Why is Germany discussing if people should pay for dental care?

Since the weekend, the German government, politicians, business representatives and the media have been discussing whether statutory health insurance providers should continue to cover the cost of dental care in Germany. What prompted the discussion, and where are we up to?

CDU Economic Council: Dental patients should pay out of pocket

Over the weekend, the CDU Economic Council published a list of policy proposals which it claimed would strengthen the German economy. Among them was a proposal that statutory health insurance providers would no longer cover insurees' dental care costs.

The CDU Economic Council, which is a business association closely linked to, but independent of the political party, suggested that “Various services, such as dental treatment, can generally be covered well by private insurance and should no longer be a burden on contributors in the pay-as-you-go system,” according to a report by Wirtschafts Woche.

Currently, statutory health insurance providers cover the cost of routine dental procedures in Germany, such as bi-annual check-ups, tooth extractions, fillings, and more. Statutory insurers don’t generally cover the costs of additional dental care, such as professional teeth cleaning or other, more cosmetic dental procedures.

What is behind the proposals?

For months, Germany has been discussing how its economy can climb out of a slump. Chancellor Friedrich Merz’s (CDU) 500 billion euro spending package is expected to, at least partially, aid the economy back to health, but the CDU Economic Council isn’t satisfied.

The Council’s theory is that, if individual dental patients were to pay for treatment out of their own pocket, they wouldn’t have to pay so much in insurance contributions, and they would spend more money on other things, which would be good for the German economy.

Their proposals don’t stop there. Alongside removing dental care from the statutory health insurance system, the CDU Economic Council’s “Agenda for Employees in Germany” paper proposes cutting taxes, reducing the cost of energy, cutting bureaucratic processes and encouraging residents to buy a house, rather than rent.

“We want to help revive the basic idea of the social market economy: ‘If you work hard and make an effort, you can achieve a modest level of prosperity for yourself and your family,’” the six-page paper states.

The term Soziale Marktwirtschaft (social market economy), also known as “Rhine capitalism”, was coined by German economist and politician Alfred Müller-Armack in 1946 to describe an economic system considered an offshoot of neoliberalism. 

Neoliberal economic policies are most closely associated with deregulation, privatisation, reduced government spending and austerity measures of the 1980s, namely by Augusto Pinochet in Chile, Ronald Reagan in the United States and Margaret Thatcher in the United Kingdom.

What has the response been?

Germany’s CDU-led coalition government immediately rejected the CDU Economic Council’s proposal, clarifying that it does not plan to privatise dental treatment.

“The demand to remove dental treatment from the list of services covered by statutory health insurance will not be implemented. I rule that out, because it would be a departure from the core idea of our solidarity-based system and contradicts the goal of strengthening prevention,” Federal Health Minister Nina Warken (CDU) said on February 2.

Asked for a comment during a trip to Warsaw, Finance Minister and Vice Chancellor Lars Klingbeil (SPD) shook his head and added, “In our country, I don’t think we want people to be able to determine the contents of someone’s wallet based on the condition of their teeth.”

Criticism has also come from dentists in Germany. “This suggestion is medically inaccurate, antisocial and economically short-sighted,” Martin Hendges, chairperson of the National Association of Statutory Health Insurance Dentists (KZBV) and Romy Ermler, President of the German Dental Association, said in a joint statement.

Hendges and Ermler urged that scrapping dental care from statutory health insurance coverage is more likely to increase the amount required to fund the healthcare system in the long term. If statutory health insurance coverage does not provide patients with preventative treatment, there will be greater follow-up costs for the overall healthcare system.