Looks like the SPD will demand single payer healthcare (among other things) if they enter another grand coalition.
"Single payer healthcare" is the wrong term. The SPD want to strengthen the statutory insurers, but it would still be a multi-payer system. I summarized the most important facts on the German healthcare system below to give you a better understanding. Then I described what the SPD want to change.
General:There are two types of health insurers in Germany: statutory insurers ("gesetzliche Krankenkassen") and private insurers ("private Krankenkassen"). Statutory health insurers are
statutory corporations, whereas private health insurers are
privately owned companies.
Insured people:All employees who have a gross income of not more than 57,600 euros a year (the exact amount changes anually) are obliged to be insured by one of the statutory health insurers. That means they can't choose a private insurer to cover their basic healthcare even if they want to. All employees with a gross income of more than 57,600 euros a year and most self-employed people (with the exception of certain occupational groups for historical reasons) are free to choose either a private insurer or a statutory insurer. It's generally easy for an insured person to switch from one statutory health insurer to another statutory insurer, or from one private insurer to another private insurer. However, people who want to switch (back) from a private health insurer to a statutory insurer often experience difficulties.
Coverage:All statutory health insurers have to cover a legally defined minimum range of services, but they are free to offer the coverage of additional health services to their customers, according to the financial situation of the individual insurer. There is no legal regulation on what services a private insurer must cover. Private insurers often cover a wider range of services than statutory insurers. It's also often easier to arrange a prompt appointment with a doctor if you have a private health insurance.
Funding:The statutory insurers have to charge a legally defined minimum percentage of an employee's monthly gross income. A statutory insurer may, however, charge a higher percentage if the insurer deems it necessary because of the insurer's individual financial situation. The contribution regulation for self-employed members of statutory insurers is more complicated, so I'll leave that out. Private insurers are free to charge whatever they want. Broadly speaking, private insurers charge less if you're young and healthy and charge more if you're old and sick. Statutory insurers are not allowed to do that. Every member of the same statutory insurer has to pay the same percentage of their income, regardless of their medical history or their age.
Number of insurers:Currently, there are 113 statutory health insurers and 44 private health insurers in Germany. Most statutory insurers are open to people from all of Germany, but a few accept only residents of certain states as customers. Even less are open only to employees of a specific (very large) company. Most statutory insurers are open to people from all occupational backgrounds, an exception being a statutory insurer exclusively for farmers and their immediate family.
What the SPD want to change:The SPD want to oblige every newly insured person to be insured by a statutory health insurer, no matter how much money they earn, no matter if they're employees or self-employed. They would also make switching to a statutory insurer much easier for policyholders of private insurers. People who are already insured by private companies and want to keep their private health insurance would be free to do so. However, the cost of private insurance would rise sharply because all newly insured people, who are mostly young and healthy, can't be insured by private insurers any more. This concept is something Die Linke and the Greens support, too. CDU/CSU and the FDP oppose this change. The AfD has no clear position. The private health insurers are protesting against it because it would severely hurt their business model. Medical associations voiced criticism, too.