class=”sc-29f61514-0 icZBHN”>
The black peter game is booming in the healthcare system due to the premium shock. Players blame each other for high costs. Groupe Mutuel CEO Thomas Boyer wants to put an end to this. The head of Switzerland’s third-largest health insurer is calling for the appointment of a health task force modeled on the Covid outbreak. SonntagsBlick met him for an interview in Lausanne.
Mr. Boyer, the bonus boom is causing trouble for medium-sized businesses. Where do you see opportunities for action that will finally slow the cost spiral?
Thomas Boyer: The premium shock shows that our costs are no longer under control. There are two main reasons for this. First of all, there is a pent-up demand. While healthcare costs increased by ten percent between 2019 and 2022, we kept premiums constant. Health chief executive Lukas Engelberger said in your newspaper last week that health insurance companies miscalculated their premiums.
So is there?
NO. We deliberately underestimated the premiums due to political pressure. We were asked to reduce reserves. So it was clear that this year the premiums would not cover the expenses. Second: Costs have increased much more than expected this year.
What should I do?
In the short term, we can start with drug prices. We use approximately 50 percent fewer generic drugs than other countries and pay twice as much for them. We need to start hospital planning in the medium term. With approximately 580 locations, we have the highest hospital density in Europe after France. That’s too much! We need to move away from cantonal hospital planning. Although the hospital environment in Switzerland is decentralized, it should be defined at the national level.
Do you support Santésuisse President Martin Landolt’s request to remove cantonal authority in hospital planning?
Not every canton can offer everything in its hospitals. This is not efficient and quality suffers, especially when there is a shortage of skilled labour. There are now more specialists than general practitioners in Switzerland. Therefore, many people are no longer guaranteed access to the healthcare system. Things go wrong in training, too.
Specialization is intentional; A career as a specialist is more economically interesting than family medicine.
I’m happy to discuss better pay for GPs, but we also need to make concessions for specialists. We also need to revise our service catalog without taboos. New services should only be included if another service is canceled at the same time. Let’s take psychologists as an example. I’m not saying it’s wrong that they’ve been able to bill us directly since January 1st. But this costs us an additional $300 million a year. For this reason alone, even one percent of the premium increase in 2024 is necessary. The question is: Which services in the catalog today are not necessarily included in the basic insurance coverage?
Thomas Boyer (52) was appointed CEO of Groupe Mutuel in the summer of 2019. He was previously with Mobiliar since 2013, most recently serving as a member of the management team. He also worked for a long time at Swiss Life and McKinsey. The father of three has a master’s degree in business administration from the University of Lausanne, is from Freiburg and lives in Geneva.
Thomas Boyer (52) was appointed CEO of Groupe Mutuel in the summer of 2019. He was previously with Mobiliar since 2013, most recently serving as a member of the management team. He also worked for a long time at Swiss Life and McKinsey. The father of three has a master’s degree in business administration from the University of Lausanne, is from Freiburg and lives in Geneva.
So should the service catalog not only be limited but also reduced?
Take acupuncture or Chinese medicine in general: I don’t think we need solidarity on basic insurance for such services.
Want to exclude alternative medicine from your basic insurance?
Not all treatment methods. We know from a study commissioned by the Federal Council that 20 to 25 percent of services are unnecessary or inefficient. These should be removed from the catalogue. In the end, we need to understand that we cannot have everything at the same cost.
What about in the long run? Does the healthcare system need to be restructured?
We need a paradigm shift. Nowadays, the price of a treatment is determined, but not the amount. The provider can determine the number of treatments. Therefore, hospitals compensate for financial losses by offering more treatments. New financing models are needed that reward the quality provided, not the number of treatments. We are currently testing various ideas from abroad.
For example?
We can provide health capital per capita. It no longer matters whether someone is healthy or not. Or we compensate for the quality of services according to clearly defined criteria. Groupe Mutuel is currently running a pilot project at the University Hospital Basel and the Hôpital de La Tour in Geneva.
They are calling for a health task force modeled on the Covid pandemic. What good will this do?
Health stakeholders should stop blaming each other. We all have responsibility. The fact that costs are out of control puts a heavy burden on families and the middle class. We must act on their behalf. I demand that the cantons, the federal government, insurers, hospitals, doctors, patient associations and pharmaceutical companies sit down and develop measures together. After all, Parliament must have the courage to decide.
There’s no shortage of suggestions. However, actors in health policy have been blocking each other for years.
We have been discussing uniform hospital financing for 13 years. Impossible! Price watchdog Stefan Meierhans showed at the SRF Club a list of more than 30 cost containment measures that are already on the table but not implemented by politicians. This shouldn’t happen. In the end, we need to pull ourselves together and find a solution together.
Health insurance companies with large lobbies in the Federal House are also needed.
Yes, but the cantons currently have the largest lobbies. Uniform hospital financing has been blocked by cantonal representatives in the Council of State for years. The cantons have a big conflict of roles: they plan the hospitals, they are involved in ensuring that the hospitals remain profitable, they determine the admission of doctors and they also set the prices.
You want to put an end to the Black Peter game, but you go along with it and point your finger at the cantons. Does this fit together?
My aim is not to blame the cantons, but to identify the problems. Without marketing and competition, health insurance companies could save billions of dollars, the hospital association’s executive claimed on SonntagsBlick. These figures are not correct. So what will this conflict bring us? Players point fingers at each other to avoid having to take action themselves.
This also applies to health insurance companies.
We also have a big responsibility and we didn’t do everything right. In Switzerland, we have always made progress by making compromises. Unfortunately, we have overlooked this in recent years. Reason must return to everyone involved in the healthcare system.
They say insurers also make mistakes. Which one?
We are criticized for maintaining the unity of the two sectors. This doesn’t actually work. We must agree on strong representation. Insurers also need to continue to reduce costs, innovate and develop new models. The entire system needs to act urgently, otherwise it will be too late. Our healthcare system deserves better than the Credit Suisse scenario where we have to resort to the only remaining solution at the last minute.
Polls show that the request for unified funding is well received by the public. Is this a worrying situation for health insurance companies?
If politicians in parliament spent as much energy promoting their ideas in the media during the voting campaign, our healthcare system would be in much better shape. Unfortunately, the debate is mostly ideological and demagogic. If we establish a single health insurance fund, we will lose more years without solving the problem of high healthcare costs.
In addition to premiums, executive salaries in health insurance companies have also increased rapidly in recent years. At almost 800,000 francs, you earn much more than a federal councillor. Do you understand that people who are being asked to pay more and more are upset about this?
Groupe Mutuel is much more than a health insurance company. We are one of the largest insurance companies for companies and operate in the fields of private life and professional pensions. Apart from basic insurance, we produce 2 billion premiums. Like all employees’ salaries, my salary is determined based on industry comparisons. The debate over executive pay is a smokescreen. Delaying tactic. If the ceiling is set, premiums will drop a few cents. Is this really the biggest challenge in healthcare?
Alain Berset is leaving his post as Minister of Health at the end of the year after twelve years. What is your assessment of his tenure?
Alain Berset addressed many issues and demonstrated leadership. He did what he could on his own; for example, it adjusted tariffs in 2018. This meant that for once, costs did not increase. I have great respect for his work. But now new dynamics are needed. The change to be made in the Ministry of Health is an opportunity for this. I hope Berset’s successor will bring new ideas. There needs to be someone to bring the players together. Without taboos and without ideology.
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.
