by The rising cost of Switzerland’s compulsory health insurance is a major political issue. The government has hatched a plan aimed at improving incentives in the hope it will reduce the seemingly never ending rise in health insurance premiums. However, a number of people sceptical of the plan’s ability to deliver the saving have organised a vote against it, which takes place this weekend. Photo by Harald Hechler on Pexels.comThe plan is focused on how various healthcare services are paid for. Health insurance premiums only cover a portion of Switzerland’s total healthcare costs. Much of it is paid out of the taxes collected by cantons. According to the federal government the current structure creates perverse incentives that make total healthcare costs higher than they need to be.
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The rising cost of Switzerland’s compulsory health insurance is a major political issue. The government has hatched a plan aimed at improving incentives in the hope it will reduce the seemingly never ending rise in health insurance premiums. However, a number of people sceptical of the plan’s ability to deliver the saving have organised a vote against it, which takes place this weekend.
The plan is focused on how various healthcare services are paid for. Health insurance premiums only cover a portion of Switzerland’s total healthcare costs. Much of it is paid out of the taxes collected by cantons. According to the federal government the current structure creates perverse incentives that make total healthcare costs higher than they need to be.
Health insurance currently pays for outpatient treatment. This includes visits to GPs, therapists and other medical service providers and hospital treatments that don’t require an overnight stay. Inpatient treatment, which includes all healthcare requiring an overnight stay in a hospital is covered up to at least 55% by cantonal taxes. Cantonal taxes are also used to cover nearly half of the cost of nursing homes. According to the government, this arrangement creates an incentive for patients and health insurance companies to seek inpatient care when less expensive outpatient treatment makes more sense. This pushes up the total cost. If the total cost was reduced it would be possible to reduce premiums, says the government.
To make this happen, the federal parliament voted in favour of dividing the costs of both inpatient and outpatient care between cantons and insurance companies. The proposed split of a total amalgamated pot of expenses is 26.9% for the cantons and 73.1% for insurance companies. A majority in government is convinced this would drive down the total costs by making the choice between cheaper outpatient treatment and more expensive inpatient treatment more objective and neutral. This would then ultimately lower the cost of health insurance. In addition, it is also hoped it would improve cooperation between doctors, therapists, carers and pharmacists, making the delivery of outpatient care more efficient and less costly.
In addition to the Federal Council, parliament (141 versus 42) and the Council of States (42 versus 3) support the plan.
Those against the change argue the reform will give too much power to insurance companies, result in higher premiums and weaken nursing homes, which are currently largely supported by cantonal taxes.
A recent poll places the government’s plan in the lead. 61% were either for (29%) or fairly for (32%) the change. However, there is room for a surprise. 13% were undecided and the 32% that are fairly for the change are not certain to vote in favour of the government’s plan.
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