Because politicians don’t save: No more new benefits!

Figures from health insurer Santésuisse give an idea of ​​how bad it will get. At the end of July, insurers had already transferred 1.6 billion francs more to service providers than in the comparable period last year. Hospital costs increased by 8 percent (690 million), pharmacies collected 6 percent (170 million) more. Extrapolated over the entire year, this would mean a total increase of approximately 2.5 billion francs. To cover the costs and maintain the shrunken reserves, premiums would have to increase by 8 to 9 percent, according to Santésuisse.

“As soon as a service is included in the catalogue, everything becomes more expensive.”

“Politicians have not been able to implement effective austerity measures over the past four years,” Santésuisse director Verena Nold told SonntagsBlick. That is why she is now calling for a stop: no additional expansion of the range of services, as Parliament demands in various initiatives. “As long as the cost trend is not broken, there will be nothing new.” The moratorium will last five years. Because: “As soon as a service is included in the catalogue, the floodgates open – and everything becomes even more expensive.” The last time we saw this was with psychological psychotherapists. Since they have been allowed to bill independently, the healthcare system has been burdened with an additional R320 million per year. Nold: “As long as politicians have not done their homework, there should be no further expansion.”

In the latest SRH election barometer, most respondents (39 percent) cited health insurance premiums as the most important political challenge of the moment – ​​ahead of climate change (37 percent) and immigration (33 percent). The autumn session that starts next week will focus on health. On Tuesday, parliament will discuss the SP’s premium aid initiative, and two days later the centre’s cost-cutting initiative is on the agenda. And on October 22, there will be a settlement at the ballot box. No wonder that the parties are outdoing each other in the election campaign with recipes to combat poor premiums.

The SP calls for nationalization of health insurers – with the wind at the back of the electorate, which voted no less than 79 percent in favor of one health insurance fund in a Watson survey. The FDP is currently pushing for a budget health insurance fund in which insured people can voluntarily forego certain services and choose a deductible of up to 3,500 francs. And Zurich SVP government councilor Natalie Rickli (46) recently even considered abolishing compulsory basic insurance.

Santésuisse director Nold has little regard for these suggestions: “We don’t need to turn everything upside down and we don’t need a revolution either.” The legal framework is there, we just need to finally apply it.

It is not true that one health insurance fund would make premiums cheaper, says Nold. “If we rely on this illusory solution, we capitulate to the often unjustified increase in costs.” Premiums increased as a result of higher healthcare expenditure. Administrative costs, on the other hand, have remained stable at 5 percent in recent years. This year they are 1.7 billion francs. And therefore approximately the same as healthcare costs increased up to and including July. Even if all employees worked for free, the bill would not increase, according to Nold.

The Santésuisse director believes that the FDP’s budget model shows good approaches, but these are not new. It is already possible today to opt for alternative insurance models. For example, those that oblige patients to purchase generic medicines instead of the more expensive original preparations: “Everyone can put together their own individual budget model.” However, Nold does not think it is a good idea to increase the maximum possible deductible to 3,500 francs. The healthy people would then pay less for the sick, which would be contrary to the principle of solidarity.

Hospitals must work together better

Whether it concerns abolishing the obligation or salary-related bonuses: this is only treating the symptoms. Nold: “We have to get the causes under control. If we only change the financing, we will not solve any problem.”

One of the most important cost factors is drug prices. In 2022, they rose by about 6 percent to 9 billion francs. They now make up almost a quarter of the costs of basic insurance. Nold sees a lever here. Switzerland lags behind when it comes to generic medicines compared to other countries. There are still too few medications prescribed. And their prices are too high.

Because hospitals, general practitioners and pharmacies make good money on expensive medicines, there are false incentives. Politics has also remained inactive in this area, according to the director of Santésuisse. “The Federal Council could immediately achieve a lot by adjusting the sales margin.”

Nold also holds the cantons responsible. In many places the motto still applies: ‘Every valley has its own hospital.’ It is nonsense that university hospitals provide basic care and small hospitals provide complicated treatments. Verena Nold is convinced that better cooperation between hospitals and sensible approval management among doctors would have a cost-saving effect.

Health politician Sarah Wyss (35) feels insulted by the call for a moratorium. “It is not the job of health insurers to intervene in the care catalog or to decide which service provider can best offer which treatment,” says the SP Land Council member.

FDP state councilor Andri Silberschmidt (29) sees it the same way. It is true that more and more services cannot be included in the basic catalogue. However, if, for example, pharmacists carry out vaccinations instead of doctors, there is no question of an expansion of services, but rather a redistribution of services. “And since the pharmacist offers the shovels cheaper, it can even be a cost-saving exercise.”