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How well has Alain Berset done in terms of health insurance premiums? What effect has it had in the fight against ever-increasing premiums? The assessments of two health experts differ.
Stefan Felder, professor of health economics at the University of Basel, draws a devastating conclusion: “He has been in office for twelve years now and, unlike his predecessor, he has actually achieved little. Actually, almost nothing that he initiated got through.”
Health expert Felix Schneuwly from the comparison service Comparis, on the other hand, also sees positive things: “At the beginning of the health insurance law in the 1990s, we had cost increases of 4.5 percent per year, in the years under Berset – with the exception of the last two – the cost increase was an average of 2.5 percent. This is a positive development.”
The main benefit: prices reduced
Berset succeeded in reducing prices, says Schneuwly. “He intervened at certain points in the Tarmed medical tariff. This has led to cost savings. The regular drug price reductions have also had an effect. And he lowered laboratory tariffs. This immediately led to cost savings.”
However, professor of health economics Stefan Felder criticizes Berset for not being decisive enough when it comes to medical tariffs: “The Tarmed medical tariff, which is still valid now, was introduced in 2004. In the meantime, for example, great progress has been made in imaging procedures – and this has not been adapted. The radiologists therefore earn far too much.”
Intervening with doctors’ tariffs is overdue. “Federal Councilor Berset, together with his colleagues, has the competence to do this – and he has not taken advantage of it,” says Stefan Felder. In fact: the new “Tardoc” medical tariff has been waiting to be implemented for years. Experts assume a savings potential of 600 million francs annually.
In doing so, he made the same mistake as his predecessors.
Another point of criticism from both experts: the reduction in reserves in health insurance. “He made the same mistake as his predecessors,” says Felix Schneuwly. “He forced health insurers to reduce their reserves. And so far it has always been the case – with Ruth Dreifuss, with Pascal Couchepin and also with Alain Berset – that there has been a premium shock after every forced reduction in reserves.
Main accusation: “Service catalog continues to grow”
By reducing reserves you can improve the numbers, says Stefan Felder. The health economist’s main accusation, however, concerns the catalog of benefits provided by basic insurance. Whatever is on there must be paid for by basic insurance.
Nobody has yet taken care of the reduction in performance.
“This catalog of services has continued to grow over Berset’s twelve-year term in office.” This means that you can treat a lot more today than you could twelve years ago. The question is whether all of this has to be covered by basic insurance, says Felder. “This is really a task that has been left undone. We introduced compulsory health insurance almost 30 years ago – but no one has yet taken care of the reduction in benefits.”
Doubling spending in 20 years
Without a reduction in services and without cuts in compensation, health insurance premiums would continue to rise, says Felder. “That’s as certain as Amen in church. A cost increase of 3 to 4 percent per year – that means spending will double in 20 years. This doesn’t exist anywhere else. What really characterizes the healthcare sector is that costs are rising very sharply. You can really only take radical measures if you want to change something.”
Comparis health expert Felix Schneuwly wants Alain Berset’s successor to boldly tackle reforms. Because: “If, of course, you always wait until the last person agrees, then you can’t implement any reforms.”