Germany needs a total reset of the health system. The chairman of the German Society for Clinical Chemistry and Laboratory Medicine, Jan Wolter, draws attention to this in an exclusive interview with MedLabPortal. The political scientist was unanimously appointed to the board by the presidium of the professional society and has held this post since January 2026.

MedLabPortal: Mr. Wolter, we know an employed doctor who pays over 1000 euros a month for the statutory health insurance, but had to wait seven months for an ophthalmologist appointment as a “statutory health insurance patient”. What is going wrong in the German healthcare system?

Wolter: Is that an invitation to write a book? There is no question that there are many problems in the German health care system and you will certainly be able to name numerous other cases where things are stuck.

MedLabPortal: We also know a 91-year-old lady who has been waiting for a special reading aid in the nursing home for 2 years. She is almost blind, and the health insurance company would pay for the device – if she filled out the application forms correctly. But because she can’t do that without a reading aid, there will be no reading aid in the future. What do you say to such cases?

Wolter: Welcome to Absurdistan! The fundamental problem with our health care system – and you can probably apply this to pretty much every other system in our state – is that we take care of symptoms, individual cases, details. Our system has grown over the last few decades. New diagnostic procedures were developed, new therapies were developed. At the same time, new diseases have emerged, society has changed and the technology – including in administration – is no longer comparable to that of 50 years ago. Of course, regulations and regulations have also changed, and bureaucracy has grown. And that’s absolutely understandable: new technologies have to be regulated and all of this has to be monitored. However, this made the overall system enormously complex, slow, error-prone and increasingly dysfunctional. At this point, people like to talk about the need to reduce bureaucracy or abolish regulations again. But that misses the point. After all, the vast majority of rules and regulations have their justification. So we don’t have to free our system from bureaucracy. We need a new system.

MedLabPortal: Do we understand you correctly? Are you calling for a total reset of the German healthcare system?

Wolter: Nothing less than that, yes. We need a complete restart. We have to rethink everything from the ground up. Our processes are essentially still those of the times of the German Empire. At the same time, laboratory samples are flown with drones and artificial intelligence recognizes cancer cells – technologies that would have been considered magic at the time. The tinkering with the system must come to an end. The reintroduction of the practice fee – in whatever form – the partial abolition of continued payment of wages in the event of illness or an end to sick leave by telephone. This is all unimaginative patchwork that does not bring us forward in the slightest.

MedLabPortal: But now it is the case that everyone in Germany is now demanding something. Do you also have concrete suggestions for pragmatic implementation?

Wolter: The BMG was to award a research contract “Redevelopment of the German health system”. Or better yet, more broadly: Politicians define goals for what is to be achieved in 10 or 15 years, such as increasing life expectancy by X years or reducing certain diseases by Y percent. Then we would first have to look at which factors have an influence on this, which would make it clear that our health system alone has only a limited influence on our health. This also includes transport policy, education policy, social policy, etc. Once you have arrived at the health care system, it is important to rethink it from the ground up. The entire application process is likely to be 99 percent smaller than it is today. Digitization does not mean writing things on the computer and printing them out on the printer instead of working with a typewriter. Scheduling an appointment with the doctor is also completely antiquated. But these are all individual fields that may not be edited individually. As I said, we have to completely redevelop our health care system.

MedLabPortal: You are a board member of the DGKL. In this role, your word carries weight – will you talk to Federal Minister of Health Nina Warken about your reset proposals?

Wolter: Laboratory medicine plays a decisive role in health care, so it can be recommended to enter into dialogue with the DGKL anyway.

MedLabPortal: Why so timid? So far, the minister has shone more with remakes of the 2000s, we are thinking of the planned practice fee. The minister could use some disruptive input…

Wolter: The entire federal government could make good use of this. But Ms. Warken could set a good example.

MedLabPortal: So far, you have penned the National Strategic Plan of the DGKL and the outline of the Cybercent model for the establishment of a cyber defense shield in the field of laboratory medicine. Major media such as the Tagesspiegel reported on this – how did politicians react?

Wolter: My experience with politics is that it reacts more to senders than to content. So if a group with strong voters comes around the corner with a thin proposal, it is more likely to be reacted to than if a small professional society brings in a substantial idea. But I like to be surprised.

MedLabPortal: The reset you are now proposing would probably save billions and enable patients to receive better care – aren’t you afraid that you will antagonize those who would no longer earn these billions as a result of the reduction in bureaucracy?

Wolter: Without a doubt, with a new approach, we could save billions in health care and people would live longer and healthier lives at the same time. And certainly you step on the toes of many because they have to adapt. But bureaucracy usually does not make money, but burns money. In the next few years, millions of people in the administration will retire. And at the same time, we lack skilled workers who have to spend a good part of their time with bureaucracy instead of doing what they were trained or studied for.

MedLabPortal: As is well known, health policy is a matter for the states. Accordingly, you would not only have to promote Nina Warken, but possibly also at the state level for your model. Under what circumstances would a pilot model in a small federal state such as Bremen or Saarland make sense?

Wolter: Certainly, you won’t be able to develop a new health system on the drawing board and then roll it out in one fell swoop. You need temporary solutions, a transformation process. This will be anything but easy. And it will be possible to roll out parts of the new system to a limited extent in pilot tests. That certainly makes sense. However, it is important not to create isolated or partial solutions.

MedLabPortal: Our last question: How long do you wait for a specialist appointment in Berlin?

Wolter: Luckily, I don’t need one right now.

MedLabPortal: Thank you for your time.

The questions were asked by Marita Vollborn and Vlad Georgescu

Editor: X-Press Journalistenbüro GbR

Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability. ected.