1. Germany Can't Afford This Anymore (Merz, Soder, Allianz CEO Oliver Baete)

82 billion euros a year in sick pay. The economy shrank. Something has to change.

The sick leave bill is now roughly equivalent to Germany's defense budget. Employers paid 82 billion euros in wage continuation for sick workers in 2024, up 10 billion from 2021. Some economists calculate that without the high absence rate, Germany's economy would have grown by 0.5% in 2023 instead of shrinking by 0.3%.

A small financial signal on day one would filter out the discretionary absences. Allianz CEO Oliver Baete proposed the Karenztag -- one unpaid day at the start of any illness -- arguing that a modest penalty would discourage workers from staying home for mild symptoms without punishing anyone who's genuinely sick. Soder went further, suggesting sick pay should start only from the third day of absence.

The phone sick note made calling in too easy. Since 2021, German workers can get five days of paid sick leave with a phone call to their doctor's office -- no in-person visit required. Proponents of reform point to a roughly 40% rise in recorded sick days since electronic sick notes were introduced. The CDU voted unanimously to abolish the system, and the head of Germany's KBV physicians' association backed the move -- though other doctors' groups have pushed back, warning abolition could harm patient care.

2. You're Punishing Workers for Being Sick (DGB, IG Metall, SPD)

The real problem isn't lazy workers. It's a system that already pushes sick people to show up.

Making sick leave financially painful forces genuinely ill workers to show up. The DGB's core argument is that German workplaces already struggle with presenteeism -- people dragging themselves to work ill because they feel pressure not to call in. Making the first day unpaid doesn't reduce illness. It just moves sick people from their beds to their desks.

People aren't calling in sick more, we're just recording sick days better. The AOK and Germany's Federal Statistical Office attribute much of the increase in recorded sick days to the 2022 introduction of electronic certificates, which capture short illnesses that previously went undocumented. The phone sick note accounts for a minority of cases. SPD health spokesman Christos Pantazis argues the phone notes ease pressure on GP surgeries and reduce infection risk.

3. This Will Backfire (ZEW, Swedish Precedent)

Sweden tried waiting days. Workers took fewer short absences but more long ones.

Cutting sick pay reduces short absences but increases long-term sick leave. The Center for European Economic Research in Mannheim found that a 20% reduction in sick pay cuts sick days by roughly 20% -- but the net effect is counterproductive. Workers who face another unpaid day if they relapse avoid taking a second short absence and instead stay off work longer, driving up long-term leave.

Sweden's Karenztag is the cautionary tale. Sweden introduced an unpaid first sick day and found exactly that pattern: fewer short absences, but a notable increase in long-duration sick leave. Sweden eventually modified the system in 2019, reducing the penalty to 20% of one week's sick pay -- an acknowledgment that the original approach created perverse incentives.

Carrots work better than sticks -- part-time sick leave and attendance bonuses beat penalties. Professor Nicolas Ziebarth, who leads ZEW's labour markets research, argues that letting workers return part-time during recovery and offering firm-specific bonuses for low absence rates are more effective than penalties. The evidence points toward incentivizing attendance, not punishing illness.

Where This Lands

Germany's sick leave costs are real -- 82 billion euros and rising. But AOK data shows 40% of those sick days come from long-term illnesses lasting more than six weeks, which no first-day penalty would deter. And the research from Sweden and ZEW suggests waiting days create perverse incentives that make the problem worse, not better.

Sources