Recipe against rising premiums?: With more transparency against scammers

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The next bonus hammer comes down on the Swiss people. In 2024, the average premium for compulsory basic insurance will increase by an average of 8.7 percent.

Politicians know: something must be done to protect our wallets against high health insurance bills in the future. At first glance, it seems all the better that the National Council will consider a new package of measures next Thursday to keep health care costs in check.

A small reform is expected

However, the name promises much more than is actually expected. The package presents a colorful bouquet of measures that have little to do with each other, from covering the costs of treatment during pregnancy to sending invoices electronically. Health politicians from left to right agree: it’s not a major reform, and therefore it won’t massively reduce health care costs.

But there is one point that is disputed. The Health Committee proposes that in future the date and duration of the consultation should be stated on medical bills. “Today’s standardized calculations are sometimes far removed from reality. The time indication will help to correct the greatest abuses,” says SP health politician Pierre-Yves Maillard (55).

Calculations are not always correct

Health insurers also support the change. “This contributes to transparency,” says Manuel Ackermann, spokesperson for the Santésuisse association. Health insurers already invest a significant part of their work in checking invoices. However, the current Tarmed invoices are difficult for patients to understand.

If it were clear how long a doctor’s visit or therapy session lasted, patients would be able to monitor this better. It would be necessary: ​​a look at an insurer’s list shows that doctors sometimes bill more than necessary. For example, service times and total billed hours do not match.

In one example, a hospital charged more than nine hours for anesthesia for a surgery that lasted only two hours. In another three-hour operation, nine hours of anesthesia were also charged. When the insurance company checked the bill, the whole thing was discovered.

Doctors fear more bureaucracy

During another check, the health insurer noted that the invoice included psychotherapy sessions of 70 minutes each. However, the insured stated that the consultations only lasted approximately 40 to 45 minutes.

Accident insurer Suva also audited 2.5 million medical and hospital bills last year. Ten percent of these apparently contained errors or inaccuracies and were rejected or appealed. Most rejections involved duplicate invoices, incorrectly invoiced or uninsured services, and in some cases invoices for services that were not provided at all.

There are black sheep among doctors, says FDP state councilor Andri Silberschmidt (29). However, under no circumstances should all doctors be saddled with new bureaucratic rules that lead to additional costs. He therefore supports a motion by Thomas de Courten (57, SVP), who wants to remove this scheme from the package. Many medical professionals, such as pediatricians and general practitioners, are already rare in many places. They’re not eager to take on more office tasks, Silberschmidt says.

Source:Blick