The word "revolution" that Health Minister Karl Lauterbach (SPD) uses for his "major hospital reform" is certainly an exaggeration.
What is true, however, is that the proposals go as far as they have not done in 20 years.
At that time, case flat rates were introduced, from which great promises were also made.
Previously there were flat rates for berths, before that cost coverage.
A lot has already been tried, but mostly the revolutions – as in politics – got out of hand after a while.
This danger also exists now, although the basic idea is correct: the incentives to settle many cases with as little effort as possible must be eliminated - which not only leads to unnecessary and sometimes poorly performed treatments.
At the same time, services that bring in little have been shut down, as can be seen from the disastrous situation in children's hospitals.
Turning away from profitability can be dangerous
So there is an undersupply and an oversupply at the same time.
The reform intends to remedy this situation by minimizing the flat rate per case, by categorizing and specializing the types of clinics, by outpatient treatment and by introducing flat rates for services of general interest: Like the fire brigade, clinics should receive money for being ready and not only becoming active when the sirens wail.
It is questionable whether the turning away from profitability is not going too far.
Lauterbach is proud that in the future there will be hardly any money to be made in the hospital sector and that private providers may give up.
At the same time, competition and the pursuit of profit can raise efficiencies, improve quality and attract good staff, and ultimately serve the patient very well.
If you overdo it with the advance payment, then a clinic may have no interest in admitting patients and caring for them well.
You have to give Lauterbach's reform a chance, but be careful that it doesn't take the market abandonment and nationalization too far.