Patients should pay fee to visit doctor in Germany, says BDA

The Confederation of German Employers’ Associations (BDA) has suggested that patients pay a fee to visit the doctor in Germany. Critics have called the proposal antisocial and populist.

BDA pushes for patient fee to visit doctor in Germany

Speaking on the POLITICO Berlin Playbook podcast, BDA leader Steffen Kampeter has suggested that patients in Germany should pay a fee every time they visit the doctor. 

Kampeter did not clarify how high he thought the fee should be, but claimed that introducing patient fees would stabilise rising health insurance contribution payments. In January, when statutory health insurance providers typically announce any contribution rises, 82 of Germany’s 93 providers increased contributions for 2025.

Between 2004 and 2012, Germany had a “practice fee” which required patients to pay 10 euros every quarter that they visited their doctor. Established to reduce the number of patient visits, the fee was scrapped on January 1, 2013, because it was ineffective.

Kampeter also claimed that a new practice fee would prevent patients from “hopping” between doctors. Since 2009, anyone with health insurance in Germany has been able to book an appointment directly with a specialist.

According to a study by Jameda, “doctor hopping” is often the result of patients not knowing which medical specialist they need to visit, so visiting multiple specialist doctors before finding the right practice. 

In May, Germany’s CDU-SPD coalition announced plans to restructure the healthcare system, with measures aimed at reducing “doctor hopping”. Under the new plan, patients will have to visit their GP (Hausarzt) first, who will make an assessment if they need to be referred to a specialist, and if so, which kind of specialist. The government hopes it will free up appointments at specialist clinics.

Critics call Kampeter’s idea “antisocial” and “populist”

While CDU general secretary Carl Linnemann voiced support for Kampeter’s suggestion and said that a commission has been assembled to consider the idea, social organisations and trade unions have called the idea “antisocial”.

“This proposal is lacking in solidarity, especially since chronically ill people will be disproportionately impacted,” Michaela Engelmeier of the Social Association of Germany (SoVD) said.

Engelmeier added that people working for low incomes would be discouraged from visiting the doctor for preventative treatment, which would cost the healthcare system more money in the long term. Already stretched practice staff would also have to spend more time on administrative tasks, which could be spent treating patients.

The German Foundation for Patient Protection was also among Kampeter’s critics. “It's the same old story. After many years of testing, the practice fee was abolished in 2012,” foundation chair Eugen Brysch said. Brysch reiterated that the policy had “no steering effect” and “the administrative burden on practices was exorbitant”. 

Representative of the German Trade Union Confederation (DGB), Anja Piel, called Kampeter’s suggestion a “crackpot populist idea designed to fill the silly season” (the period when the Bundestag is on summer break and news is slow).