Operation canceled

First guest patient from Lower Austria sues the City of Vienna

Vienna City Councilor Hacker and Lower Austria's Governor Mikl-Leitner: The dispute over the costs of operations and care is escalating.(Bild: Krone KREATIV/Imre Antal, NLK/Khittl, Mario Urbantschitsch)

It also affects the 205,458 commuters: Vienna's so-called guest patient regulation, which puts Lower Austrians at the back of the queue for operations, is a bitter pill to swallow. Now the province of Lower Austria is filing a lawsuit on behalf of one of those affected in the coming weeks...

The decision by Vienna's SPÖ city councilor Peter Hacker to turn away or put "guest patients" from Lower Austria at the back of the queue for planned operations has severely soured the mood between the two federal states. Now, in an interview with the Kronen Zeitung newspaper, Governor Johanna Mikl-Leitner is increasing the pressure on Vienna.

Calls for help to the patient advocate
According to the governor, numerous Lower Austrians have contacted the Lower Austrian patient advocate following an appeal. "We should return to a common path throughout Austria. It cannot be that foreign citizens with a Vienna registration form, who may never have paid into the system, are treated in Vienna hospitals and Lower Austrians are not, just because they are Lower Austrians. Many of my fellow citizens report that they have spent months preparing for scheduled operations, which were then canceled at short notice. This has unnecessarily prolonged their suffering," said Mikl-Leitner.

Negotiations (so far) unsuccessful
It seems that no common solution can be found: official negotiations have been going on for months, but even a "guest patient summit" at the end of October 2025 between Hacker and ÖVP Provincial Councilor Anton Kasser has not yet produced a solution to this pressing problem. However, negotiations are to continue despite the lawsuit.

State Governor Johanna Mikl-Leitner states: "The guest patient regulation continues to function without complaint in other federal states, such as Upper Austria and Burgenland. The focus is not on asking for registration forms, but only on how patients can be helped. Unfortunately, Vienna has abandoned this joint approach in the eastern region, which worked well and was the right thing to do for decades. At the expense of our fellow citizens in Lower Austria. That is unacceptable."

220 million euros in municipal tax
The actions of some Viennese politicians are also incomprehensible because the two federal states are closely linked. More than 200,000 Lower Austrians commute to Vienna every day and generate more than 20 percent of Vienna's added value. "Lower Austrians contribute around 220 million euros in municipal tax to Vienna's coffers through their work. We will therefore continue political discussions with Vienna so that we can find our way back to a common path as quickly as possible," Mikl-Leitner concludes.