New brooms sweep well, as the saying goes. Actually, it's clear, because you only need a new broom when the old one is no longer of any use. What about the change of office in the Federal Ministry of Health? Nina Warken was not replaced because she was bad at sweeping. On the contrary, because, in the opinion of Chancellor Friedrich Merz (both CDU), she turned around so well that she deserved an even more important place: as Minister of the Chancellery.
And how successful can her successor Carsten Linnemann be? The starting conditions are not bad. He didn't make any big mistakes as CDU general secretary, is considered a close confidant of the chancellor and party leader and serves as an all-purpose weapon. But he doesn't take on the job with enthusiasm. Linnemann always wanted to be labor and social minister, but the health department was far from his mind. In 2025 he considered himself unsuitable in a television interview. He actually has no experience in this difficult political area.
On the other hand, this also applies to most of his predecessors, especially Nina Warken. When she came, many skeptics rubbed their eyes: a domestic politician, lawyer and fairly unknown MP? In the meantime there were already rumors that she would be fired. Today, even critics recognize that as Health Minister she delivered quickly and quietly, including the first major social policy project of this coalition, the austerity law for health insurance companies.
The minister has achieved what her predecessor Karl Lauterbach (SPD) found difficult: organizing compromises and majorities, including when dealing with lobby groups and the states. So Warken reopened Lauterbach's hospital reform and thus accommodated countries and clinics. This dilution was wrong in terms of content, but it made the powerful actors favor further reforms.
That's exactly how politics works, with give and take. Technical expertise takes a back seat; the many employees in the ministry and the affiliated institutions are responsible for this. Linnemann also masters this political game inside out. Added to this are his years of nationwide contacts, his joviality and his youthful charisma. He is two years older than Warken.
Despite the strangeness of the subject, these characteristics suggest that Linnemann will do no worse than her. He has the further advantage of being the first economist to hold the post since Daniel Bahr (FDP) 13 years ago. This qualification is important in a health and care system in which there is a lack of efficiency everywhere and many disincentives. Expenses are rising faster than income without improving supply.
The clinics operate particularly uneconomically
Things are going particularly wrong economically in clinics, which are by far the most expensive field. The number of cases is falling, beds are empty, but costs are still escalating, especially for staff. Even if large parts of the healthcare system are decoupled from supply and demand, one could speak of a structural market failure. Anyone who wants to intervene here should have economic expertise. Linnemann does that.
This competence can also help him in the upcoming major projects, the nursing reform, primary care, and the structural restructuring of the health insurance system. He should give patients and those in need of care more responsibility - as responsible market participants, and even as customers. They will respond sensibly to incentives, including bonuses and penalties in practices and emergency rooms.
Funded, privately organized additional funds are needed in insurance companies. Watering can solutions such as flat-rate care subsidies should be abolished and assets and income should be given greater consideration. There should be more freedom of choice and tariffs in the health insurance funds to cover the risks. Models are conceivable in which higher earners would have fewer legal entitlements and would have to make more provisions themselves. And why doesn't the state encourage young people to take out private supplementary care insurance - similar to the early start pension?
The “de-economization” that the Social Democrat Lauterbach had so much hope for is not the right path, but rather the opposite: the health care system must be trimmed to be cost-effective; this is the only way it can survive. If Linnemann, who has a doctorate in economics, contributes to this, he would have made a good introduction as Minister of Health.
