The cost of healthcare has doubled in the last 30 years and keeps rising. As a consequence, it has become a question of affordability and now - ahead of the June initiative - we see a majority of Swiss supporting a change from a per capita model to income-linked financing.
What can be done to get the cost under control? I appreciate we are getting older, so I am not looking for an absolute reduction of cost but rather for ways how to slow down the rate of increase?
What is your view on the financing side? I would hate if insurance premiums became linked to income as we would clearly have to pay more. I also don’t see how people with higher incomes create higher cost, it is probably the other way around.
This year I have chosen for the first time a telmed insurance model where I have to call the insurance before going to a doctor. It offers a slightly lower premium as there is an expectation that this way the can avoid unnecessary doc visits. I chose it to get to go to a specialist immediately without having to go to the general practitioner first. But I doubt this will in the end be much cheaper from an insurance perspective. I went to have my knee checked recently because of some pain. The doc gave me 4 different meds - 2 of which were the same really only that one was a spray and the other a balm …
They can as well “nationalise” it and make it into a public health care system as this proposal of linking the costs of your health care with your income is a total BS when operating with a private system. That majority of Swiss who approve of this change are living on the French side, I can bet on it.
There is no regional split of the poll, only by party affiliation. But yes, I would expect that support of linking to income will be particularly strong in the French part.
Funny enough we voted on that a few years back and it did not pass. But I wonder if with the recent increases, this vote would have a different outcome.
I think for the basic insurance, having so many providers cannot but increase the cost and I don’t buy in competition as they are all just increasing. If you think that every provider has a management team, a system (app/website) to manage, contracts etc, it seems obvious to me that having less players would reduce costs. Let insurances battle for the extra coverage.
The issue is also that the costs are spread amongst so many different players and they are all increasing their costs but there is not one player to blame. Hospital say “we are only x% of the issue”, pharma companies the same and so on.
The vote in June will allow citizens to decide whether there should be a cap of max 10% of income as a price as well as if health insurance should only be allowed to increase costs related to inflation/cost of life increase.
I am in favour of both with a cap on it as cannot expect high salaries to pay 10% of income (on top of financing the AHV for everyone and already paying a lot more in tax etc - sooner or later the wealthy will start looking to go elsewhere…). So let’s see!
I think it depends on the income. A family of 4 with one earner at 60k needs that cap. If it becomes “everyone pays 10%” then it’s way too much and out of control…
There was a report done on heath services around the world (I mentioned this on EF).
There are three facets to healthcare:
The quality of the actual healthcare - Switzerland scores very highly here.
The cost to the consumer of the healthcare.
The cost efficiency of the healthcare - Switzerland scores extremely low here. The healthcare is extremely inefficient with regard to bureaucracy amongst the worst in the world.
If you want to keep the standard of healthcare, and keep current premiums then, IMO, it would make sense to scrap the multitude of insurance providers and just have one, government run one.
This would remove so much of the bureaucratic payload.
In a country where self-responsibility is a favourite saying of the locals, I would act on that and give people premium reductions for healthy lifestyles and premium hikes where they choose to smoke, drink excessively, eat too much and not take enough exercise.
There are ways this could be measured which could be speedy and cheap given current technology.
Government run insurance providers doesn’t sound like a good solution to me. If everything, there will be more bureaucratic payload…not less!!! I don’t trust the govs to run efficiently so many funds. And there will be less of what it makes Switzerland…well - Switzerland. Currently there is a very good balance between state/public and private.
my $0.02, if they ask me to pay 10% of my income, bye bye Swiss alps, cows and buenzli’s. Secondly the Swiss health care in my experience is the worst I’ve ever encounter. I have to pay a lot for nothing… state run healthcare is useless, but if it’s provided the private health centers have to compete with it in guality and costs, so it doesn’t cost much to have premium healthcare. Here they love to screw you, give you placebo, send to a unnecessary checkups, everything to milk the money but not help you.
No denying there is waste in the system but…
Treatments are getting better and more expensive. In Switzerland drugs, scans and treatments are available that are not ( as easily if at all) available under health schemes in other countries. This is a major factor in the increased expenditure, not just the ageing population.
The principal of linking premiums to income or wealth is the same as for all the progressive taxes - it is the basis of a social system that has served us very well.
Honestly, I was impressed by the tax, social support, and direct democracy when I came to this country “naked” financially. However many years later, I can see that this country is just milking me as any other. I definitely won’t stay here for retirement, there are much nicer countries which would cost me less per year to sustain quality life.
By the way, I believe that Switzerland should turn into public health model. If you look at the insurance premiums, they follow the taxes, just compare the premium from Zug with premium from Neuchâtel, nothing changes in the costs of the health care providers, it’s just the tax mismanagement. Ironically, people in Neuchâtel earn much less than people in Zug.
I can’t get on board with single payer since I’ve seen the problems the UK and Canada have with wait times to get appropriate care. Competition can be useful. One way to immediately lower costs (albeit by a little) is to get rid of the medikamenten and bezugs checks that the pharmacy charges everyone. That’s about 8 Francs per medication. Also some of the taxes. I received another laboratory bill recently, and the tax was higher than the actual lab cost!
I bought that too (that competition lowers prices) a few years back when we voted. But now a few years later and the premiums keep on rising and the payout keeps on lowering - so this is obviously not working.
