Difficult task for Baume-Schneider: physiotherapists argue for a procedure against the BAC

“Which of you civil servants would accept a pay cut after 25 years of equal pay?” was on the poster of a physiotherapist who demonstrated with several thousand people on the Bundesplatz last month. The large demonstration was in front of the Federal Office for Public Health (BAG) led by the outgoing Federal President Alain Berset. The authority has started a major dispute with the physiotherapists with a planned collective bargaining intervention – in the eyes of those affected, this amounts to a pay cut.

You need to know: Physiotherapists have been working with the same rate model since 1997 – only in 2016 there was an adjustment. Higher educational requirements, new treatment options and organizational concepts such as ‘outpatient before inpatient’, higher rental prices and even general inflation are not adequately reflected. The Physioswiss association speaks of “significant underfunding” in the industry.

This situation could worsen. A new tariff system will apply from 2025. The Federal Council sent the proposals for consultation in late summer. He hopes that the change in regulations will have a cost-saving effect and greater transparency in billing.

Nowadays a physiotherapy session usually lasts 30 minutes, but this is not regulated. The Federal Council now wants to make up for this with its collective bargaining intervention. He proposes two variants. In variant one, a minimum session duration of 30 minutes and 45 minutes respectively is introduced for general and complex physiotherapy. In particular, a short session of 20 minutes should be created, with a maximum of 5 minutes being spent on changing time, consultation and maintaining the patient file.

In option two, a basic rate would be introduced with a meeting time of 20 minutes. If the meeting lasts longer, this must be justified. A new rate item applies for each additional 5 minutes of treatment.

Fysioswiss rejects both proposals because it fears a deterioration in the income situation. Adequate treatment is not possible in 15 minutes. The association mobilizes through various channels against government intervention in collective negotiations. With political initiatives, a demonstration on the Bundesplatz and a petition with almost 300,000 signatures. And now the physiotherapists are increasing the pressure further: the association has filed a supervisory complaint against the BAG. It is available to this editor.

The Association of Physiotherapists is bringing out the big guns. He demands that a supervisory procedure be opened against the BAG to investigate the complaints. Three points are mentioned.

First, there is the question of whether the federal government’s collective bargaining intervention is appropriate at all. The federal government only has subsidiary powers. In other words: he can only intervene if the two collective labor agreement negotiating partners – in this case Physioswiss and the health insurers – cannot reach an agreement. The two collective labor agreement negotiating partners blame each other for the fact that no agreement has yet been reached on a new collective labor agreement negotiation model.

Fysioswiss now also accuses the BAG of misconduct. Health insurers are legally obliged to negotiate collectively. Because the BAG always signaled to insurers that they would take their concerns to heart in the event of an official order, the insurers never had an incentive to negotiate collectively. The BAG did not comply with its obligation to inform insurers of their legal obligation to negotiate. Instead, the BAG is now rewarding the insurers’ blockade.

Secondly, the association complains that the federal government has no legal basis for introducing a tariff time component. This fundamental change in the tariff structure model falls under the purview of the collective bargaining partners.

Thirdly, the consultation proposal violates the principles of economic assessment of tariffs. Physioswiss criticizes the fact that the proposals are based on the 1997 tariff model, which in turn is based on cost and performance studies from 1994. The association collected new data “which was deliberately not taken into account as part of the collective bargaining intervention of the Federal Council, despite official knowledge of it”.

With this supervisory complaint, Physioswiss is trying to ensure that the Federal Council abandons its proposals. It will be one of the first difficult questions that the new Health Minister Elisabeth Baume-Schneider will have to deal with. (aargauerzeitung.ch)