Berset recalls cantons

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The Swiss healthcare system is a patient whose fever curve points steeply upwards. After health insurance premiums rose by 6.6 percent in the current year, the next shock is imminent in the autumn: the first figures point to an increase of 7.5 percent. In the Sunday vision, Santésuisse director Verena Nold (60) warned last week: “If we do nothing, we will drive the healthcare system to the wall.”

The gloomy outlook also put Health Minister Alain Berset (51) in an alarming mood. He must announce the new premiums in six months. A sharp rise would ultimately ruin his already troubled presidential year.

“Increase would not be acceptable to the system”

Hospitals that are groaning under rising costs are therefore extremely inconvenient for the SP Bundesrat. When the Insel Group had to announce the closure of two Bernese hospitals at the end of March, Chairman of the Board Bernhard Pulver (57) said: “If the rates for our medical services are not adjusted, further drastic adjustments to the offer will follow.” services will be inevitable in the future.”

As early as October last, the hospital association H+ called on politicians and insurers to raise all rates by about five percent. This call for help probably prompted Alain Berset, among other things, to comment on the requested rate increases. A letter to the cantonal governments, available Sunday, said: “Such an increase would not be financially viable for the system.

Cantons have to close gaps

In its letter, the Bundesrat makes it clear that measures that lead to an increase in premiums are out of the question for it: “Containing the cost increase at the expense of compulsory health insurance remains a priority for the Bundesrat.” The Health Insurance Act does not provide for rate increases outside the collective labor agreement or even an automatic adjustment of the cost of living. It is the responsibility of the rate partners to ensure that rates are appropriate and updated.

What is not in the letter, but resonates in every line: closing the gaps in the coffers of service providers should be a matter for the cantons – or also: the taxpayer.

The letter from the Federal Republic of Bern caused irritation among the recipients. The cantons are well aware of their responsibility in approving and setting rates, says Tobias Bär, spokesman for the cantonal conference of health directors (GDK).

Inflation causes problems for hospitals

The Hirslanden Group has sharply criticized Berset. The rates are far too low and should be raised as soon as possible, says spokesman Claude Kaufmann. Hospitals depend on millions of tax dollars to survive. “With his premium policy, Alain Berset consciously accepts the burden for the cantons and the taxpayer.” According to Kaufmann, the cantons are closer to the population and health workers than the BAG. “They know that if inflation is not offset, quality health care will be at risk.”

The health insurance law states: “The collective agreement requires the approval of the responsible cantonal government or, if applicable throughout Switzerland, by the Federal Council.” And furthermore: If there is no collective agreement between service providers and insurers, the cantonal government will set the rate after hearing the parties involved.
Anne Bütikofer (50), the director of the hospital association, tells SonntagsBlick: “We are surprised that the federal government is interfering with cantonal sovereignty.” Inflation is causing problems for hospitals emerging from a pandemic. They are severely underfunded in all areas and suffer from a major shortage of skilled labour.

Health insurers do not want rate increases

“We do not understand that the Federal Council has not yet recognized the explosive nature of security of supply for the Swiss population as a whole and is reducing it to a discussion of costs.”
Berset’s office defends the approach. In principle, people speak out against tariff increases, says BAG spokeswoman Katrin Holenstein. According to the Health Insurance Act, the rates must be based on the reported costs of effective services. “In order for any rate increases to be approved, transparent calculation bases must be available.”

Tomorrow, the hospital association and the cantons want to discuss how to proceed in a joint exchange. There is no doubt for them that something must be done. GDK spokesman Bär: “The system of hospital financing and collective bargaining is not designed to respond to unexpected, massive changes in costs.”
The demands for a rate increase are not well received by the health insurers. Both associations agree once in a while.

Santésuisse spokesman Matthias Müller says “many hospitals have managed to turn a profit in recent years”. People are fundamentally critical of national tariff increases. However, it is also clear to the insurance companies that inflation and all other relevant cost factors must be taken into account in the forthcoming wage negotiations. Curafutura uses the same arguments. Their spokesperson, Adrien Kay, says: “A nationwide price increase would lead 1:1 to a corresponding premium increase. This would not be acceptable to the premium payers.”

Source:Blick