On Tuesday, the Swiss National Council voted in favour – by a majority of 108 to 85 votes – to impose a mandatory charge on emergency room visits for minor medical conditions. 

The proposal will now go to the Council of States, where it is expected to be approved. 

While representatives in several cantons including Zurich and Bern have debated the measure, supporters have argued that it would be ineffective unless it was established at a federal level. 

Member content: What you need to know before taking out Swiss health insurance

Under the proposal, the rule will be adopted federally but individual cantons will decide whether or not the fee should be implemented. 

A 'personal responsibility' initiative?

Arguing that the move would improve personal responsibility and bring down overall healthcare costs, Thomas Weibel (Green Liberals) was behind the successful parliamentary initiative. 

Weibel suggested that the fee would encourage patients to consult their general practitioner before visiting the hospital, as family doctor consultations are significantly cheaper than emergency room visits. 

According to figures introduced into the National Council by Weibel, a visit to an emergency room costs the hospital CHF427, with GP visits costing less than half. 

Photo: Depositphotos

Supporters of the proposal also say that it would make hospital emergency departments more efficient, as they would be able to focus purely on actual emergencies rather than an array of non-urgent medical complaints. 

Weibel also said the move would make patients more aware of how much it costs hospitals when patients visit the emergency room. 

As The Local reported in the lead up to the October 2019 Swiss election, rising healthcare costs were one of the major concerns of voters in Switzerland. 

Have your say: What are the most important issues in the 2019 Swiss election

The devil in the detail?

While details remain relatively scarce, Swiss media is reporting that people who have been referred to the hospital by their doctors as well as people under 16 would be exempt from the new fee. 

Medical ailments considered ‘minor’ would be those which do not require a subsequent hospitalisation. 

The fee would be imposed regardless of the patient’s existing insurance coverage, meaning it would need to be paid in addition to any relevant deductible and would not impact monthly premiums. 

An uneven impact? 

Those opposed to the fee argued that it would be administratively difficult to implement and that it would lead to disputes.

They also criticised the lack of detail in the proposal, particularly the specifics surrounding which conditions would be deemed ‘minor’ and if any exceptions would apply. 

Yvonne Feri, of the Social Democrats, said that the costs of the new fee would be borne out by the poorest members of society – as well as those in rural areas. 

Speaking in parliament, Feri said “above all, the fee hurts the poorest, the elderly and the chronically ill.” 

“In the countryside, you often don't find a family doctor so quickly.”

p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; line-height: 14.0px; font: 12.0px Helvetica}
p.p2 {margin: 0.0px 0.0px 0.0px 0.0px; line-height: 14.0px; font: 12.0px Helvetica; min-height: 14.0px}
p.p3 {margin: 0.0px 0.0px 0.0px 0.0px; line-height: 14.0px; font: 12.0px Times; color: #0000e9; -webkit-text-stroke: #0000e9}
span.s1 {text-decoration: underline ; font-kerning: none}

A commission established to consider the proposal issued a non-binding rejection of the idea in April, arguing that the costs of introducing the fee would be disproportionate to the actual effect – and that the exceptions would be difficult to properly set.