Germany's Bold Healthcare Overhaul: Higher Fees, Sugar Taxes, and Emergency Room Crackdowns

Gerald Gaß, head of the German Hospital Federation (DKG), has proposed a series of bold healthcare reforms. His suggestions include higher patient fees, a sugar tax, and stricter rules for emergency department visits. The proposals aim to cut costs, reduce bureaucracy, and promote healthier lifestyles.

The federal government and statutory health insurers have not yet publicly responded to the plans. Instead, the DKG has clashed with officials over recent changes to hospital funding laws, adding tension to ongoing debates.

On February 17, 2026, Gaß called for a sharp rise in daily hospital co-payments. Under his plan, patients would pay €20 per day—double the current €10 fee. This change alone could bring in an extra €800 million annually for health insurers.

He also proposed a €40 charge for anyone visiting emergency departments without first calling for advice. The move targets unnecessary visits and aims to ease pressure on overstretched services.

Beyond fees, Gaß pushed for broader health measures. He backed a sugar tax to fight obesity and urged more physical activity in schools and daycare centers. Better nutrition education also formed part of his strategy to cut long-term healthcare costs.

The DKG, however, remains locked in dispute with policymakers. On February 23, 2026, Gaß criticized a government amendment to the Krankenhausreformanpassungsgesetz (KHAG). The federation argued that recent changes worsened tensions over nursing budgets, especially after insurers raised fraud allegations. Gaß now wants realistic compromises in the Bundestag and Bundesrat talks.

His wider reforms also focus on slashing hospital bureaucracy and boosting prevention. These steps, he claims, would streamline care and reduce avoidable illnesses in the long run.

Gaß's proposals would reshape how patients pay for care and how hospitals operate. If adopted, the higher fees and sugar tax could generate significant funds while pushing people toward healthier habits. The next steps depend on negotiations between the DKG, government, and insurers—talks that remain deadlocked for now.