medicine, almost every second emergency department in Germany considers itself overloaded.
Health policy and health insurance funds, by contrast, stress, according to Merkur, that fixed appointment quotas and coordinated patient steering via the emergency centres are necessary to ensure fair and needs-based care and to shorten waiting times for emergency patients. For publicly insured people in Germany this means a double burden: the reform is intended to relieve the emergency departments, while the KBV fears the opposite for regular appointment allocation in practices.
How sharply waiting times will actually rise cannot be read from the available information. The KBV gives no figures on waiting times but points to the cut funding and the blocked quotas. What will be decisive is how high the Associations of Statutory Health Insurance Physicians and the regional associations of the statutory and substitute health insurance funds set the fixed quotas – and whether the reform comes into force as planned in 2027.
