The prospect of more privately paid doctor’s appointments for people with statutory health insurance prompted strong criticism in Germany on 14 November 2026. The National Association of Statutory Health Insurance Funds and the Social Association of Germany disagreed with the chairman of the National Association of Statutory Health Insurance Physicians, Andreas Gassen. In light of planned changes to doctors’ remuneration, he had expected practices to offer more appointments in private consultations.
Gassen explained his expectation to the RedaktionsNetzwerk Deutschland in terms of the cuts to fees. Practices could not continue working as before in the face of the reductions. According to him, people with statutory health insurance who chose a private consultation would be treated as private patients outside their statutory insurance and would have to pay the costs themselves. This is an assessment by the doctors’ representative, not an announced general requirement to pay out of pocket.
The National Association of Statutory Health Insurance Funds rejected the account. Its deputy chair Stefanie Stoff-Ahnis accused doctors of putting pressure on insured patients in order to secure higher fees. The National Association of Statutory Health Insurance Physicians has a statutory duty to ensure that people can access medical care, rather than make it harder to obtain. Stoff-Ahnis also referred to the average incomes of doctors in private practice and said there was no indication that these would change next year.
The Social Association of Germany also criticised the scenario described by Gassen. Its chair Michaela Engelmeier warned that people on low incomes and those with chronic illnesses in particular depended on reliable care. In her view, if access to necessary doctor’s appointments depended on people’s ability to pay, inequality in the health system could worsen.
Behind the dispute is the savings programme for of the Federal Government, published on the same day. They show both increased participation in the statutory health insurance. It also includes cuts to doctors’ fees. According to the National Association of Statutory Health Insurance Physicians, outpatient specialties such as orthopaedics, cardiology and radiology are particularly affected. Gassen expects fewer appointments for patients covered by statutory insurance in those fields. This does not establish whether practices will in fact switch to private consultations on the scale he described.
The positions reflect different interests: the doctors’ association chief warns of the economic consequences for practices, while the health insurers’ association emphasises their duty to provide care. The social welfare association focuses on those who might struggle to pay additional bills. The dispute is therefore not only about the level of doctors’ fees, but also about how appointments are divided between treatment covered by statutory insurance and private treatment.
The question of self-pay appointments has a history. In a response to a parliamentary question in Berlin the local Association of Statutory Health Insurance Physicians was quoted as saying that restricting appointments for patients with statutory insurance while self-pay appointments remained available would be objectionable. This statement concerns the legal assessment of such conduct; it does not establish that it will happen as a result of the announced cuts.
Editor: Clara Simonichek (Article created with AI assistance).