German Chancellor Friedrich Merz has ignited a fierce political debate by proposing to eliminate telephone sick notes, arguing that the nation's generous sick leave policies are undermining economic growth. The controversial plan has met with immediate and vocal opposition from labour unions and medical professionals across Germany.
Chancellor Targets "Too High" Absenteeism Rates
At a recent regional campaign event, Chancellor Merz highlighted that German employees take an average of 14.5 sick days annually, which he described as "too high." He questioned whether this level of absenteeism was truly necessary, noting that it equates to nearly three working weeks lost per employee each year.
Merz, who spent two decades in the private sector before assuming office last year, specifically criticised the telephone sick note system, suggesting it makes it too easy for employees to avoid work without proper justification. He received backing from the National Association of Statutory Health Insurance Physicians, whose chair Andreas Gassen stated that no doctor can reliably assess a patient's fitness for work over the phone.
Government Ministers Back Review
Health Minister Nina Warken has pledged to conduct a critical review of the telephone sick note practice, which is commonly used for minor illnesses like colds, flu, and Covid-19. She acknowledged that while Germany's sick leave rates are high compared to other nations, the low-threshold telephone option could potentially be abused.
"The truth is that the low-threshold option of reporting sick by telephone can be abused," Warken told Berlin's Tagesspiegel newspaper. "That is exactly what we will tackle."
Fierce Opposition from Medical and Labour Groups
The proposal has faced substantial resistance from multiple quarters. The Social Democrats, junior partners in Merz's coalition government, have argued that forcing patients with minor illnesses to visit doctors in person would constitute "harassment." Former health minister Karl Lauterbach, who introduced telephone sick notes during the pandemic, warned that abolishing them would be "counterproductive" and unnecessarily fill doctors' waiting rooms.
Medical professionals have also voiced strong objections. Markus Beier, chair of the Association of General Practitioners, pointed out that all evaluations by health insurance companies confirm that telephone sick notes do not lead to greater abuse of sick leave. He emphasised that doctors can only issue such notes to known patients, with a maximum duration of five days.
Union Leaders Condemn "General Suspicion"
The German Trade Union Confederation has delivered particularly sharp criticism of the proposal. DGB leader Yasmin Fahimi described it as "highly indecent to place employees who have called in sick under general suspicion, as if they were shirkers and slackers."
This opposition comes amid broader concerns about Germany's economic performance. The Cologne-based economic institute IW estimates that sick leave cost the economy €82 billion in 2024, equivalent to nearly €1,000 per person annually and matching the country's military defence spending.
International Context and Generous Benefits
International comparisons reveal Germany's position within European norms. A study by the Iges Institute for public health insurer DAK placed Germany in the upper midfield of European countries, with 6.8% of weekly working time lost to illness in 2023. This figure is similar to Belgium (6.7%), Sweden (6.6%), and Iceland (6.1%), though significantly lower than Norway's 10.7%.
Germany offers some of Europe's most generous sick pay provisions, with employers required to provide full pay for the first 42 calendar days of absence. After this period, health insurers step in to cover 70% of gross salaries. The BDA employers' association notes that this level of protection exceeds that of nearly any other European nation.
Broader Political Context
Chancellor Merz, who faces record unpopularity with 71% of Germans dissatisfied with his government according to recent polling, has repeatedly framed national work habits as an economic burden. At a business conference last May, he stated that Germany would not maintain its prosperity "with a four-day week and work-life balance," though he has since clarified that not all Germans need to work more, but rather that the national average needs improvement.
The telephone sick note system, initially introduced as a pandemic measure to prevent infection spread, was made permanent in 2023. Public health insurers report that such notes constitute less than 1% of total sick leave certifications, suggesting their abolition would have limited impact on overall absenteeism rates while potentially creating significant administrative burdens for both patients and healthcare providers.
