Doctor wait times in Germany set to surge from 2027, KBV warns

Physicians have warned that anyone with statutory health insurance in Germany will have to wait longer for a doctor's appointment in 2027 thanks to 2,7 billion euros in cuts to outpatient care. German health insurers, however, have rejected the warning as "fearmongering".

Doctor wait times could increase in Germany

Next year, the government is set to introduce a round of funding cuts that will impact the German healthcare system. According to Andreas Gassen, chairman of the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, or KBV), "more than 50 million [doctors'] appointments" will be cancelled and result in a worsening of current shortages, reports Tagesschau. 

Gassen went on to criticise planned changes to how contracted statutory health insurance physicians report appointment availability. Introducing mandatory appointment quotas will "not lead to patients getting appointments any faster," Gassen commented. "On the contrary: If a fixed quota of appointments to be reported is set and these are thereby blocked in practices, they will no longer be available for patients in those practices."

“Only when more money is available for outpatient care will it be possible to have more appointments,” Gassen said. He described the link as “comparatively easy-to-understand economic dependencies.”

Currently, doctors in Germany are required to report available appointments, passing free slots to a short-notice appointment hotline (reachable on 116117). 

From 2027, practices will need to reserve a specific share of their appointments for a new centralised system. Gassen notes this approach creates challenges, as the set-aside spots get blocked off and are no longer open to the practice's regular patients. The KBV previously raised concerns about these expanded reporting requirements during recent reform discussions. 

Where the 2,7 billion euros of cuts come from

The cut to outpatient care is part of wider austerity measures for the public health insurance system. The German government passed the reform in July, and it is due to take effect on January 1, 2027. It aims to close a deficit of almost 19 billion euros, without further raising contributions for insured people and employers.

The KBV explained that doctors' appointments will be lost because the new law partly scraps extra pay that doctors have received since 2019. Without this extra pay, practices will offer only the appointments they are actually paid for. For insured people, that would mean fewer slots in practices, and longer waits for routine check-ups and specialist visits.

The Appointment Scheduling and Healthcare Provision Act (TSVG) introduced the extra pay in 2019. It gave practices bonuses for arranging appointments more quickly, aiming to shorten waiting times. However, the Federal Court of Auditors found that waiting times did not fall despite billions of euros in added costs, so the new law partly removes the bonuses. The KBV says this will cost GPs around 1,64 billion euros a year.

Insurers reject warning of longer wait times

The Association of Substitute Health Insurance Funds (VDEK) accused Gassen of "deliberately stoking fears among millions of people with statutory health insurance."

VDEK chair Ulrike Elsner said the new appointment quotas will not reduce the system’s capacity, but will ensure appointments are given based on medical urgency. “Not a single appointment will be lost simply because an extra surcharge is no longer paid for something that should be standard practice,” Elsner explained.

Florian Lanz, spokesman for the umbrella organisation of statutory health insurers (GKV-Spitzenverband), supported this statement, saying no appointments have been cancelled. Lanz claims they withdrew only a bonus for faster scheduling because it did not produce faster appointments.

Meanwhile, Eugen Brysch, Executive Director of the German Foundation for Patient Protection, accused the lobby of creating “pseudo-scarcity” in outpatient care for almost 75 million people with public insurance. He said they are already being hit hard by government plans, including higher medication co-payments and lower fixed subsidies for dentures.