Germany pushes reforms on health insurance thresholds and long-term care funding

Germany is debating major changes to its health‑care financing. Lawmakers are reviewing the annual income threshold (JAEG) that lets high‑earning workers leave the statutory health insurance (GKV) for private plans, a move aimed at shoring up the GKV’s finances and possibly paving the way for a unified citizens’ insurance.

At the same time, the sustainability of the long‑term care system is under fire. Patient‑protection group head Eugen Brysch condemned CDU proposals to lower the income level at which adult children must help pay parents’ care costs, to tap inheritances and even property for funding, calling the measures “absurd” and warning they could create existential anxiety for the elderly. Average out‑of‑pocket expenses for a first‑year nursing‑home stay now exceed €3,200 per month.

Trade union Verdi has protested a government package that would impose spending caps on hospitals and other health providers, describing it as a “spare‑orgy” that could jeopardise quality and staff. The package seeks to relieve the statutory health insurance fund by €16.3 billion by 2027 through cost‑containment measures across clinics, pharmaceuticals and co‑payments.

A parallel debate concerns preventive care: proposals to curb statutory skin‑cancer screening are being discussed, while a lung‑cancer screening programme for high‑risk smokers proceeds, reflecting evidence‑based assessments of benefit versus cost.

Separately, a petition has been drafted to allow German care allowance (Pflegegeld) to be paid for care received abroad in low‑cost countries such as Thailand, but current law blocks benefits once a person relocates permanently.