Comment: Will Minister Lauterbach, who made the announcement, be followed by Minister Warken, who is responsible for the change?

The lobbyists were quick to step in. No sooner had Chancellor-elect Friedrich Merz publicly appointed his CDU/CSU colleague Nina Warken as Minister of Health than the congratulations poured in. From representatives of the medical profession to the umbrella organization of hospitals. They could be interpreted as an assessment of a system in disarray, a reckoning with the outgoing minister , Karl Lauterbach (SPD) . They provided the newcomer in office with an overview of what to expect.

Nina Warken has high hopes, in a field in which she previously had little experience. The 45-year-old CDU politician served on an advisory board during the coronavirus pandemic. Her expertise as a lawyer was in demand. As such, she also advocated for mandatory vaccination, but later retracted this proposal as premature. She seems to have a certain pragmatism. Will this benefit her in her future job?

Germany spends a lot of money on its healthcare system. Approximately 500 billion euros per year flow into various sectors, according to the Federal Statistical Office for 2023 , the first year after the pandemic. This amounts to an average of just under 1.4 billion euros per day. Its share of gross domestic product is 12 percent. This puts Germany above the European average.

These figures are offset by significant financial problems. The lobbyists' reactions to Warken's nomination make this clear. The AOK (German Health Insurance) addresses one of the biggest problems. Insured members will face rising costs again this year. All statutory health insurance providers are likely to increase their supplementary contributions again. Given this, it is high time to act, warns the AOK.

Employers in the elderly care sector see an opportunity for a fresh start. They have long complained that nursing homes are going bankrupt due to financial pressure and the associated staff shortages. The burden in this sector already falls heavily on the relatives of those in need of care, and this burden will continue to grow. Nursing insurance funds are unable to keep up with the financial needs, pushing a deficit ahead of them.

Meanwhile, the German Hospital Federation ( DGF) is pursuing a new communication style. It complains that Lauterbach initiated the restructuring of the hospital landscape without its involvement, even though university hospitals, among others, were represented on the minister's advisory staff. The National Association of Statutory Health Insurance Physicians even speaks of distrust in self-governance in the recent past. It offers Nina Warken its support in strengthening outpatient care "as a key element of the healthcare system and a pillar of our democratic society."

Pharmacists are looking forward to working with the minister, noting that their fees haven't been increased in years. Businesses in this sector are also constantly going offline. The umbrella organization Pharma Deutschland welcomes the personnel decision at the top of the ministry, although the industry had little cause for complaint under Lauterbach. Prices for patent-protected medications have been rising sharply in this country for years, and opaque pricing could exacerbate this trend.

Situation in the healthcare system continues to worsen

Clearly, the billions are not being spent exclusively in the interests of those who should be at the center of health policy: the citizens and those who care about their well-being. Unraveling the web of vested interests and vested interests will be the most difficult task for a future health minister. And that's in light of a situation that is set to worsen further in the foreseeable future.

Demographic challenges are increasing the pressure to act: Fewer and fewer people are having to care for more and more people. This will not work without digitalization, which relieves healthcare staff of tasks far removed from patient care. Nor will it work without a shift away from repair medicine and a shift toward prevention.

Against this backdrop, his predecessor, Lauterbach, is now celebrating the nationwide introduction of electronic patient records as a turning point. However, several changes will likely still be necessary to adapt this digital innovation to current requirements and dispel concerns that it is merely a data-collection machine that benefits patients the least.

When Karl Lauterbach, a man with expertise, was appointed to the position in 2021, expectations were high. The euphoria quickly faded. Goodwill and best wishes now also accompany Nina Warken, who is not an expert in the field. However she interprets her future job, one thing is certain: the agility she once demonstrated on the issue of mandatory vaccination won't get her far.