Krankenkassen released an analysis showing that long‑lasting diseases are the largest cost driver in the German health‑care system. The result highlights a disconnect between current legislative efforts to tighten sick‑note rules and the actual drivers of expenditures, affecting insurers, employers and overall health spending. German statutory health insurers (Krankenkassen), federal health policymakers, employers and employees. Policymakers may shift focus toward preventive care and chronic disease management; insurers could adjust contribution rates or demand stricter sick‑note rules only after evaluating cost‑impact. An analysis by the statutory health insurers (Krankenkassen) concludes that lengthy illnesses, not short‑term absences, generate the biggest expenses for the system. This finding comes as the government pushes to require sick notes from the first day of illness in order to curb absenteeism. The mismatch suggests that policy aimed at reducing short‑term leave may miss the true source of spending pressures. Likely next events: Possible revision of sick‑note legislation Increased investment in preventive health programs Health insurers may adjust contribution rates Sectors affected: Healthcare Insurance Employers / Labor market Regulatory implications: Stricter sick‑note rules under review Preventive care incentives may be expanded Historical parallels: Past debates over 'Kostentreiber' in the tourism sector (2026‑06‑19) showing similar cost‑driver framing
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