Where I see a massive possibility to safe money and at the same time increase the quality of treatment would be to decrease the numbers of hospitals in the country. There is real world evidence from Denmark that a concentration of hospitals increases the quality of the treatment (as medics get more routine in treatments) and lowers the overall cost significantly.
Denmark at a similar size/population (arguably with a different geography) has only about 50 hospitals where in Switzerland there are more than 250 hospitals. The >250 hospitals is insane and comes from previous times where the mobility between valleys was way harder than it is nowadays.
Every proposed closing of a hospital unit is fought hard, which is maybe understandable from a convenience perspective but financially it does not make sense to have some many hospitals all doing more or less the same treatment.
At some point we need to face this or stop complaining about the price increase.
During those times, when the mobility between valleys was an issue, the population here was probably less than half what it is today. Now we have easier movement around the country but the population is much higher.
I don’t see how reducing hospitals would really be of a benefit. Sure it might bring down costs but you’d end up with UK-level waiting lists, and a sicker population.
Major savings could be easily made by eliminating duplicated organisations, IT systems, marketing and PR, management structures, call centres, claims processing and regulatory infrastructure not to mention the mega salaries and bonuses the CEO‘s of the individual Krankenkasse‘s ‘earn’.
How can such high salaries be justified? Especially a salary increase of 200,000 Swiss francs? Helsana spokesman Tobias Lux says the increase is “closely linked to the company’s positive performance.” The number of people insured under basic health insurance has increased “significantly,” and the supplementary insurance business has grown by around 100 million to 1.4 billion Swiss francs. Helsana pays “attractive, but clearly market-based salaries” at all levels of the company.
Baptiste Hurni, the Social Democratic Party (SP) member of the Council of States from Neuchâtel, is angered year after year by these high wages. He finds it intolerable that basic health insurance premiums contribute to paying exorbitant salaries. “Greed is the reason for these excessive increases. It’s as simple as that.”
I remember watching this documentary, focus on the first 5 mins, the story of the “mountain doctor”:
Just wondering about how many consultations per day (efficiency) and costs. But sustaining mountain villages is part of national pride, lots of people dream about living like this, so careful with comments about efficiency and costs.
Part of the problem is the Cantonal organisation. AFAIK, about 50% of health costs are met from the Cantonal tax take and 50% from health insurance premiums with a small percent being direct patient payments.
There are more insurance companies than required for healthy competition. Efficiency would require fewer bigger hospitals but no town wants to lose their local facility. Add on to this the federal regulation and the system gets very complicated, but is there any data to back up the claim that the Swiss system is more bureaucratically inefficient than other systems?
There’s also the documented fact that people with a low franchise, or any franchise, but especially a low one, who, once the franchise amount has been used up, visit the doctor as many times as they can in the remainder of that year - to get their money’s worth.
I had to see a specialist the other day and he said that a suprising amount of people who went to see him had absolutely nothing wrong with them.
I think there’s some truth to this but it might be because older people tend to have lower franchises (at least the older people I know - always banging on about their doctor visits) but younger and healthier people have higher franchises because it lowers their premiums.
For me, a low franchise makes no sense because I can’t justify the higher premiums as I’m never really sick (touch wood). It wouldn’t even enter my head to go to a doctor for a jolly with nothing wrong with me. Obviously I go for the obligatory lady-checks but otherwise I’d rather stay away from the doctor.
The same could be said about any industry with multiple major suppliers that sell to the consumer. From retail over fuels to construction, to name just a few. Heck, even the cantons themselves compete with one another.
But I’ve yet to see people make claims like yours in these industries and sectors. Let alone cantons, quite the contrary, people want to reign in the most successful ones.