Germany's Health Minister Nina Warken has quietly included significant contribution increases in a draft health reform bill, reversing earlier signals of relief for workers and businesses. The contribution assessment ceiling (the monthly income threshold above which no health insurance premiums are due) will rise by an additional €300 per month beyond the standard annual adjustment, generating an extra €1.2 billion each from employees and employers, who split contributions equally. The German Economic Institute in Cologne estimates the total additional burden on the economy at €4.5 billion annually, affecting 6.3 million workers and their employers — a major concern for a country whose labour costs already rank among the highest in the OECD, second in Europe only to Belgium.