class=”sc-29f61514-0 icZBHN”>
Rapidly increasing health expenses are on everyone’s lips. The impending premium shock is causing problems for the Swiss public and increasing political pressure to cut costs. Anne-Geneviève Bütikofer does not like this debate. SonntagsBlick meets the director of the Swiss Hospital Association H+ at the hospital headquarters in Biel BE for an interview. Bütikofer demands nothing less than a revolution in the Swiss healthcare system.
Mr. Bütikofer, next Tuesday, Minister of Health Alain Berset will once again present that health insurance premiums will be too high. This is due to the unexpected sharp increase in healthcare expenses. What’s going wrong in Swiss hospitals?
Anne-Geneviève Bütikofer: There is a problem not with the hospitals, but with the understanding of how the healthcare system is financed. Today’s funding no longer covers hospitals’ real costs. Therefore, many hospitals are in danger and under enormous financial pressure.
So, is everyone responsible for this misery, not the hospitals?
It is useless to blame this or that actor in the healthcare system. The system as it is needs to change.
How do you imagine this?
Today, the legislature has only costs on its mind. If possible, they should not increase further – even though political decisions constantly lead to new costs. The cost containment argument is complete nonsense. If we want to change things, we need to talk about financing health care.
What do you specifically want?
We demand that all tariffs be increased by five percent. Finally, inflation needs to be taken into account. Retailers and electric companies can adjust their rates if costs rise, but hospitals cannot. Tariffs are negotiated and approved by the cantons. But authorities and insurers are not ready to increase these rates.
Because this will automatically cause the population’s premiums to increase even more than they already are.
TRUE. But be careful: I’m not asking for higher premiums. I’m asking whether we’re funding the right things in the system with the right sources of money. Today, all hospital services are financed by compulsory health insurance. No matter what the parliament decides, there are no new resources. One example: The introduction of electronic patient records cost hospitals millions. No additional compensation was paid for this. Today, politics costs much more than optimizing the system. This is why large amounts of funds are allocated to hospitals. If we don’t act now, the healthcare system will collapse.
So is there a need for a revolution?
Definitely! The current system is no longer sustainable not only for those providing services but also for those who pay premiums. The pain is so great that revolution seems inevitable.
What do you suggest?
For example, we need to ask ourselves whether today’s health insurance model is still correct. Is the system of 50 insurers still sustainable? Did this competition keep its promise? The health insurance company must pay for the service provided to the patient. Not more. If 2.5 million people change their health insurance every year at a cost of 800 to 1000 francs per change, then we have already found the potential to save billions of dollars. Therefore, thoughts about a single fund are legitimate.
SP calls for the establishment of a state health insurance fund; Recent surveys show that standard health insurance funding is also popular with the public due to the premium shock. So, do you agree with this call?
I’m not saying one fund is the way to go. But it’s worth thinking about. When we call for revolution in the system, we have to take everything into account. We approach all new ideas with interest.
Insurers do not see the need for a revolution, but point to the need to reduce costs. Many patients are still placed in hospital beds for procedures that have long been performed on an outpatient basis. However, inpatient treatment brings more income to hospitals.
TRUE. But here too the deterrent lies in the system: the outpatient sector is already underfunded by 30 percent! However, a significant amount of outpatient care is currently provided in Swiss hospitals.
In surrounding countries, this change has progressed significantly further.
Yes but why? Because we don’t have funding. The more hospitals operate on an outpatient basis, the wider the financial gap becomes. This is a big problem. In questionable cases, hospitals are penalized financially if they choose the most medically sound treatment. We are burning money because we have to finance outpatient treatment. However, it is important to expand this area. Outpatient services can be provided with fewer staff and infrastructure; This is very important considering the shortage of skilled workers. This is politically desirable. What is missing are financial incentives.
Hospital density, which is quite high by international standards, has a major impact on healthcare costs in Switzerland…
…but who determines hospital density?
Cantons.
And these should be determined according to the needs of the population. High hospital density is a social desire. I live in Neuchâtel. Here, attempts to reduce the cantonal hospital to a single location have repeatedly failed due to voters. That’s why we’re losing, but the people don’t want to change that. Ultimately, what matters is what society is willing to compromise on.
We’re having this conversation at Biel Hospital Center. There are five hospitals here for a catchment area of 180,000 people. Crazy!
Economically yes. However, these hospitals are not empty. On the contrary, there is a lack of expert personnel to look after the beds. There is also a shortage of skilled personnel as there is not enough money for ideal working conditions. Throughout the entire debate, we must not forget the role hospitals play in the Covid epidemic. In other countries, people died due to inadequate infrastructure or a lack of skilled workers to treat patients. In our case, we applauded the hospitals and especially the employees during the pandemic, but today almost no one remembers this. We can save hospitals from death. So do the people want this?
The question arises as to whether all hospitals should offer everything. Instead of pumping more money into the system and engaging in an arms race, interregional cooperation should be developed.
More cooperation is needed, yes. But there’s a lot going on there. Hospitals are forced to work together due to financial pressure because they can no longer do it alone. This will continue to increase. We should discuss in round tables with politicians and insurers how this should be organised. Which health zones should there be? Who offers what?
They tried to do just that in Eastern Switzerland. However, the six-canton supra-cantonal hospital planning failed due to special interests on the grounds that it could lead to the closure of hospitals. Do we need more pressure from the federal government?
We live in a federalist country, hospital planning is the responsibility of the cantons. Of course, the federal government also plays a role; must be at the table, must have a vision of what healthcare services should be offered in Switzerland. I haven’t heard anything about this yet. I don’t know what kind of hospital environment the Federal Council wants in the future.
A high-level meeting was held with the Minister of Health Alain Berset about three weeks ago. So, you weren’t hopeful about that?
Mr Berset is stepping down as a Member of the Bundestag at the end of the year and is now unlikely to trigger the necessary revolution. We speak with the responsible Federal Council member once a year. Mr. Berset has always been open to our concerns in recent years. Unfortunately it doesn’t exist anymore.
Do you expect hospital deaths in Switzerland in the next few years?
Yes. We already had to close the first ones in Bern. If there are no general considerations for adapting the system in the medium term, more will follow. Patients will no longer be cared for and quality will no longer be guaranteed. When our hospitals go bankrupt, foreign investors step in. Economically profitable areas will be expanded, the rest will be closed. It shouldn’t come to this point.
Source :Blick
I’m Tim David and I work as an author for 24 Instant News, covering the Market section. With a Bachelor’s Degree in Journalism, my mission is to provide accurate, timely and insightful news coverage that helps our readers stay informed about the latest trends in the market. My writing style is focused on making complex economic topics easy to understand for everyone.
