What happened
Germany's long-term care system, based on mandatory insurance and a 'home care first' principle, is under strain as demand grows and costs rise.
The number of care recipients increased by 15% from 2021 to 2023, while care staff grew only 0.6%, leading to 1,264 care facility closures or bankruptcies in 2023-2024.
The government is reforming care insurance to ease pressure, but acknowledges difficulty in balancing worker pay and patient costs.
Why it matters
The dilemma highlights the challenge of sustaining elder care as populations age, with Germany projecting a rise in care recipients to 7.5 million by 2049 and a potential shortfall of 280,000 workers.
The outcome of reforms will affect millions relying on home care, which currently covers 86% of recipients, and may offer lessons for other aging societies.
Key facts
In 2023, Germany had about 5.7 million care recipients, with 86% cared for at home.
Care spending reached 82.4 billion euros in 2023, up 94.2% from 2013.
From 2023 to 2024, 1,264 care facilities filed for bankruptcy or closed.
By July 2026, average monthly out-of-pocket costs for nursing home residents in their first year are projected to be 3,364 euros, up 256 euros year-on-year.
What to watch next
Will the government's reform bill, which includes flexibility in home care benefits and digitalization, be passed and effectively address staff shortages?
Can Germany attract and train enough care workers to meet the projected demand, or will the gap widen?
How will the rising costs affect the affordability of care for individuals and the sustainability of the insurance system?