Birgit Fischer, Chairwoman of the board for the GEK, one of Germany’s largest state health insurers, told the paper that a projected loss of some €4 billion in funding in 2010 was looming.

“Our fears have been confirmed, unfortunately,” she said. “The health fund is arranged so that there will be additional premiums at all insurers.”

German law requires that health insurers charge members extra fees when they can’t make do with the money doled out for each customer by the government’s central statutory health care fund.

Fischer told the paper she feared this would become the rule rather than exception in the coming year.

She said that the GEK, with 8.5 million customers, would not be among the first wave of insurers to institute new fees, but could not say whether they would do so later in the year.

Meanwhile head of the TK health insurance company Norbert Klusen also told the paper that the shortfall was a major issue.

“A deficit of €4 billion is not a small thing,” he said, adding that Health Minister Philipp Rösler needed to clarify the situation to doctors, clinics and the pharmaceutical industry.

Germany’s public health care system instituted a new universal premium in January 2009. Set at 15.5 percent of each insured’s gross pay, it has turned out to be insufficient to maintain the budgets of the country’s statutory insurers.