Explainer: Swiss To Vote On Healthcare 'Cost Brake'

(MENAFN- Swissinfo) The Centre Party wants to curb spiralling healthcare spending with a proposed mechanism to limit cost increases – citizens will vote on June 9.

Journalist based in Bern. I am particularly interested in topics about society, Politics and social media. Previously I worked in regional media, for the newspaper Journal du Jura and radio Jura bernois.

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The Swiss healthcare system is one of the most expensive in the world. Spending in the sector has risen steadily since the 1990s; it now accounts for 11.8% of GDP.

The spiralling costs have invariably led to significant annual hikes in the cost of health insurance premiums, putting a heavy strain on lower-income households. Surveys have shown that health costs are the biggest issue of concern for the Swiss population.

To address the problem, the Centre's External link initiative, which comes to vote along with three other issues on June 9, wants to introduce a mechanism to curb the rise in compulsory health insurance costs.

Like in many developed countries, an ageing population as well as (expensive) advances in medical technology partly explain the rise in health costs in Switzerland.

But certain features of the Swiss system exacerbate the problem. The duplication of medical procedures, wrongheaded incentives and inefficient structures can often result in treatments which are not medically justified, according to the Federal Office of Public Health (FOPH)External link .

Making the system more efficient would enable spending cuts of CHF7 to CHF8 billion ($7.7 billion to $8.8 billion), a study by the Zurich University of Applied Sciences (ZHAW) has found.

Over the past decade, the cost of compulsory health insurance has risen by 31%, while wages have increased by around 6% over the same period. The Centre wants to narrow this gap.

To do so, the party's initiative – tabled in spring 2020 – proposes a cap on costs, which it says should not be allowed to increase significantly faster than the economy and wages.

The text calls on government to activate a mechanism whenever healthcare spending increases by 20% more than wages in a year. So, if wages wages rise by 1%, medical costs should not go up by more than 1.2%.

If expenditure increases more than this in any one year, the federal government would be obliged to step in to bring costs down, in cooperation with cantons, insurance companies and healthcare providers.

However, the initiative does not specify what type of measures the authorities should take to control costs. Should the idea be accepted by voters, the details would be decided by parliament in the implementing legislation.

The Swiss government and parliament are opposed to the Centre's text and have drawn up a so-called indirect counter-proposal. This will come into force if the initiative is rejected by voters, provided it is not challenged in another referendum.

Instead of a cost brake, the government suggests defining targets to control the cost of compulsory health insurance. Under this system, federal and cantonal authorities would set goals for the maximum growth in spending each year.

If these goals were exceeded, the authorities would then have to decide on the necessary measures, working together with the various partners involved. Such measures could involve an adjustment of premiums or the authorisation of service providers.

Both government and parliament believe that the counter-proposal would enable a systematic reflection on cost increases.“All players would have to do their bit to reduce services which are not medically necessary,” they reckon.

The Centre is presenting its text as the answer to rein in ballooning health costs and ever-pricier premium payments.

The party believes a cost brake would force all players in the healthcare system to work together to implement measures that have already been on the table for a long time: for example, encouraging more outpatient procedures, favouring generic drugs and digitalising patient files.

The Centre is convinced that its initiative will help solve the problem without reducing services or jeopardising the quality of the Swiss health-care system.

On June 9, Swiss voters will decide on two initiatives aimed at capping the cost of healthcare in the country. Have your say on the issue here.

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