Germany’s Sick-Pay Bill Soars to Record €21.6bn as Experts Say Proposed Law Changes Tackle Wrong Problem
Veröffentlicht: 08.07.2026 um 02:33 Uhr, Redaktion boerse-global.de
Germany’s statutory health insurers spent €21.6 billion on Krankengeld (sickness benefit) in 2025—the highest figure ever recorded for a single expenditure item in the public health system. The overall sickness rate hit 6.1 percent, and every fourth missed workday was attributed to a recipient of long-term sick pay. Over the last decade, the number of days covered by Krankengeld rose 24.4 percent, driven overwhelmingly by long-term illness.
Regional data from the Barmer health insurance fund for Saxony underscores the trend: the state recorded a 6.3 percent sickness rate in 2025. By March 2026, preliminary surveys showed an average of six sick days per insured person, compared with 6.5 in the same period a year earlier.
Proposed reforms draw fire
The federal government is considering tightening sick-leave rules—including scrapping the option of a telephone-based sick note and requiring a doctor’s certificate from the first day of absence. A researcher at the University of Bamberg called the plans counterproductive, arguing they fail to address the real cost driver: long, psychologically related absences. Short-term leaves account for only a small fraction of total expenditure, while the new rules could fuel Präsentismus—employees turning up at work despite being ill. The measures would also pile extra strain on GP surgeries.
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The DGB trade union confederation’s chair, Yasmin Fahimi, warned that many workers no longer expect to stay in their jobs until retirement. Skepticism runs especially high in high-stress sectors: 71 percent of nursing staff, 67 percent of elderly-care workers, and 66 percent of high-rise construction workers doubt they can continue to retirement age. Fahimi called for healthier working conditions and dignified transitions into retirement.
Another planned change—extending fixed-term contracts without cause to up to four years—could increase psychological pressure, critics say.
Mental illness drives longest absences
Although psychological disorders account for only 5.4 percent of all sick-leave reports, they cause the longest spells away from work—on average more than five weeks. Burnout cases, in particular, drag on significantly longer.
At the same time, short absences of up to three days have become more common: their share rose from 35 percent in 2021 to 40.5 percent in 2025. Older employees are sick less frequently but, once off work, remain absent for considerably longer periods.
Engagement at historic low
The quality of management is emerging as a key lever for workforce health. The 2025 Gallup Engagement Index found that only 9 percent of German employees feel a strong emotional tie to their employer—the lowest figure on record. The link to absenteeism is stark: workers with high engagement average 5.5 sick days per year; those with low commitment or “inner resignation” take 7.9 days.
Lea Feder, head of the consultancy JETZT Performance GmbH, argues that illness often begins with ignored symptoms—sleep problems, concentration difficulties, exhaustion. “Companies only react once a sick note arrives, rather than addressing the causes,” she says. A resilient organisation, Feder adds, is the product of a leadership culture that detects strain early.
Employers turn to private health offers
To bypass months-long waits for therapy places—six to twelve months are common for statutory-insured patients—more firms are taking out betriebliche Krankenversicherung (bKV) with mental-health components. These plans can give employees access to professional counselling or coaching within weeks and are available to companies with as few as three staff, without a health check.
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Specialised training is also gaining traction. The employers’ liability insurance association for the food and hospitality sector (BGN) is running “Healthy Leadership” seminars from 7 September to 30 October 2026. Topics include stress management, bullying prevention, and the legally required psychological risk assessment. An online seminar on health-compatible working-time design runs from 19 October to 27 November.
Executive coach Ragnhild Struss stresses that empathy in management is not about being nice for the sake of it, but about accurately reading emotional dynamics. “Only then does a team remain capable of action even under pressure,” she says.
