This measure is directed at revising medical care standards and has sparked significant discussions in expert circles. Currently, homeopathy is not included in the basic catalog of services; however, insurance organizations have the right to subsidize it as an additional statutory service. Many funds utilize this opportunity, voluntarily covering the costs of specialized examinations and the purchase of preparations.
Interest in this topic is driven by the fact that a certain portion of insured individuals regularly resort to alternative—unproven—types of treatment. The proposed changes call into question established practices and force the insurance sector to seek new ways of interacting with clients under changing legislation.
No More Exceptions
The federal government plans to legally prohibit funds from using insured members’ contributions to pay for methods that lack scientific confirmation. The current draft law emphasizes that the effectiveness of homeopathic and anthroposophic services has not been proven according to recognized international scientific standards. The document states that the use of such methods for only a small percentage of insured individuals should not be financed by the entire collective of insured persons, as this contradicts the principle of rational resource allocation.
The legislative initiative aims to close any loopholes that allowed health insurance funds to bypass general rules through their statutes. It is expected that a single standard for all insurance organizations will increase system transparency and eliminate discrimination against insured persons based on their choice of a specific fund.
Proof of Benefit Required
The financial aspect of the reform is estimated at 50 million euros in annual savings. In the context of overall goals to reduce the health budget deficit by double-digit billion sums, this amount is considered insignificant. However, the decision is based on a fundamental principle of statutory health insurance: citizens’ contributions must be directed exclusively toward diagnostics and treatment whose benefit and effectiveness are confirmed by the criteria of evidence-based medicine (EbM).
Evidence-based medicine investigates whether a therapy has an effect beyond the placebo effect—the psychological impact associated with the mere act of seeing a doctor. Currently, there is no confirmed data on specific effectiveness for homeopathy and anthroposophic medicine. This makes their funding from general funds unjustified from the perspective of modern medical ethics and law.
Joint Decisions of Funds and Physicians
The compliance of a service with EbM criteria is determined by the Federal Joint Committee (G-BA)—the highest body in the German healthcare system. Its membership includes representatives of insurance funds, medical associations, and clinics. It is this body that forms the list of services mandatory for reimbursement.
Within the committee, homeopathy never stood a chance of being recognized as a general service, as G-BA experts rely exclusively on a scientific basis. Nevertheless, until now, individual funds could independently deviate from the general line by making decisions at the level of their own boards. The new reform is designed to eliminate this inconsistency.
The Question of Competition
For many insurance organizations, homeopathy has long served as a tool in the competitive struggle for new clients. Perhaps Germany lacks professional marketers who could easily find competitive tools for health insurance funds.
The inclusion of alternative treatment methods in the service package of such funds was supposed to improve their positions on online comparison portals. But in reality, it involves millions in waste for a very small percentage of German residents. In private conversations, representatives of health insurance funds admitted that they are ready to pay for services whose benefits they themselves may not be convinced of, solely for the sake of maintaining market share and attracting insured persons oriented toward non-traditional approaches.
The ban on financing homeopathy will level the playing field for competition. Insurance companies will have to find other ways to attract clients, focusing on service quality or additional preventive programs with proven benefits.
Resistance to Exclusion Plans
The government’s intentions have met with a mixed reaction. The medical community and experts in evidence-based medicine support the bill. Ferdinand Gerlach, Director of the Institute of General Medicine at Goethe University, emphasized that services without proven benefit should not be reimbursed at the expense of solidarity-based medical insurance.
On the other hand, homeopathic associations and anti-vaccination activist groups have launched an active campaign to protect their interests—or rather, the interests of so-called “gray pharma companies.” Signature collection and lobbying under the motto “Homeopathy must remain a health insurance service!” are aimed at convincing the ministry of the value of these methods for certain groups of citizens. Supporters of alternative treatments claim that the department is ignoring a number of studies (Editor’s note: In reality, there are no such studies conducted according to scientific methodologies, only PR focus groups paid for by gray pharma companies) that allegedly confirm the effectiveness of their methods.
Not the First Attempt at Exclusion
The current Minister of Health, Karl Lauterbach, already made an attempt to exclude homeopathy from the insurance system in 2022. At that time, the initiative faced political resistance within the coalition, particularly from the Green Party, and was not implemented. The current stage of the reform is seen as a second attempt to bring the GKV system to a single scientific standard.
The final decision of parliament will show how far the government is willing to adhere to the principles of evidence-based medicine under intense political and public pressure. Nevertheless, the very fact of introducing such amendments indicates a serious intention to reform the financial structure of German healthcare.
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