Health ministry · Prevention and public health
Prevention: the policy that keeps people out of the waiting room
Germany spends more than half a trillion euros a year on health, and only a small fraction of it on keeping people healthy in the first place. The new minister has called prevention the best health policy. The instruments, and the gaps, are older than his tenure.
„Die beste Gesundheitspolitik lässt Krankheiten gar nicht erst entstehen.“
A sentence and a programme
In English, the sentence says that the best health policy is one that stops illness from arising at all. Linnemann said it during the government question time on 23 September 2026, and on the same day he named prevention among his main themes in the Bundestag Health Committee, alongside digitalisation, patient steering, stable contribution rates and solidarity (hib 733/2026).
The sentence is a statement of direction rather than a programme. As of 8 October 2026 the ministry had announced no new prevention law, no new budget line and no national target. What exists is an inherited framework: the Prevention Act of 2015, screening programmes decided by the Federal Joint Committee, vaccination recommendations by the Standing Committee on Vaccination, and a federal public-health institute renamed in 2025. This page sets out that framework, the evidence base, and the questions a prevention-minded minister would have to answer.
Prevention also connects to Linnemann’s economic thinking. A workforce that stays healthy stays employed for longer — a link he has drawn throughout his work on work and performance and on demographic change. Critics of purely economic framings point out that prevention matters equally for people outside the labour market: children, older people and those with disabilities.
Why lifestyle-related conditions dominate
Most long-term illness in high-income countries is linked to a small number of modifiable risk factors.
According to the World Health Organization, non-communicable diseases — mainly cardiovascular conditions, cancers, chronic respiratory conditions and diabetes — accounted for about 75% of non-pandemic-related deaths worldwide in 2021. The WHO names tobacco use, physical inactivity, harmful use of alcohol, unhealthy diets and air pollution as the main risk factors, and stresses that effective responses require action beyond the health sector: in education, transport, finance and urban planning.
For Germany, this means that a large share of future demand for care is shaped by conditions that develop over decades and that can, in part, be delayed or avoided. It also means that much of prevention is not health-ministry business at all. Tobacco and alcohol taxation are set by the finance ministry; food labelling and advertising rules by the agriculture and food ministry; school sport and school meals by the Länder; workplace safety by employers and the statutory accident insurers.
Health literacy — the ability to find, understand, assess and apply health information — is the bridge between information and behaviour. The second German Health Literacy Survey (HLS-GER 2), published with support of the Federal Ministry of Health, found that 58.8% of the population had limited health literacy in 2020/21. Assessing information was hardest: 71.5% of respondents found it difficult. People with lower education, lower income, migration experience, older age or long-term illness were more often affected.
These figures matter for policy design. Campaigns that rely on reading and self-motivation tend to reach people who are already well-informed; approaches that work through settings — nurseries, schools, workplaces, neighbourhoods — reach a broader population. That is the logic of the German Prevention Act.
Evidence noteThe WHO figure is global. National cause-of-death statistics are published by Destatis; they are not reproduced here to keep this page focused on prevention policy rather than illness.
Five layers of prevention in Germany
From national strategy to the individual vaccination. Each layer has a different owner — which is both a strength and the main coordination problem.
National strategy — Prevention Act 2015
The Präventionsgesetz came into force on 25 July 2015. It created the National Prevention Conference (NPK), carried by the statutory health, long-term care, accident and pension insurers, which adopted federal framework recommendations in February 2016. It also obliges health insurers to spend minimum amounts per insured person on prevention. In force · inherited
Settings — nurseries, schools, municipalities, care homes
Insurers fund projects in “living environments” (Lebenswelten). Long-term care insurers spent €25 million on prevention in care homes in 2024, 25% more than in 2023 (Prevention Report 2025). In implementation
Workplaces — occupational health promotion
Health insurers spent €282 million on workplace health promotion in 2024 (+5%), reaching 28,142 workplaces and about 2.06 million employees — both slightly fewer than in 2023. In implementation
Early detection — screening and check-ups
The Federal Joint Committee (G-BA), the self-governing body of doctors, hospitals and insurers, decides which screening examinations statutory insurance covers, including organised programmes and the general health check-up. Self-administration
Vaccination — STIKO recommendations
The independent Standing Committee on Vaccination (STIKO) at the Robert Koch Institute recommends vaccinations; the G-BA turns recommendations into insurance benefits; the Länder issue public recommendations. Measles vaccination is mandatory for children in community facilities since 2020. In force
High coverage, late completion
Robert Koch Institute data show that most children are eventually vaccinated, but often later than recommended.
Second measles vaccination, share of children
SourceRobert Koch Institute, as reported by Deutsches Ärzteblatt (11 Dec 2025) and press reports on the RKI vaccination monitoring. The 95% figure is the RKI coverage target.
The Measles Protection Act, in force since 2020, requires proof of measles vaccination for children in nurseries and schools. Since then, the share of children with two doses at 24 months rose from 70% (2019) to 77% (2023), and at age six from 89% to 92%, according to RKI data. More than one child in five still lacked the second dose at their second birthday.
Other gaps are larger. In 2024, 55% of girls and 36% of boys aged 15 were fully vaccinated against HPV. Uptake of recommended vaccinations among adults — for example against influenza and COVID-19 — is well below 50%, the RKI reported in December 2025. One recent success: the RSV immunisation recommended for infants roughly halved the number of babies needing hospital care for RSV in the 2024/25 winter season.
Recent laws widen access. The pharmacy reform of 2026 allows pharmacies to give all non-live vaccines, and trained pharmacy staff to vaccinate (In force · inherited). The GeDIG bill, debated in the Bundestag on 8 October 2026, would add a digital vaccination overview with reminder function to the electronic patient record (Inherited · in parliament).
At the same time, the GKV contribution-stabilisation law of July 2026 raised the discount on patented vaccines to 9% and imposes a price moratorium on vaccines from 2027 to 2030 (In force · inherited). Manufacturers argue this weakens incentives; insurers argue prices had risen too fast. See pharmaceutical policy.
Where prevention happens
Open each field for the institutions involved, the status of policy and the open questions.
Children’s health
Statutory insurance covers a series of check-ups for children (the “U” examinations from birth to school age, plus a youth examination), which track development and offer vaccination advice. The Länder carry out school-entry examinations through local public health offices. Many children’s health questions — physical activity, nutrition in nurseries and schools, mental well-being — fall under Länder and municipal responsibility, or under the family and education ministries.
Inherited The federal ministry’s current line is unchanged. Linnemann has made no specific statement on children’s prevention since taking office. As an MP he caused controversy in 2019 with a proposal on language tests before school entry — an education rather than health topic, documented on the criticism page.
Early detection and screening
The G-BA decides which screening examinations are covered, for which age groups and at what intervals, on the basis of benefit assessments by the Institute for Quality and Efficiency in Health Care (IQWiG). Organised programmes invite eligible people by letter. The general health check-up for adults also includes counselling on risk factors.
Self-administration The minister does not decide screening content directly; he supervises the legality of G-BA decisions. Whether the primary-care reform announced for November 2026 will assign GPs a stronger role in organising prevention is an open question.
Workplace health
Employers are responsible for occupational safety; the statutory accident insurers for prevention of work-related accidents and illness; health insurers for voluntary workplace health promotion under the Prevention Act. Smaller firms are harder to reach — a recurring finding of the prevention reports.
Inherited No new initiative announced. The link to Linnemann’s labour-market agenda — longer, healthier working lives, the “Aktivrente” for people working past retirement age — is clear in principle but has not been turned into a health-ministry measure.
Health literacy and public information
The Federal Centre for Health Education (BZgA) was renamed the Federal Institute for Public Health (BIÖG) by ministerial decree on 13 February 2025, with a broader public-health mandate and a cooperation agreement with the Robert Koch Institute. Its seat is in Cologne. The institute runs national information campaigns and gathers data on health behaviour.
Inherited The renaming was done by decree under Karl Lauterbach; a statutory basis for a larger public-health institute was not passed before the 2025 election. Its future structure is not settled.
Pharmacies and primary care as prevention points
The pharmacy reform adopted in 2026 adds preventive services to pharmacies, including counselling on stopping smoking, rapid tests and vaccinations. At the German Pharmacists’ Day in September 2026 Linnemann called for a stronger role for pharmacies in guiding patients.
In force · inherited for the pharmacy reform; Announced for the primary-care system that may link prevention to patient steering.
Four tests for a prevention minister
Questions raised by the evidence and by the minister’s own emphasis. None has yet been answered by a concrete proposal.
Money under pressure
The 2027 health budget falls from €21.77 billion to €14.33 billion in the draft, and the contribution-stabilisation law caps spending growth. Prevention budgets are easy to cut because their returns are slow and diffuse. Will prevention be protected?
Beyond the health ministry
The strongest levers — taxes on tobacco, alcohol or sugar, advertising rules, school meals, urban design — sit with other ministries and the Länder. A “health in all policies” approach needs cabinet-level coordination.
Reaching those with least access
Health literacy is lowest among people with lower education and income. Prevention that relies on individual motivation can widen inequalities rather than narrow them.
Measuring success
Germany has no binding national prevention targets. Without measurable goals, a political commitment to prevention is hard to hold to account.
Sources & further reading
- Federal Ministry of Health — Government question time (23 Sep 2026)
- German Bundestag — hib 733/2026, Linnemann in the Health Committee (23 Sep 2026)
- World Health Organization — Noncommunicable diseases fact sheet (25 Sep 2025)
- Federal Ministry of Health — HLS-GER 2 short report on health literacy
- Bielefeld University — HLS-GER 2 study
- GKV-Spitzenverband — National Prevention Conference
- GKV-Spitzenverband / Medizinischer Dienst — Prevention Report 2025
- zm-online — Health insurers invest almost €700 million in prevention
- Deutsches Ärzteblatt — Vaccination coverage: often late or incomplete (RKI data) (11 Dec 2025)
- Federal Ministry of Health — BZgA renamed Federal Institute for Public Health (BIÖG) (13 Feb 2025)
- Federal Ministry of Health — Bundestag passes pharmacy reform (22 May 2026)
- Federal Ministry of Health — Bundestag passes GKV contribution-stabilisation law (10 Jul 2026)
- German Bundestag — First reading of the GeDIG (8 Oct 2026)
- Federal Government — Health budget 2027 debate (10 Sep 2026)