Health policy, measured

The starting point of her health policy was arithmetic. In the first reading of the 2026 federal budget on 23 September 2025 she told the Bundestag that health expenditure had reached roughly €6,000 per person and more than doubled in two decades, and she set this against the slower growth of wages, which finance most of the system through contributions. When presenting the FinanzKommission Gesundheit the same month, the ministry said spending was growing by around eight per cent while revenue lagged well behind.

Official statistics support the direction of that argument. Destatis records that health expenditure more than tripled between 1994 and 2024, from €175.3 billion to €538.2 billion, and that its share of GDP rose from 9.5 to 12.4 per cent. The debate is not about whether costs are rising but about what drives them — demographic ageing, wages in labour-intensive care, new therapies, or inefficient structures — and therefore about who should bear the adjustment.

Quality was the original justification of the 2024 hospital reform: complex treatment should be concentrated where staff and equipment meet defined standards. Her Hospital Reform Adjustment Act of March 2026 kept that logic but gave the Länder more flexibility to grant exceptions and longer transition periods — a trade-off between uniform standards and the realities of regional provision that critics on both sides read differently. See Hospitals.

Quality also runs through the data agenda. Medical registers allow outcomes to be compared across hospitals and over time; the Medical Registers Act was presented as a way to make such comparisons reliable. The GKV act added mandatory second opinions for certain high-volume procedures from 2028, intended to reduce operations that are not clearly indicated.

Patients experience the system through waiting times, overcrowded emergency departments and the distance to the nearest practice or pharmacy. Three projects of her tenure addressed this. The emergency care reform adopted by cabinet in April 2026 would create integrated emergency centres at selected hospitals and split the 116117 service into an appointment line and a round-the-clock acute line with telemedicine. A primary care system — in which a structured first assessment guides patients to the right level of care — was named as a central structural reform for 2026. And the pharmacy reform aimed to keep local pharmacies viable, particularly in rural areas.

Critics of primary-care models in Germany warn that gatekeeping can restrict free choice of doctor; supporters argue that unmanaged access produces both overuse and long waits. At handover, only the emergency and pharmacy reforms had reached parliament.

The electronic patient record for all statutory insured, introduced under her predecessor on an opt-out basis, became mandatory for doctors, psychotherapists and pharmacies to use from 1 October 2025. Her ministry's next step was the GeDIG bill, adopted by cabinet on 15 July 2026: it would turn the ePA app into a digital front door to care, with appointment booking and first assessment, and make electronic referrals mandatory from September 2029. Data-security concerns raised by researchers before the national rollout remain part of the debate. See Digital health.