German Doctors Threaten Four?Day Week as Coalition Ends Phone Sick?Note Rule and Tightens Tax Brackets
02.07.2026 - 14:13:35 | boerse-global.de
The German government’s ambitious reform package, sealed by the coalition on Thursday, has ignited a bitter dispute with the medical profession before a single clause takes effect. While the headline change — mandatory doctor visits from the first day of illness and a full ban on telephone sick?note certificates — dominates public debate, doctors’ associations are warning that the accompanying cost?cutting measures will push surgeries past the breaking point.
The Spitzenverband der Fachärzte (SpiFa), the umbrella group for specialists, has threatened to introduce a four?day working week from 2027 in protest against the GKV?Spargesetz (statutory health insurance savings law). The German parliament is scheduled to vote on that law on 10 July. According to the coalition’s own projections, the specialist sector alone faces cuts of 2.7 billion euros, while the overall deficit in the statutory health insurance fund has ballooned to 19 billion euros.
Markus Blumenthal?Beier of the German Association of General Practitioners described the new sick?note rule as a “catastrophic” wave of extra paperwork for already?overloaded practices. Janosch Dahmen, health?policy spokesperson for the Greens, criticised the additional strain on medical staff. Even former health minister Karl Lauterbach publicly distanced himself from the decision, saying he would not have made such a choice. The head of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, warned that practices are already operating at their limit.
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Under the new regulation, which applies to all employees, the previous grace period that allowed workers to present a medical certificate only after the fourth day of absence has been scrapped. From now on, a doctor’s note is required on day one. Companies may still set more lenient rules individually, but the national standard has shifted decisively. The telephone sick?note procedure, introduced only at the end of 2023, is abolished entirely. The coalition also plans stricter penalties for falsified sick?leave certificates.
Chancellor Friedrich Merz justified the tightening by pointing to Germany’s rising sickness?absence rate. According to the DAK health insurance fund, the average employee recorded 19.5 sick days in 2025. The KBV estimates that short?term sick notes account for roughly one?third of all 116 million annual cases.
The package stretches well beyond labour law. Beginning 1 January 2027, an income?tax reform will provide relief totalling about 10 billion euros for citizens. At the same time, a new “wealthy tax” kicks in: an annual income of 250,000 euros triggers a rate of 45 percent, rising to 47 percent for incomes above 280,000 euros. In labour law, the maximum duration of fixed?term contracts without a material reason is extended to 48 months.
A separate provision in the pharmaceutical sector is already stirring debate. Instead of annual renegotiations, the mandatory rebate on patented medicines will be frozen at 15.5 percent. The coalition argues this creates planning certainty for manufacturers, but the immediate financial burden on drugmakers will be heavier than under the previous system.
