The primary medical care in Germany is facing a severe test. While the Bundestag debated two key Green Party motions, a clear picture emerged: reforming the healthcare system remains a fiercely contested issue. A Green Party motion to reform Medical Care Centers (MVZ) failed in parliament on Wednesday. A majority consisting of the CDU/CSU, AfD, and SPD rejected the proposal, while the Left Party abstained. The faction had called for making it easier to establish municipal MVZs and creating more transparency regarding ownership structures, with a particular focus on investor-led centers (iMVZ). In their motion, the Greens described these as “problematic,” as short-term profit interests could conflict with the goal of long-term good patient care. They demanded legal clarifications to facilitate municipalities in establishing or taking over MVZs in the legal form of a GmbH. Additionally, mandatory registration in the medical register with details about the operator and the economically entitled parties was intended to provide more clarity.
Simultaneously, the parliament deliberated on a second, groundbreaking motion from the Greens. This aims to legally establish a comprehensive primary care system. After a half-hour debate, the proposal was referred to the leading health committee for further consultation.
The Greens demand the rapid introduction of a system that relies on digitalization, interdisciplinary teams, and strong coordination of treatment. They argue that a high-performing future healthcare system needs patient-centered primary care as its foundation. Specifically, all insured individuals should have access to a general or pediatric practice within 20 minutes by car from their residence.
These practices are intended to become the coordinating key point in the care network in the future. Patients could be treated as comprehensively as possible there or, if needed, be referred specifically to specialists. In their motion, the Greens criticize that the federal government’s planned primary physician system overlooks that, given the shortage of general practitioners and demographic change, only multiprofessional teams can ensure nationwide coverage.
The debate reveals the fundamental fault lines in health policy. On one side is the desire for more steering, planning, and municipal responsibility. On the other side is skepticism toward further regulations and the question of affordability. While one motion on MVZ reform has already failed, the proposal for a new primary care system remains on the agenda. Its future is now being negotiated in the health committee.
Pacts for the Public Health Service
Kommunen — Deutscher Bundestag
