The militarization of society has not spared the healthcare system. Hospitals and medical staff are being made ‘fit for war.’ This regressive social transformation, driven by the war effort, is met with both support and resistance within the healthcare sector. Nadja Rakowitz assesses the situation.
*
The large-scale military exercise ‘Medic Quadriga 2026: Rescue Chain from the Front to the Hospital’ took place in Berlin and Lithuania in February and March. The website Military Medicine.com has this to say about it: “In an emergency, the transport of wounded soldiers must run smoothly – from the medic on the front lines to the doctor in the German emergency room. This requires civilian-military cooperation in its purest form. To ensure this works, aid organizations and the Bundeswehr are currently practicing the entire rescue chain from the Baltic region to Germany for the first time during Medic Quadriga 2026. A visit to the site shows just how dependent military defense really is on civilian aid.”
‘War-readiness’ of the health care system
Since the Bundeswehr lacks the personnel to cover essential parts of the rescue chain, it relies on medical professionals from civilian rescue and aid organizations. Since the proclamation of the ‘Zeitenwende’ (turning point) in early 2022, the public – especially healthcare workers – have been preparing for this. This has been politically accompanied by Boris Pistorius’ announcement that Germany must be “war-ready” by 2029. Judith Gerlach (CSU), Bavaria’s Minister of Health, supports this. She is quoted in the Deutsches Ärzteblatt as saying that the goal is to prepare the entire healthcare system for all kinds of crises, including military attacks: “An intact healthcare system is just as important for a country’s defense as the Bundeswehr.”
At the same time, the euphemistic term ‘civil-military cooperation’ is used to create the false impression that the same logic applies to both civilian and military spheres, and that they are equal. However, in war, military rules and logic apply, and priorities are set according to military needs. In the event of defense or war, the healthcare system must function according to military specifications and hierarchy. It must not cooperate. Facilities must be easily accessible, provide beds for soldiers, and have staff professionally trained to treat war injuries. Hospitals must be located in strategically advantageous places and ideally have underground facilities. These details are described in the “GREEN PAPER ZMZ 4.0: Civil-Military Cooperation 4.0 in the Event of a Military Crisis” published by Zukunftsforum Öffentliche Sicherheit e.V. These regulations will be codified in the Health Security Act, which is still scheduled for this year. Similar to the recently reformed Work Security Act, which governs obligations in the workplace during a state of emergency, it will regulate the Bundeswehr’s access to civilian healthcare workers and infrastructure.
All of this suggests that a war can be waged and won with limited harm to the population because they will be well cared for. Current reports on Bundeswehr war exercises and the war readiness of the healthcare system estimate an additional 1,000 casualties per day. According to these calculations, military hospitals would reach capacity within two days. Then, civilian structures would be utilized. However, these structures already function poorly because they have undergone drastic economic rationalization over the past 25 years. If the upcoming hospital reform is implemented, hundreds of hospitals will close, further exacerbating the situation. Yet this is not yet clear to the population or many employees.
Democratic doctors raise critical questions
The left-wing Association of Democratic Doctors published an informational brochure in 2025 titled “We Will Not Be Able to Help You” („Wir werden Euch nicht helfen können“), now in its third printing. The brochure explains what demands are placed on the healthcare system and its employees when it is made ‘fit for war.’ One text serves as a guide for employees who do not want to be co-opted for military purposes. Another text, from the 1980s, asks – a question still relevant today – whether the welfare state is being dismantled through military spending.
Thus, the Democratic Doctors (and IPPNW) stand against the majority of the organized medical profession in Germany. To date, the medical profession has almost universally thrown itself into the arms of the Bundeswehr with anticipatory obedience, participating in preparations for war through medical associations and professional societies. They are organizing joint symposia and demonstrating a great deal of ‘defense policy rationality’ and understanding of the necessity of arming society and the healthcare system. This discursive obedience is exemplified by the report on the second edition of the symposium on civil-military cooperation at Oranienstein Castle, which is titled “Defense Only with Civilian Support. In an Emergency: What Does War Medicine Mean?” in the November 2024 issue of the Hessian Medical Journal.
Hospitals advocating for militarization
Some medical professional associations are actively advocating for militarization. There could be two reasons for this: First, doctors finally feel important as a professional group again. They were accustomed to having a very good reputation and being taken very seriously. However, since the economization of the healthcare system, business people in hospitals have become significantly more important. Second, doctors hope that militarization will bring funding to their field. Professional associations such as the German Society for Orthopedics and Trauma Surgery are already demanding funding. For example, the society is requesting 480 million euros for training, materials, personnel, and exercises to prepare for war.
Parliament’s approval of an open-ended funding pot for rearmament and the military in early 2025 is having its intended effect as a material supplement to changing the ‘mindset.’ The German Hospital Association wants its share, too, and has published a study on investment needs to build the resilience of hospitals in Germany. In the study, the association estimates a financial requirement of approximately 15.2 billion euros and assumes the funds will come from the public special funds dedicated to defense since “the measures do not serve normal patient care.” At such events and in such publications, doubts, calls for diplomacy, and demands for disarmament are nowhere to be found.
In Germany, the militarization of the healthcare system is becoming increasingly apparent. In fall 2025, the Berlin Senate Administration for Science, Health, and Care collaborated with the Bundeswehr, the Berlin Hospital Association, and twelve Berlin hospitals to draw up the ‘Framework Plan for Civil Defense in Berlin Hospitals 1.0.’ This plan considers reverse triage, a system in which slightly injured military personnel are given priority over critically injured patients and civilians in hospitals. The goal is to return soldiers to duty as quickly as possible. People with acute illnesses from long-term care facilities are identified as a disruptive factor in the emergency room, and plans are being made to transfer extensive hospital powers to government agencies and the military.
Protests against ‘disaster medicine’
Protest has finally emerged within the organized medical community in Berlin against the shift from ‘individualized medicine to disaster medicine’ announced in the framework plan. On December 17, 2025, the Berlin Medical Association passed a resolution initiated by FrAktion Gesundheit, one of the lists of the Berlin Medical Association and effectively a ‘party’ in the Berlin Medical Parliament. The resolution states: “It is part of the medical profession’s self-image to treat patients individually, independently of their personal characteristics, and, of course, independently of their military or civilian status. We call on Berlin’s doctors to openly uphold their ethical principles and resolutely oppose the planning of a hierarchy of human life value, even in peacetime. The task of doctors must be to preserve peace.”
What about the unions? The Marburger Bund fully aligns with the government’s agenda and distributes Bundeswehr recruitment ads in its newsletter. Meanwhile, the United Services Union (ver.di) is struggling to take a clear left-wing stance. There is significant opposition to militarization among individual union secretaries and at the local and regional levels. Of course, many active members earnestly and energetically oppose rearmament and militarization. The same applies to IG Metall. Currently, however, ver.di and IGM still find it challenging to take a clear stance against militarization at the federal level. The anti-militarist, leftist history of the unions is no longer part of today’s unions’ active, accessible organizational memory. The same is true for the unions’ anti-capitalist history.
However, the struggle against militarization will be just as unsuccessful as the struggle against the economization of the healthcare system if we do not reflect on its relationship to the capitalist mode of production. It will not be successful if it remains confined to the national level. Currently, Democratic Doctors are beginning to establish contact with colleagues in other countries. For example, they are in contact with VitalSigns Magazine from the UK, Peoples Dispatch, and Médecine Pour Le Peuple in Belgium. They plan to hold a workshop on this topic at their Manifiesta Festival to expand their international network further. However, these are just small steps. There is still a great deal of hard work ahead.