Berlin – September 13, 2026 -- Germany's largest doctors' association, the Marburger Bund, has warned lawmakers that a draft reform of emergency medical care could hand health insurers de facto control over which local emergency sites survive, ahead of a public hearing before the Bundestag's Health Committee.
Marburger Bund backs the goal of linking outpatient and inpatient emergency care but flags flaws in the bill
Dr. Susanne Johna, chairwoman of the Marburger Bund, told the committee that better integration of ambulatory and hospital-based emergency structures is needed so patients reach the appropriate care point reliably. She cautioned, however, that the current draft contains provisions that could create new operational problems in practice.
Decision-making structure could let cost bearers dictate which sites remain open
The bill provides for Integrated Emergency Centers (INZ) at hospitals, a concept the association supports in principle. Johna said it remains unclear at how many locations and where exactly these centers will be established, and warned that the reform must be guided by medical need and regional care requirements rather than by financial parameters set by statutory health insurers. The association fears the decision-making structures written into the law would ultimately let payers determine which emergency sites are retained and which are closed.
Unvalidated triage tools raise access concerns for non-digital and non-German-speaking patients
The Marburger Bund also criticized plans to deploy different initial-assessment (triage) procedures at various points of first contact, noting that sufficient validation of these tools does not yet exist. It warned that digital triage systems must not create barriers for patients unable to use them, and that telephone-based assessment must account for language barriers among patients.
Mandatory transfers between hospitals could strain already limited ambulance capacity
A further provision would require hospitals without an INZ to redirect patients needing acute but likely outpatient treatment outside consultation hours to a hospital that has one. Johna called this medically unjustifiable, arguing that patients are not packages to be routed between care sites based on jurisdiction and billing rules. She said the rule would add further strain to already scarce personnel resources in ambulance services and patient transport.