This paper examines the reaction of physicians to the inauguration of a system of social insurance at the beginning of the twentieth century in Germany. The writings of Erwin Liek--a spokesman of German physicians in this respect--show how social insurance, which was inextricably connected with a social and an economic crisis, had a negative influence on medicine: individual therapeutical relationship has been replaced by a bureaucratic dialogue which favours upholding a state of disease instead of promoting health. This study suggests that Liek's criticism bears some analogy with today's german criticism of the social insurance system