Cost brake initiative – what can stop the exploding health insurance premiums? – News


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The National Council is today advising the cost brake initiative of the “Centre” party. There are various alternative proposals.

The National Council is today advising the initiative of the “Centre” party for a cost brake in the health care system. The popular initiative “For lower premiums – cost control in the health care system” is intended to oblige the Federal Council and the cantons to take cost-cutting measures if the cost growth per insured person is one fifth higher than the nominal wage development two years after the initiative was adopted.

Thanks to the initiative, the costs of compulsory health insurance should develop in accordance with the economy as a whole and average wages, and the premiums should remain affordable. The Federal Council considers the linking of cost growth to wage development to be too «rigid» and, in an indirect counter-proposal, provides for cost targets in compulsory health insurance.

Cost brake initiative and counter-proposals – that’s what it’s all about


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It’s all about this: Healthcare costs have risen by an average of between 4 and 5 percent in recent years, which is reflected in rising health insurance premiums. The center party wants to curb these costs of their initiative: If these rise significantly more than wages, the Federal Council and the cantons must adopt concrete measures. These would have to take effect in the following year so that – according to the aim of the initiative – the premiums remain affordable.

This is controversial: The Bundesrat shares the concern, but opposes this proposal. It is too rigid and could lead to rationing. The Federal Council is therefore presenting an indirect counter-proposal – with more flexible cost targets (originally part of the second cost containment package). In it, the Federal Council proposes an annual maximum target for the costs of basic insurance and apportions this to the cantons. These in turn break it down by area – so that there are maximum cost targets for the hospital, medical practices, laboratories, physiotherapy and so on. If these are exceeded, all those involved should check when and which measures would make sense.

This is the current status: The proposals are now coming to parliament for the first time, to the National Council. However, it does not stop with initiative and indirect counter-proposal. Because the responsible commission rejects the initiative and presents its own counter-proposal – without cost targets. She wants to slow down the cost growth with tariff interventions, especially for doctors and laboratories – who are supposed to agree contractually cheaper tariffs with the health insurers. More applications will follow.

The National Council Health Commission has an alternative concept to the Federal Council’s proposal. She doesn’t want to know anything about the initiative project with targets for maximum cost growth and is asking for concrete measures, especially with regard to tariffs and laboratory analyses.

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The popular initiative “For lower premiums – cost control in the healthcare system” was submitted on March 10, 2020 in Bern.

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On behalf of the initiators, Christian Lohr (Die Mitte/TG) emphasized that the rising premiums would lead to more and more people falling into debt. The referendum does not call for rationing of medically necessary services, but wants to encourage active thinking in the healthcare sector. It is about personal responsibility and personal competence in healthcare.

“There is no talk of a global budget. Anyone who claims that is deliberately practicing pessimism and showing that they don’t want to react,” says Lohr. The Swiss health system is very good, but must remain affordable. Studies showed that a fifth of the costs could be saved without any loss of quality.

There is no talk of a global budget. Anyone who claims that is deliberately practicing black painting.

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