Liberalism has lost its sovereignty of interpretation in health policy in recent years. Now he’s trying to win her back. But the party has no solution ready for the biggest problem.
Doctors treat a broken leg in the Ospidal Val Müstair.
Healthcare costs regularly make it into the top 5 of the Swiss Worry Barometer – and with the premium shock that is expected in about two weeks, the topic will become even more urgent. No wonder some parties try to cultivate the field. The center wants to curb costs with a popular initiative, the SP wants to massively expand premium reductions.
On the other hand, there is little to be heard from the SVP and the FDP. While the People’s Party simply has other priorities, the reluctance of the Freisinn, traditionally chosen by many doctors, is irritating. The reason may be that the FDP has a personnel problem. It hardly has any outstanding health politicians in parliament like Felix Gutzwiller, Ignazio Cassis or Christine Egerszegi once did. None of the important cantonal health directors have an FDP party book either. Just a few years ago, the liberal Zurich government councilor at the time, Thomas Heiniger, played a major role in shaping health policy.
With a new position paper, the FDP is now trying to get back into the discussion. After all, it does not do well in an election year to be left without any proposed solutions in one of the key policy areas. The catalog of demands is hard stuff in parts and comes across as rather abstract and cerebral. But there are also some tangible points.
More competition
Unsurprisingly, the FDP is calling for more market to prevent health insurance premiums from rising sharply in the future. At the same time, the quality and accessibility of the healthcare system, which is important to the Swiss, should not be deteriorated. “It needs rationalization, but not rationing,” emphasize the authors of the paper.
The FDP calls for more competition between hospitals and doctors thanks to improved transparency: Patients should be able to find out which medical service providers offer good value for money and who do not carry out unnecessary treatments. However, it remains unclear how this could work exactly. The abolition of the obligation to enter into a contract – which has hitherto had no political chance – aims in a similar direction. This would allow health insurance companies to decide which hospitals and practices they want to work with. This in the hope that the inefficiently working companies would disappear from the market.
Patients who consciously choose cheaper providers could receive a reward for this, for example in the form of lower premiums. People who live near the border should be allowed to be treated abroad. Such health tourism at the expense of basic insurance is not allowed today. The FDP is also warming up an old demand: an increase in the maximum deductible, which is currently CHF 2,500. However, it is no longer an issue to significantly increase the minimum deductible – from 300 francs today to 5,000 francs, for example. The basic insurance, which also covers minor cases, would have been converted into insurance for serious medical cases.
Against the pharmaceutical industry
The FDP distanced itself from the pharmaceutical industry, with which it is traditionally close, with one demand: parallel imports of cheaper medicines from the EU or the USA should be made easier. The drug industry warns that this would increase the risk of counterfeits entering the Swiss market. Security of supply is also at risk because parallel traders are not obliged to supply Switzerland and would quickly leave if the business were no longer lucrative.
The FDP also wants to save costs with nationwide hospital planning, which would lead to greater concentration and thus the closure of smaller hospitals. This is particularly necessary in the area of highly specialized offers: If only large central hospitals are allowed to carry out certain interventions, this will increase efficiency and quality. When selling medicines, the party wants to eliminate false incentives so that a pharmacist or a doctor does not earn the most when they sell the most expensive medicine.
The FDP only deals very superficially with one of the biggest problems in the healthcare system: the shortage of skilled workers, especially in nursing. It is undisputed that an “increase in the attractiveness of training” is needed, as is the fact that too many nurses leave the profession too quickly. But the party leaves open how this problem could be solved.
This shows that a position paper alone is of no use: the decisive factor will be whether and how the FDP translates its ideas into concrete political advances and initiatives.