Visana health insurance relies on American model: “We don’t force anyone to wear a heart rate monitor”

What are you up to?
Already in the first quarter of 2023, more health services were purchased than in the same period of the previous year. More drugs, therapies, hospitalizations. This is reflected in the premium: the health insurers foresee a price increase of 6 to 10 percent.

In the canton of Bern I paid about 400 francs a month at Visana next year. If I had three kids it would be tight.
This is becoming a problem for many. Someone once said to me: “In Switzerland we would rather drive a BMW than a VW Golf.” If you ask for a top health system, you have to pay for it. All well and good. Only: More and more people can no longer afford these amounts. Then they get premium discounts, which ultimately have to be paid by the taxpayer. So something has to be done now!

The FDP does not speak of BMW and VW, but of “water instead of champagne”. What do you think of the liberal idea of ​​a slimmed-down “budget health insurance company”?
In the Healthcare Barometer, healthcare premiums fluctuate at the top. So there is a lot of campaigning going on. However, such a model meant a departure from our system in which the healthy are in solidarity with the sick.

So Visana would not include budget insurance in its offer?
We’re going different ways. A number of good elements from the FDP proposal are already included in our alternative insurance model of regionally integrated care, which we will launch next year in the Jura region: the focus on prevention, for example, or a working electronic patient file to avoid duplication of work.

Integrated care sounds very abstract. What makes the model?
The healthcare system with all its players currently lives off the sick. You make money because people have to go to the doctor, the pharmacist or under the knife. Integral care, on the other hand, works if everything is done to prevent people from becoming patients as much as possible. That’s why true prevention and early detection are so crucial. There is a fixed budget for all insured persons. This creates a positive incentive to avoid duplication of work as much as possible.

Existing models also rely on prevention.
For example, many do of course pay something for the fitness subscription. But our approach goes further. Why not integrate a fitness center into the system? Free. With coaches who advise. That would be concrete prevention. So don’t just hand out a pedometer and ask them to walk a little more.

Not everyone wants someone to point out wrong eating habits or too little exercise.
We don’t force anyone. And we certainly do not equip our policyholders with a heart rate monitor. The fact is that everyone is interested in staying healthy for as long as possible.

You still have to prove that integrated care works in Switzerland. Nevertheless, you are already planning further clusters in other regions. What makes you so confident that you will succeed?
I am 120 percent convinced of the model. We studied the role models abroad. “Kaiser Permanente” in the US and “Ribera Salud” in Spain managed to cut costs by about 20 percent. It’s simple: the market decides. If we manage to convince enough people of the benefits of our model, we’ll let it fly.

How many people should participate?
That depends on the region. However, we try to reach the limit of 20,000 insured persons as quickly as possible. Then the system of integrated care comes into play.

If you are healthy, you pay particular attention to the price. If the premium for the basic insurance increases, he or she simply switches to the competition at the end of the year.
If policyholders feel they are being treated well and efficiently, they will stay. This enables us to set an attractive premium that does not increase every year.

What does Visana deliver?
We don’t just do it because we are do-gooders. However, as one of the major insurers, we have an obligation to do something to counter the increase in costs. We have no interest in breaking bad news every fall.

Over the past four years, politicians have failed to push through major health care reforms. Some attribute this to increasing polarization. Election forecasts now say that the two pool parties SVP and SP will grow in the fall. What does this mean for health policy?
Polarization does not help anywhere, certainly not in health policy. Not only the parties, but also the various actors constantly emphasize that action is required. But when it comes to finding solutions together at the table, you stick to your own points of view. In any case, Minister of Health Alain Berset has put together an austerity package. Opinions are divided on the measures contained therein. But it shows an example why we hardly get any further: A player always puts a red line. And finally there are paper tigers. This is very sobering. This insistence on extreme positions eventually led to us doing something ourselves and not waiting for everyone to get their act together.

As chairman of the Board of Directors of a large health insurance company, you are one of the players.
The associations are responsible for the lobby in the Federal Palace – we even have two with Santésuisse and Curafutura (laughs). Sure: the middle doesn’t sound so sexy. You can make more noise left and right. But in health policy in particular, success is only possible if compromises can be made. The Réseau de l’Arc is a good example of this. It is the first time that the canton, the service providers and we as an insurer have developed something together. Otherwise, these players sit across the table negotiating. Within a year we submitted a concept to the BAG.

Briefly about the elections: according to a current forecast, the center could overtake the FDP. Are you going to demand a second seat from the Federal Council if this happens?
There must be a clear result on the evening of the election Sunday. However, it would not be implemented immediately. Because this would mean deselecting an existing Federal Council from the FDP. I am firmly against that. The question would only come up with a vacancy. And as said only if there is a clear result.

The magic formula is clear: the three largest parties each have two seats.
It’s like in sports: whoever has a hundredth of a second ahead at the finish wins. So if we were to actually catch up with the FDP, this question arises.