Majority calls for system change
Citizens’ insurance is getting a new boost
Updated April 23, 2026 – 9:29 p.mReading time: 3 minutes
The majority of Germans want fundamental changes to social insurance. Citizens’ insurance in particular is very popular, even among privately insured people.
Whether pension, health or care: According to a survey, people in Germany have high expectations of the welfare state and are also prepared to pay for it. The “Social State Radar 2026” survey presented on Wednesday shows “that people still want solidarity-based security systems and that the privatization of social risks as an alternative is rejected by large parts,” said Anja Piel, board member of the German Trade Union Confederation (DGB), in Berlin.
According to the study, many people perceive the existing differences as unfair, especially in the areas of health and care. The feeling of two-tier medicine is widespread. A large majority of those surveyed (77 percent) therefore advocate an end to the dual system of statutory and private health insurance. This is to be replaced by citizens’ insurance, into which all employed people pay. Even among those with private insurance, a slim majority (53 percent) voted for the introduction of citizens’ insurance.
There is also a great desire for readjustment when it comes to long-term care insurance. In view of the rapidly increasing personal contributions, half of those surveyed (50 percent) would like the so-called base-top exchange. To do this, they would also be willing to pay higher contributions for long-term care insurance.
The base-top exchange is a reform model to cover the financial burden for those in need of care. The insured person’s own contribution is limited to a fixed amount, the base. All costs that go beyond this, the top, are paid by statutory nursing care insurance. At the moment it is the other way around, so that the additional costs in the care system have to be borne by the insured.
Another twelve percent, however, would like to have comprehensive nursing care insurance that covers all costs. They would also be willing to pay significantly higher contributions for this. Meanwhile, 13 percent voted for mandatory private nursing care insurance, and another twelve percent do not want to change the existing contributions despite increasing personal contributions.
“The welfare state is worth something to people,” summarized Peer Rosenthal, general manager of the Bremen Chamber of Employees. This commissioned the survey together with the Saarland Chamber of Labor and the DGB. “But you also know that good performance doesn’t come for free,” says Rosenthal. The vast majority of insured people are therefore prepared to pay higher contributions for a stable welfare state.
According to the welfare state radar, this also applies to pensions. 74 percent of those surveyed were open to higher contributions in return for better pension benefits. Almost one in eight people would even pay significantly higher contributions if the pension level were raised as a result.
