Federal Councilor Elisabeth Baume-Schneider announced on Thursday that the average health insurance premium would be increased by six percent for the coming year. There is growing anger and incomprehension among the population about the constantly rising prices. Heinz Locher knows the healthcare system like few others. He says: More moderate price growth is possible, but politicians have to do more.
Heinz Locher
Health Economist
SRF News: Will premium growth stop at some point?
Heinz Locher: It can be assumed that this will no longer be the case. The question is more about how much and why the costs are increasing. And on this issue, in my opinion, those responsible are currently exuding a kind of helplessness that is paralyzing.
Why is that so?
Each interest group can thwart the plans of the others, but cannot achieve anything themselves.
But it cannot be due to politics alone – after all, demographic change is progressing inexorably.
Aging is a fact. Nevertheless, there is potential for optimization. The system still provides too many places in many places. But many cantons are overwhelmed by the need for reform. The political risks are simply too great – government councilors have already been voted out because they called for regional hospitals to be closed. It takes leadership from above. I also criticize Ms. Baume-Schneider. She announced a round table on Thursday – but that’s not enough.
Could Switzerland learn something from other countries?
I used to be an advisor to the WHO myself and traveled a lot. I learned that you cannot separate a healthcare system from the political culture of a country. The Netherlands, for example, has five university hospitals – just like Switzerland, although it has a larger population. But when I asked my colleagues there how they did it, they said: “The central government does it all.” That would be unthinkable in Switzerland. You can adopt individual elements, but not the entire system.
I expect politicians to recognize that we are in a crisis situation.
What role do health insurance companies play? Do we need fewer of them?
A reduction would be advisable – but would not completely solve the problem. On the one hand, the health insurance companies are the weakest actors in the system, but on the other hand, they do not fully fulfill their task. By law, they actually have to take care of the care and not just the health insurance premiums.
The costs for the insured remain. For many people, the problem here seems to be getting more and more pressing. Do you see it that way too?
From a macroeconomic point of view, the current cost development in the healthcare system is bearable. Nevertheless, on the one hand we have a financial problem for certain families. And on the other hand, we have a quality problem: every year there are 2,000 avoidable deaths in Switzerland. Patient safety is not guaranteed – and it is not measured either.
What do you expect from politics?
Reforms are always difficult – one way or another. One could, for example, encourage more outpatient treatments because they are less personnel-intensive than inpatient ones. But that would also mean that many beds would remain empty. This would affect the hospitals and clinics’ equity. You see: it is very complicated. This is exactly why political leadership from the federal government and the cantons is needed. I expect politicians to recognize that we are in a crisis situation.
The interview was conducted by Patrick McEvily.