Germany’s Small Hospitals Are Disappearing

The current hospital reform and the ongoing financial strain are threatening the survival of regional hospitals in Germany, necessitating a change in approach. Nearly every month, a small hospital in Germany shuts its doors. Politicians argue that there are too many hospitals and that the healthcare system cannot afford to keep them all operating. Critics, however, warn that such closures might endanger patient safety. Lisa Baumberg, is passionately advocating for the preservation of the hospital in her small hometown of Frankenthal in western Germany. Despite sweltering heat, she takes to the streets to protest against the planned closure of the town's only hospital, the Frankenthal City Clinic. Under the banner "No Hospital, No Town," residents have called for a peaceful protest march to the town hall at 2 PM today. Many hospitals in Germany are on the brink of closure. Due to the hospital remuneration law, revenues can hardly be increased and are no longer sufficient to cover rising costs, which exceed inflation rates. The financial situation is particularly alarming for non-profit hospitals. They face similar economic challenges as municipal hospitals but lack equivalent political support. Nevertheless, reliable and sustainable healthcare is inconceivable without nonprofit hospitals in many communities. In Stuttgart, for instance, three major nonprofit organizations provide 40 percent of available hospital beds: Robert Bosch Hospital, Marienhospital, and Diakonie Hospital, accounting for 2,254 beds and approximately 6,900 employees. In a recently published appeal, these three significant non-profit hospitals urge that all hospitals be equipped with public tax funds to fulfill their service commitments. This call is also reflected in a recent legal study commissioned by associations of non-profit hospitals in Germany. The previous system of case-based payments is set to be replaced by what are termed as "provision fees." Hospitals will receive funding for offering certain services rather than for services rendered. Former Federal Health Minister Karl Lauterbach hoped this change would ensure high-quality care while reducing the economic pressure on hospitals. However, as part of the reform, the number of hospitals in Germany was expected to be significantly reduced. The new Federal Minister of Health, Dr. Carsten Linnemann (CDU), intends to revisit and implement this idea. The new classification of hospitals into so-called performance groups will focus on high-performance centers of excellence.