Digitalisation: look behind you

Germany's political landscape has been marked by recent developments centered around digitalization, with one particularly contentious proposal drawing sharp criticism from medical professionals and researchers alike. The ruling coalition agreed on July 1, 2023, to draft a reform plan titled “A Program for Growth and Employment,” which includes the abolition of telephone-based sick leave certifications. This move has sparked debate over its potential impact on both workers and employers, with critics arguing that it reflects a misplaced focus on perceived misuse rather than addressing underlying issues. The initiative was introduced by Chancellor Olaf Scholz, who stated that Germany’s high rate of sick days is problematic. However, this claim appears to stem more from concerns raised by certain business groups than from empirical data. A representative from Unternehmer Baden-Württemberg, a prominent employer association, expressed frustration with what they describe as widespread abuse of the system, stating that such practices must end immediately. Despite these claims, several organizations have voiced serious reservations about the proposed change. Medical associations warn that removing the option for doctors to issue sick leave via phone could lead to overcrowding in clinics, as patients would need to visit their physicians in person. The German Institute for Economic Research (DIW) added further concern, suggesting that the measure might inadvertently increase the number of sick days due to delays in certification processes. According to research conducted by the Central Institute for Health Insurance Physicians, the rise in reported sick days can largely be attributed to two factors: the implementation of electronic sick leave certificates (eAU) and the aftermath of the coronavirus pandemic. These findings suggest that the current system is already functioning effectively in terms of transparency and accuracy, even though the numbers appear higher compared to previous years. The introduction of eAU has improved the tracking and reporting of sick days, providing clearer insights into workforce health trends. However, this increased visibility does not necessarily indicate a surge in actual illness rates. Instead, it highlights how the pandemic has had lasting effects on public health, including psychological stress and long-term physical conditions that continue to affect employees. Critics argue that the proposed changes fail to address the root causes of high sick day statistics. They point out that the percentage of sick leaves issued through telephone consultations remains relatively low, between 0.8 and 1.2 percent of all cases up to 2024—which suggests that the issue of widespread fraud is overstated. In response to these criticisms, the government has emphasized its commitment to maintaining information freedom while ensuring responsible use of digital tools in healthcare. Officials have acknowledged the importance of balancing transparency with practicality, recognizing that any reforms must consider the broader implications for both workers and employers. As discussions continue, stakeholders from various sectors remain divided on the best approach moving forward. While some advocate for stricter controls to prevent abuse, others insist that the existing framework should be preserved to avoid unnecessary disruptions in the healthcare system. The outcome of these deliberations will likely shape future policies related to digitalization in Germany’s labor market.