Chancellor Friedrich Merz’s proposal to require German workers to obtain a doctor’s note in person from the first day of sick leave has triggered a political storm that extends well beyond Berlin. The measure, slipped into a package of 34 economic reforms, is intended to curb what Merz calls a “competitive disadvantage” caused by prolonged absences. German employees take an average of 3.5 weeks of sick leave per year, according to OECD figures, a level that places the country in the middle of a north-western European trend that sees Norway at 5.7 weeks and France at 4.1. Merz’s Christian Democrats argue the change would restore a pre-pandemic norm and reduce short-term absenteeism, but the proposal has immediately exposed deep rifts within the governing coalition and across society.

Resistance has come from multiple directions. Labour Minister Bärbel Bas of the centre-left Social Democrats, the junior coalition partner, publicly disowned the measure, stating it was not her proposal. Medical associations warn that the requirement would flood already overstretched GP surgeries with unnecessary appointments, while the head of the CDU’s own employee wing, Dennis Radtke, cautioned against placing sick workers under “general suspicion”. A study by the Federal Association of Company Health Insurance Funds (BKK) further complicates the government’s case: it shows that the real cost explosion comes not from short, often respiratory, illnesses but from long-term absences due to musculoskeletal and psychological conditions. Sickness benefit payments, which kick in only after 42 days, now cost statutory insurers €21.6 billion annually, with the number of benefit days rising by 24.4 per cent over a decade.

Viewed from Stockholm, the German debate echoes a parallel Nordic reckoning. Sweden’s centre-left parties are campaigning to abolish the qualifying day (karensavdrag) that currently leaves workers unpaid for the first day of illness, arguing that remote work has made the rule unfair. Swedish business groups and analysts, however, point to Norway as a cautionary tale. Norway, which has no qualifying day and offers 100 per cent pay from day one, records the highest sick leave in the OECD despite better public health indicators. The Norwegian Labour and Welfare Administration (Nav) has noted that Swedes who move to Norway quickly adopt local absence patterns, suggesting a strong behavioural effect. Oslo has recently introduced “graded sick leave”, requiring doctors to specify what work an employee can still perform and adjusting their fees accordingly, a reform that has met union opposition similar to that in Germany.

The sick-note controversy is unfolding against a backdrop of mounting political fragility for Merz. Italian and German press analyses describe a chancellor who “skates from one misstep to the next”, struggling to rally public support while the far-right Alternative für Deutschland (AfD) consolidates its position. At a party congress in Erfurt, held amid large protests, Alice Weidel was confirmed as co-leader and positioned as the AfD’s candidate for chancellor, with national polling now around 30 per cent, five points ahead of the CDU. The party is leading in the eastern states of Saxony-Anhalt and Mecklenburg-Western Pomerania, where regional elections in September could see it enter government for the first time. The traditional “firewall” against cooperation with the far right is showing cracks at local level, a development that, according to analysts in Rome, reflects a broader loss of confidence in the ability of mainstream parties to address economic stagnation and demographic anxiety. The sick-note proposal now moves into legislative consultation, where coalition tensions and the weight of the BKK data are expected to shape the final text.