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SonntagsBlick: Ms. Nold, health insurance premiums continue to rise unabated. How bad will it get?
Verena Nold: The numbers are indeed alarming. Costs per capita rose by 7.5 percent in the first two months of the current year. Last year the health insurers suffered a loss of CHF 1.5 billion. Now there is not enough left to close the gaps. The result is a further premium increase.
When can regular earners stop affording health insurance?
Soon. Depending on the insurance model and place of residence, a family of four pays up to CHF 1,200 per month for compulsory basic insurance. Premiums rise much faster than wages, leaving less money for other things. If we do nothing, we will crash our healthcare system.
Have you failed to adjust the premiums to the cost reality in recent years?
Premiums have remained stable during the pandemic. But that wasn’t just about stopping the treatment. The health insurers also used their reserves so as not to burden the insured extra. Once the pandemic was over, costs skyrocketed. Last year, the Federal Council set a political bonus that was not enough to cover costs. At some point it will catch up with you. We should have already increased the premiums for 2023 by ten percent.
What drives healthcare costs so high?
For example, we are concerned about the increase in pharmaceutical costs. Pharmacies and doctors’ practices that are allowed to dispense medicines saw an above-average increase. There are two reasons for this: the high prices in this country – and that many drugs are prescribed.
Maybe we just get sick more often…
I do not think so. It’s a simple mechanism: if there are many doctors, more people go to the doctor and automatically get more treatment. We do not know whether these therapies are always necessary and effective. We just don’t have the data for that. We see the cost development, but in terms of quality we fly blind.
Why is this data missing?
Anyone who is allowed to settle an account without having to give an account can make it quite easy for themselves. With the introduction of the new Health Insurance Act in 1996, service providers were obliged to develop quality concepts. But nothing happened. A stricter law has been in force since 2021, but the work of the Federal Quality Commission that was introduced with it is still in its infancy. Efforts are now being made to carry out quality measurements in order to finally create transparency.
A huge administrative burden that entails even more costs.
The effort will be limited. In addition, unnecessary treatments can be avoided. This saves a lot of money and protects patients. In a study, the Federal Council found that efficient treatment can save almost 20 percent or about CHF 8 billion in costs.
The recently published health atlas shows striking regional differences in treatments. In Neuchâtel far more Ritalin is prescribed than anywhere else, and in Basel far more people suffer from lung cancer.
This is certainly not the fault of the patients. Again: where the density of orthopedics is high, the number of orthopedic procedures skyrockets. This connection cannot simply be dismissed. The highest premiums are paid in the cantons of Geneva and Basel-City, where an above-average number of doctors are employed.
What would your solution look like?
Parliament has responded and obliges the cantons to take a closer look at the approvals: Should new doctors be found at all? Anyone who wants to practice in Switzerland must settle where there is a shortage of doctors.
How do you get a young doctor from the city of Zurich to open her practice in a mountain village?
If you lose your job as a banker at Paradeplatz, you may have to transfer to a branch in Chur. Is that so bad? As a native of Graubünden, I also found work in Zurich. And imagine: Switzerland is beautiful everywhere!
People are getting older, the number of their chronic diseases is increasing. In the past, these people would have simply died.
Demographic development has an effect on healthcare costs, but this is overestimated. Certainly: with age, the chance that you have to go to a nursing home or need the Spitex increases. These healthcare costs are rising at an above-average rate. Other factors have a greater impact on healthcare costs, especially medical advances.
What do you mean?
Fortunately, we now have many more treatment options for cancer patients. At the same time, new, innovative cancer drugs and therapies are one of the largest cost items in healthcare. It’s good that we afford this. However, I think it is a big mistake not to remove from the list of benefits treatments that have proven to be of no benefit. If we want to make our system sustainably financeable, we must become more efficient.
How do we do that?
A surgeon who performs a complicated procedure often achieves better results. That has been scientifically proven. Based on this, it must be decided what should be done where. Specialization also leads to quality improvement. The cantons should be stricter and not give all service mandates to every small hospital.
In the US or UK there is a cap on the cost of an extra year of life. Why not also in Switzerland?
Then we did everything wrong. Before we ration, we need to rationalize the healthcare system, that is, make it more efficient. To protect the premium payers!
Shouldn’t we also question our attitude towards rights? If you get nervous after a tick bite and have to wait half an hour for an emergency, you can’t complain about rising health care premiums.
It is important that the emergency room does not become clogged with trivial cases. To prevent this, the House of Representatives is debating whether hospitals are allowed to charge compensation for minor cases.
We have the best healthcare system. Why shouldn’t it cost anything?
If it’s great, it may cost something. But today we have a high quality black box. We suspect that our health care system is good, but there are no numbers to back this up. You have to be a professional to understand statistics that provide information about the quality of a hospital. The decisive factor is: how are patients doing after the treatment? There are no statistics on this.
The Council of States demands that insurers contribute more to the costs of long-term care. Why are you resisting it?
The proposal is part of the harmonization of the financing of outpatient and inpatient treatment. In principle, we have nothing against that. Integrating the costs of long-term care is problematic. Health insurance is not long-term care insurance, and old age is not a disease. Health insurers now pay 33 billion annually from the compulsory basic insurance. If long-term care were to be integrated, this would be about five billion more in the medium term. There would be an explosion of bounties.
Would you like everything to remain the same in this area?
The problem of financing care must be solved – but the proposal from the Council of States is a no-go for us.
Source:Blick
I am Liam Livingstone and I work in a news website. My main job is to write articles for the 24 Instant News. My specialty is covering politics and current affairs, which I’m passionate about. I have worked in this field for more than 5 years now and it’s been an amazing journey. With each passing day, my knowledge increases as well as my experience of the world we live in today.
