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What exactly is the additional comfort – that is, the additional benefit of this insurance? To date, this has not been definitively and uniformly defined anywhere. That’s why I fought for a mandatory specification for many years.
Financial Market Supervisory Authority Finma, as the competent supervisory authority for insurance companies, has also found that supplementary health insurance bills are often non-transparent and sometimes appear unjustified or high. Therefore, she calls for the correction of the complaint along with me.
Finma expects insurers to have comprehensive control: insurance companies should only pay rates that can be justified by the actual additional costs of additional services, for example, better comfort in a room compared to a general department.
But be careful: a plate with a gold rim alone does not justify the bill twice as much. In the hospital industry, there are sometimes violent threats, complaints and warnings against meeting these simple requirements: loss of quality, additional costs through basic insurance, administrative efforts for these measures, which can lead to the closure of some hospitals. I can’t understand it.
In my opinion, it is extremely important that the contracting parties transparently regulate what tariff can be billed. And also the fact that the quality of the service provided is checked at the end. That this has not yet happened is nothing less than a very costly omission for premium payers, which may even have negative consequences for their health.
In short: Be careful who has extra insurance! The treacherous part of this story is that supplemental insurance patients are such a lucrative business (see my 2021 study) that they are sometimes advised to undergo interventions that are not medically necessary: US Federal Public Health Administration study . 2016 states: “Orthopedic services seem to be of particular interest.”
It was found that persons with semi-private or additional private insurance in Switzerland were operated on their knees 2.2 times more often, and on the spine – 1.5 times more often. Hip replacement was performed 1.3 times more often. A study this year by the University of Basel and the Cantonal Hospital of Aarau concluded: “Patients with private supplementary insurance in Switzerland are more likely to need cardiac intervention than people who only have basic insurance.”
In 2022, Handelszeitung wrote about a small Basel clinic specializing in orthopedic surgery: “There, those with additional insurance cover two-thirds of the margin, although only one-third of the treatment is for privately and semi-privately insured persons.”
But even those with only basic insurance cannot breathe a sigh of relief: they risk inflicting reflex damage when calculating the premium! For what reason? Since unnecessary treatment for those with additional insurance (who also always have basic insurance) is co-financed by fixed rates of mandatory basic insurance based on the case treated, this false incentive also increases the financial pressure on the basic insurance and thus contributes to insurance premiums unnecessarily rising.
These are disturbing facts that make me wonder: should those with supplemental insurance bleed forever (mistakenly) because hospitals are used to it? I say clearly: it is better to end in horror (from the point of view of hospitals) than endless horror (from the point of view of premium payers).
Source: Blick
I am David Miller, a highly experienced news reporter and author for 24 Instant News. I specialize in opinion pieces and have written extensively on current events, politics, social issues, and more. My writing has been featured in major publications such as The New York Times, The Guardian, and BBC News. I strive to be fair-minded while also producing thought-provoking content that encourages readers to engage with the topics I discuss.
