Why Lauterbach wants to remove homeopathy as a health insurance benefit

Small balls – big impact? This is scientifically unproven for homeopathy. The belief in small doses is firmly established among supporters. The dispute is certain after Lauterbach’s initiative to remove the medicines from the service.

Alternative medicine has a tradition in the Bundestag as a term of abuse: people accuse each other of only pushing forward reform “drop by drop” or in “homeopathic doses”. Nevertheless, politicians have so far found it difficult to take a clear position on the often expensive means. Health Minister Lauterbach now wants to change that. With an initiative that is primarily intended to have a symbolic effect.

If globules are a cash benefit, that would give “a false picture of science,” said Lauterbach at a press conference on Thursday morning. “Homeopathy is a service that does not provide any medical benefit based on scientific evidence,” said the minister. “Then such a service should not be paid for.”

Lauterbach himself admits that the savings effect for the health insurance companies is not great, but also says: “This is about the principle.” Politics should not ignore science. Lauterbach left it open when this would apply – he wanted to “implement it shortly”.

The decision is part of a policy paper from the Federal Ministry of Health to combat the financial difficulties in the healthcare system: Expenditures would increase every year, it says. The statutory health insurance funds also recorded a billion-dollar deficit in 2023. “Services that have no medically proven benefit may not be paid for using contribution funds,” writes the Ministry of Health. Therefore, “the possibility of health insurance companies to provide for homeopathic and anthroposophical services in their statutes will be deleted.”

However, according to health insurance companies, spending on globules or Schuessler salts is declining anyway. In 2021, all statutory health insurance funds spent around 22 million euros on homeopathic or anthroposophic medicines. Given the billions in gaps every year, that’s little. The AOK, for example, considers the decision to be “medically understandable”, but it has “hardly any financial significance”.

Why is Lauterbach still taking this step? The Health Minister has long been a critic of homeopathy: it is a “dangerous pseudoscience,” he tweeted in 2022. As early as 2019, Lauterbach tried to push for its deletion in the grand coalition, at that time still as SPD parliamentary group vice-chairman. But the Union said they wanted freedom of choice for patients.

Step at the right time?

Now, as Minister of Health, he probably doesn’t want to be constantly accused of overlooking savings from health insurance companies. The FDP, for example, has long been demanding that the costs should no longer be covered.

The Greens are having a hard time: an emotional homeopathy dispute has been going on in the party for years. It should be decided with the help of a commission from 2019. But their preliminary discussions were so “aggressive” that the party scrapped the plan. In the current basic program, a somewhat evasive formulation has been found: services whose “effectiveness has been scientifically proven” must be “taken over by the solidarity community”. The passage leaves it open whether others can also be paid.

The Green parliamentary group is now saying that they will not oppose the plans. But there are doubts as to whether the step comes at the right time: “In these turbulent times, politicians have a responsibility not to conduct debates about sideshows, but rather about effective instruments,” says Janosch Dahmen, health policy spokesman for the parliamentary group. The savings are minimal and major structural reforms are needed.

Supporters of homeopathy still want to avert the cuts: They will “form themselves in professional medical associations and enter into dialogue with Karl Lauterbach,” says Michaela Geiger from the German Central Association of Homeopathic Doctors.

Homeopathy makes sense: “We see this every day in our practices.” Without the health insurance benefits, “patients who live in socially disadvantaged areas can no longer be met,” said Geiger.

Benefit cancellation socially unfair?

The health insurance companies can continue to offer the funds through private supplementary insurance. Not everyone can afford that. But a large proportion of homeopathic or anthroposophical medicines are already purchased by patients themselves, without a prescription or a visit to the doctor.

Health Minister Lauterbach could possibly hope that his move would also reduce the credibility of the preparations and that patients themselves would demand less teething beads or belladonna globules. Whether that will happen is questionable. According to studies, pharmacists rarely inform people that the preparations have no effect beyond the placebo effect.