This is what Baume-Schneider expects as Minister of the Interior: “It will be difficult with big decisions.”

There are two big topics waiting for Baume-Schneider in the EDI that are incredibly important, terribly complex and highly competitive: healthcare and pensions. The challenges in both are enormous.

She has to deliver quickly

When it comes to pensions, the SP federal councilor hardly has any training time: at the beginning of March she has to win two votes, one of which – the popular initiative for a 13th AHV pension – against her own party. The real battle will take place in June or September, when she will have to argue, again against her own party, for a reform of the pension funds that is unlikely to convince her. And for that she will have to study hard: Almost no other system is as complicated as that of the second pillar.

If Baume-Schneider has to fight defensive battles on the big stage, the next Herculean task is already waiting in the office on the Inselgasse in Bern: she must put a new AHV reform on the table by 2026. Despite the retirement age for women being 65 and the VAT increase, the financing of the first pillar is only assured until 2030. After that, further reforms are needed.

Like every pension minister, Baume-Schneider only has three options: reduce pensions, extend working years or put more money into the AHV. As a leftist, she would probably prefer to propose the latter option, but that would likely put her in the middle-class dominated Federal Council. Creative ideas are needed.

A thousand construction sites in health policy

The problems in healthcare are no smaller. Baume-Schneider not only has to get the electronic patient file operational and update it again soon, solve the medication shortage, implement the healthcare initiative, introduce a new doctor rate and reform the Epidemics Act.

In addition, it must also implement a huge project approved by parliament: the uniform financing of inpatient and outpatient services – the most important reform in many years, says expert Andreas Faller, who previously worked at the Federal Office of Public Health (BAG). ) and the Basel Health Directorate. “And the reform is not out of the barrage yet,” he says. Health insurers would probably be on the same footing as cantons. “That’s going to be difficult.”

Ideas against the bonus hammer

September will also be tough: because then the new Minister of Health will have to announce the next bonus hammer. What another massive construction site reveals: It should slow cost growth in the health care system – something that predecessor Alain Berset (51) struggled with.

There are many options. “With a reduction in laboratory fees, savings on medicines and clear efficiency criteria for hospital rates, more than a billion francs could be saved annually – without premium payers having to give up anything,” says Verena Nold, director of health insurer Santésuisse.

Health economist Heinz Locher (80) has a different idea: basic insurance should only reimburse for services that really add value, he says. And Baume-Schneider must ensure that the laws are finally enforced. “There are 2,000 preventable deaths every year, and yet many collective agreements do not yet contain quality assurance clauses,” he gives an example. That is illegal.” He also proposes shifting more powers from the cantons to the federal government, for example in the field of hospital planning.

Is the period sufficient for this work?

Faller thinks differently: “To curb cost growth we do not simply need further measures, but rather a halt, an analysis of the numerous false incentives and then a clean reform concept with an implementation plan.”

But all these things require ‘bite, commitment and time’, says Center Health politician Lorenz Hess (62). What worries him: “If Mrs. Baume-Schneider remains in the Federal Council for another five to six years, as announced, it will be difficult to make major decisions.”