Germany's Hospital Reform: A Step Towards Better Healthcare

Germany is on the cusp of a significant transformation in its healthcare sector, following the Bundestag's approval of a comprehensive hospital reform bill. Spearheaded by Federal Health Minister Karl Lauterbach, the reform is touted as the most substantial in two decades. This initiative aims to enhance medical specialization by categorizing treatments into 65 performance groups, such as heart surgery and leukemia. This means smaller hospitals will focus on fewer, more specialized services, potentially requiring patients to travel further for specific treatments.

Financial restructuring is a core component of the reform, addressing the dire financial state of many hospitals, with approximately 30% operating at a loss. The reform introduces a "provision fee" covering 60% of hospitals' costs, reducing reliance on case-based payments which previously incentivized unnecessary treatments. The remaining 40% would still come from case fees. This shift aims to alleviate financial pressures and improve service quality.

Despite the positive outlook, the reform faces significant challenges. Concerns about potential hospital closures loom, particularly in rural areas with staffing shortages. The reform includes provisions to support small rural hospitals, allowing specialists to provide outpatient care and granting "secure hospitals" some flexibility in meeting quality standards.

Critics, including state governments, express skepticism about the reform's ability to prevent rural hospital closures and the financial burden of a proposed €50 billion transformation fund. Half of this fund's cost would fall on the states, with the rest on public health insurers, prompting calls for private insurers to contribute as well.

In essence, the reform seeks to balance improved healthcare delivery with financial sustainability, amid resistance and uncertainty over its broader impacts.