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OPINION AND ANALYSIS

OPINION: How bureaucracy is slowly killing Germany

Germany is struggling so much under the weight of bureaucracy that it would take even more red tape to make things better, writes Jörg Luyken. Is there any hope for the beleaguered Bundesrepublik?

stack of paper
Archive photo shows a stack of paper following a Bundestag session. Photo: picture alliance / dpa | Ole Spata

In the summer of 2022, I attended a Q&A session that Olaf Scholz held with members of the public in the city of Magdeburg. Coming only a few months after the Russian invasion of Ukraine, most of the questions centred on sanctions, energy costs and Berlin’s response to the war.

But the response I found most revealing was on the dull topic of tax reform.

An audience member asked Scholz why the VAT rate on dog food is seven percent but on baby food it is 19 percent. Parts of the system “don’t seem very coherent to me,” the man said with obvious understatement.

READ ALSO: Bureaucracy and high taxes: Why Germany is becoming less attractive for business

“I don’t think you’ll find anyone who understands the list of VAT exceptions,” Scholz replied with a grin, adding that “at any rate I don’t understand it.”

“But I can tell you that all attempts to change it have ended in a massive disaster,” he continued. “If we were to lay an empty table today, we would definitely do differently. But the system is there now and I think we will have to live with it for a while yet.”

It was a fascinating answer. Essentially, Scholz admitted that there are some regulations that are so complex that no one really understands them anymore. But trying to simplify them just isn’t worth the effort.

It reminded me of a story I once heard about Cairo’s famously dysfunctional traffic system.

Legend has it that Egypt invited a group of Japanese planners to come up with a way to fix it. But the Japanese were so befuddled by what they found that they advised the Egyptians to leave things exactly as they were. The system was so confusing that any attempt to tamper with it might only make things worse.

A similar thing could be said of Germany’s regulatory system. It can be contradictory and infuriatingly slow, but open the can of worms of trying to simplify it and you will probably live to regret it.

private pension plans spain

VAT is just one more confusing piece of German bureaucracy. Photo: Mathieu Stern/Unsplash

Summer snow and other oddities of German red tape

VAT serves as a notorious example. But, wherever you look in German life, you will find egregious cases of sprawling and overlapping regulations.

A few amusing examples:

In August 2022, the town of Esslingen in Baden-Württemberg wanted to organise a summer fête to help local restaurants get back on their feet after Covid. The idea was to build temporary food huts that restaurants could rent cheaply. But planning authorities insisted the huts be built to take the weight of heavy snowfall – during a month with average temperatures of 19C. The fête went ahead, but the eventual costs were “exorbitant,” city officials said.

Last winter, the town of Tübingen acted on an appeal from the federal government to cut gas usage. They decided to switch off street lights between 1 am and 5 am, something that would cut energy costs by 10 percent. Shortly afterwards though, they had to backtrack. The measure contravened a regulation on providing light for pedestrians. In the event of an accident they could have been sued.

A landlord in Hanover recently recounted her efforts to turn an empty attic into student housing. Her planning application was first rejected by fire authorities who said that the branches of a tree were blocking an escape route. Their proposal to cut the tree back was then turned down by the city authority for green spaces, which argued that trees form “a vital part of the city scenery” and “must be protected at all costs.”

Flood of new rules

It is not as if politicians aren’t aware that over-regulation is having a stifling effect on society’s ability to function and adapt.

In its coalition agreement, Scholz’ ‘traffic light’ government committed itself to cutting bureaucracy 63 times. There is an entire section in the agreement on how they planned to cut down official paperwork.

READ ALSO: Germany unveils new plan to be more immigrant and digital friendly

But changing such a deep-seated German mentality is a different matter.

In a withering report published in November, the government’s own bureaucracy watchdog, the Normenkontrollrat, concluded that under the current government the costs of bureaucracy “have reached a level that we’ve never seen before.”

Far from cutting back paperwork, the traffic light coalition has loaded companies, administrators and citizens with a whole raft of new rules, the watchdog said. “Ever more regulations have to be observed and implemented in less and less time,” it concluded.

The frustration is being felt most acutely by local administrators, who say that they just don’t have enough staff to cope anymore.

An open letter sent to Scholz by town councils in Baden-Württemberg pleaded that “things can’t go on like this. Ever more laws and regulations, all too often containing mistakes …are simply resulting in an unmanageable flood of tasks.”

Meanwhile, Germany’s revered Mittelstand, or small and medium sized family businesses, has warned that over-regulation is the single biggest threat to their future viability. A survey among middle-sized companies last year showed that they were far more concerned about regulation than energy prices. Other surveys have shown that a majority of companies don’t understand the regulations they are expected to follow, while two thirds say they make no sense.

“Enormous bureaucratic burdens are combining with labour shortages, lengthy administrative procedures, permanently high energy prices and high taxes in a blow to the future of our business location,” warns Marie-Christine Ostermann, head of the association of family business.

READ ALSO: Why German family businesses are desperately seeking buyers

Stuck in the analogue era

For some though, the problem isn’t the regulation itself, it is the fact that there are not enough bureaucrats to deal with it all. After all, they argue, the rules are there to ensure that everyone’s concerns are accounted for.

“An unbureaucratic administration would be a nightmare,” protested economist Georg Cremer in a recent article for Die Zeit. “Sure, there can be too much of a good thing… (but) a prosperous social life is absolutely dependent on the government and administration being bound by law.”

Germany’s welfare system, Cremer points out, requires an army of bureaucrats who assess each claimant’s case based on things like the age of their children and their specific rental needs. “Undoubtedly, the welfare system is over-regulated”, he admits, but we also shouldn’t forget that any attempt to simplify it would make it less fair.

The Deutsche Institut für Wirtschaft, a left-wing economic think tank, has therefore argued that the answer to Germany’s woes is not to strip back regulation, but to employ more staff and push on with the digitisation of key services.

That sounds good in principle. But, when it comes to modernising Germany’s ossified public institutions, it is easier said than done.

A law passed in 2017 obliged local administrations to offer close to 600 of their services online by the end of 2022. A year past that deadline, just 81 of the services have been made available across the country.

The reason for the delays? Local governments are using software that is incompatible with the services developed by the federal government. Meanwhile bureaucrats often display a “grievous” lack of knowledge of how to use a computer, a recent analysis by consumer website Verivox found.

Bürgeramt

A man walks to the Bürgeramt, one of the many centres of German bureaucracy. Photo: picture alliance/dpa | Martin Schutt

A German Javier Milei?

In September of last year, Scholz appeared to have finally recognised that things have gone too far.

Doing a good impression of an anarcho-capitalist then running to be president of Argentina, the chancellor gave a rousing speech to the Bundestag in which he called on the country to unite against the scourge of excessive regulation.

“Only together can we shake off the blight of bureaucracy, risk aversion and despondency that has settled over our country for years and decades,” he said. “It is paralyzing our economy and causing frustration among our people who simply want Germany to function properly.”

Two months later, Scholz announced he had reached a “historic” agreement with the federal states to speed up planning processes and to make life “palpably” easier for German citizens.

The agreement, since praised by the Normenkontrollrat as “having a lot of potential,” will mainly muzzle environmental agencies, thus allowing LNG terminals, wind turbines and motorways to be built through sensitive natural environments.

The jury is still out on whether it will simplify your everyday life.

At the start of this year more new laws came into force, including the government’s now notorious gas heating ban.

One that passed with less attention was a decision to abolish child passports. Under the old system you could take your child to your local Bürgeramt and they would give you a Kinderpass on the spot for €13.

READ ALSO: How Germany can make life easier for foreign parents

Now, all children are required to have proper documents that are valid for six years. The hitch? The passport (which costs €40 and takes six weeks to arrive) is only valid as long as your child’s face remains recognisable.

“The new system makes absolutely no sense for children under six,” the lady at the Bürgeramt told me when I applied for my newborn baby’s first passport this week. “A baby’s face changes so much that you’ll have to get a new one after a year anyway.”

This article originally appeared in The German Review, a twice weekly newsletter full of analysis and opinion on German politics and society. You can sign up to read it here.

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OPINION AND ANALYSIS

OPINION: Why it’s becoming harder to get a doctor’s appointment in Germany

Germany's health service is known as one of the best in the world but securing a timely appointment with a doctor is getting harder. A creaking system and the culture around excessive doctor visits are part of the problem, argues Brian Melican.

OPINION: Why it's becoming harder to get a doctor's appointment in Germany

Germans have always been known for being health-conscious – some would even say hypochondriacs. That has its down-sides (see Covid…), but also some notable advantages. One is the ability to go to any doctor’s practice and request treatment, skipping general practitioners, referrals, and all of the attendant bother.

As a result, in any well-to-do area of a major German city, you’ll have a bewildering array of medical practitioners within walking distance, from general physicians (Allgemeinmedizin) and orthopaedic practices (Orthopädie) to ones that will have you Googling (HNO stands for Hals-Nase-Ohren – ears, nose, and throat – by the way. You’re welcome.)

The strength of this patient-choice system is that it allows people to manage their own care. So if one doctor can’t see you, you go and find another. And if you’ve moved towns or fall ill away from home, you can still access care. In theory, this spreads demand and keeps people with non-urgent complaints out of casualty wards. Yet in practice, the system is now creaking audibly. 

In recent months, I’ve tried to get appointments for several routine procedures with doctors’ offices I have been visiting for years – and the earliest I could get anything was, to my surprise, now several months off. Both dentists and dermatologists are currently, it would seem, planning their schedules for September and October. And when a rather unpleasant case of shoulder pain struck earlier this year (fittingly, just ahead of my 39th birthday…), the earliest appointment I could get at any of the three(!) local orthopaedic practices was at least a month off.

This isn’t just me getting unlucky here. In a recent representative survey, only 25 percent of respondents reported having no trouble getting a doctor’s appointment. The rest are having to wait anything between two weeks and two months – and I’m clearly now one of the 15 percent who report even longer delays. 

I’m not alone in thinking – knowing – that it didn’t used to be this way. So what has gone wrong? 

READ ALSO: Seven things to know about visiting a doctor in Germany

Structural changes in medical practice: fewer doctors working fewer hours

First off, there are changes afoot among Germany’s niedergelassene Ärzte – literally ‘settled doctors’ with surgeries, called so in order to distinguish them from hospital medics. For one, these doctors are getting old and retiring – just like the population they serve (or rather: have served). And as younger cohorts are less numerous, physicians looking to pass on their practices are having difficulty finding takers – especially in disadvantaged urban areas or out in the sticks.

A patient undergoes a consultation with his doctor.

A patient undergoes a consultation with his doctor. Photo: picture alliance/dpa/AbbVie Deutschland GmbH & Co. KG | AbbVie Deutschland GmbH & Co. KG

Even where there is no shortage of potential successors, ever fewer of them actually want to set up in business for themselves. For most young medics’ taste, there’s too much paperwork, too much commercial risk, and far too much work involved in running their own surgery. Instead, they prefer to merge with others or sell on to management companies who will, in turn, employ them (often part-time, with no annoying evenings or weekends on call). 

The results of all of this are as follows. Within the space of just one year, between 2022 and 2023, the number of surgeries fell by 1,987 – a drop of over two percent. Meanwhile, in 2023, for the first time ever, more than one third of Germany’s 150,000 non-hospital doctors were employees, not self-employed. That’s twice the number in 2013. Moreover, over the same period, the number of medics opting to go part-time has gone up by 235 percent to 60,000. This means that, if your local surgeries haven’t closed, the likelihood is that the doctors there are now working fewer hours – and so there are fewer appointments left to go round.

READ ALSO: Do doctors in Germany have too little time for their patients?

This would be bad news for any society, but it hits particularly hard in Germany. As a rapidly-ageing society with a relatively unhealthy population (high rates of smoking and obesity), our demand for medical services – often for complex chronic illnesses – is rising just as provision is declining.

Cultural differences in consulting doctors

Another problem is that Germans are accustomed to a historically high number of available doctors – and as serial worriers (and passionate sick-note seekers) make excessive use of them. Your average German racks up almost 10 consultations a year – not including visits to the dentists! The OECD average is closer to six. And the stoic Swedes, strong silent types that they are, go the doctor’s just 2.3 times a year.

Even if I wanted (or needed) to, I simply couldn’t to get to the quack’s almost once a month: I don’t have the time and they don’t have the appointments. But in conversation, I notice that others clearly do manage to find both. Increasingly, I’m wondering how many of them, unlike me, have private health insurance. 

This brings us to the third major issue facing non-hospital care in Germany. When the figures in the representative survey I quoted above are broken down, it transpires that almost 60 percent of people who are insured in the state system (gesetzlich versichert) are now waiting longer than two weeks for an appointment; among those who are privately insured (privat versichert), that figure is only 37 percent.

Doctors ‘keen on private patients’ 

Doctors are keen on private patients because their insurers pay more for the same procedures and will also cover all sorts of supplementary stuff – from the clinically-proven through to the just plain wacky. As such, practices reserve as many appointments as possible for private patients and try to keep the rest of us at bay.

Given that around four in five people in Germany are in the state system, however, this leaves the majority of patients competing for the minority of slots. If you want to see how the other fifth live, try “accidentally” clicking privat on surgeries’ online booking tools: you will now see a range of appointments available within days while the rest of us are being fobbed off for weeks or even months.

Not only is this, as my grandmother used to say, enough to make you want to join the Communist Party – it’s wildly inefficient. By restricting the hoi-polloi to slots often months off, doctors are creating their own appointment-management problems: sometimes, the complaint in question will have disappeared by the time the consultation rolls around; more often, it will have actually been dealt with – not infrequently by the same physician – if the patient presents as an acute case earlier.

As such, slots weeks away are booked, only to be cancelled later by conscientious patients (and left blocked by others), while those same patients crowd into waiting rooms begging to be seen urgently at an open surgery. (That’s how I got my shoulder looked at.)

A German health insurance card.

A German health insurance card. Photo: picture alliance/dpa | Jens Kalaene

The cynic in me says that, in the long run, this might not be such a bad thing. If the increasing scarcity of doctor’s appointments gets Germans thinking about whether they really, really need to be seen for yet another case of the common cold (“No, Christian, it isn’t pneumonia this time, either!”) or various nebulous self-diagnosed ills (Kreislaufbeschwerden (circulatory problems) is the day-off-work-one I love to hate), maybe it’s not a bad thing.

Swedes don’t die unnecessarily because they avoid the doctor’s: in fact, they live a good year longer than us on average. The German in me, though, says: “My shoulder hurts. Maybe I’ve got early-onset arthritis. I should probably go and get it checked out…” And even though I don’t go too often, I’ve got used to being able to see a specialist when I need one. It’s a shame that this is becoming markedly more difficult.

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