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HEALTH

Why Swiss patients pay too much for healthcare

Switzerland is an expensive place to live - and that includes healthcare costs. But a new report has revealed how doctors and hospitals are overcharging their patients on a regular basis.

Are you paying too much for healthcare in Switzerland? Photo by Online Marketing on Unsplash
Are you paying too much for healthcare in Switzerland? Photo by Online Marketing on Unsplash

Some doctors and hospitals in Switzerland overcharge their patients by either invoicing services that have not been provided or billing more than is necessary.

This practice is a problem particularly as health insurance premiums are expected to increase significantly in 2023 to reflect rising health care costs.

READ MORE: Why Swiss health premiums are set to rise — and what you can do about it

Swiss health insurers have confirmed that patients in Switzerland are charged three billion more than they should be each year by doctors and hospitals. 

Without these additional charges, healthcare premiums in Switzerland could be ten percent cheaper, estimate the country’s healthcare insurers. 

However, in order to do so, the system would need significant changes to ensure greater transparency. 

Cost gouging hard to prove

Matthias Müller, spokesperson for health insurance umbrella organisation Santésuisse, confirmed that certain doctors charge too much.

“We see this problem particularly in the outpatient care, where doctors can choose from numerous tariff positions”.

However, proving excessive charges is difficult, according to Felix Schneuwly, a health industry expert at Comparis price comparison service.

That’s because “patients do not sign a ‘work report’ for the medical services rendered”, so health insurance companies cannot check whether a service was provided at all and whether it was indeed necessary, Schneuwly said, explaining that an insurance company can only verify whether the quantities and costs of the services on the invoices comply with the law.

Patients also have very little power to prove that they have been overcharged, which effectively gives doctors and hospitals the freedom to charge more. 

Yvonne Gilli, of the Professional Association of Swiss Doctors (FMH) said that while they could not confirm whether these allegations were accurate, she was aware of instances where doctors had charged too much, although she reaffirmed that this “did not happen often”. 

FMH said there were 58 cases of overcharging in Switzerland in 2019, the last year before the pandemic, but that “Every doctor convicted in this regard is one too many”.

Schneuwly said hospitals and doctors should be required to produce “treatment reports” which would allow insurers to compare costs and the treatment provided. 

“(That way) the insurance companies can understand exactly which service was provided and for what reason.”

Müller notes that the same procedure can cost up to three times as much in different parts of the country and at different practices. 

As patients do not pay these costs directly they are less likely to question them, although they eventually pay more through their healthcare premiums.

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HEALTH INSURANCE

How Switzerland’s political parties want to curb surge in health costs

As voters in Switzerland are set to weigh in on two initiatives seeking to lower insurance premiums, the country’s politicians are proposing their own cost-cutting measures.

How Switzerland's political parties want to curb surge in health costs

On June 9th, the Swiss will cast their votes on two issues aiming, though in different ways, to curb the continually increasing cost of the obligatory health insurance (KVG / LaMal).

One calls for capping the insurance rates at 10 percent of income, while the other provides for a ‘brake’ on health costs, which should evolve according to the economy and wages.

READ ALSO: How Switzerland’s two crucial health insurance referendums could impact you 

Each initiative has its supporters and opponents, but regardless of what happens on June 9th, the issue of health insurance premiums, and health costs in general, will remain the focus of many political debates.

But while everyone in Switzerland agrees that health insurance is too expensive for most people, opinions on how to make it more affordable  differ along the political lines.

These are some of the main views, as reported by Swiss media.

Social Democrats 

The party that has spearheaded the ’10-percent of income’ initiative to be voted on June 9th, is also calling for scrapping of multiple private carriers  in favour of a single, government-run health fund.

The party argues that such a system would help keep the costs low.

Others, however, disagree, saying that lack of competition would have just the opposite effect: instead of reducing costs, it would increase them further.

They also point out that a private insurance system offers more choices  and provides a higher quality of services — including better access to specialists and shorter wait times for medical procedures —  than a public option.

READ ALSO: Could Switzerland ever change to state-run health insurance scheme? 

The Greens

The party has also spoken in favour of a single health provider, in addition to premiums based on income and wealth.

While the idea has gained support in some circles, others, including the Federal Council, have pointed out that the current system is “already income-based,” because low-earners are eligible for government subsidies if health insurance premiums exceed 8 percent of their revenue. 

The Greens also consider the fight against global warming as a health policy, saying that in Switzerland alone, more than 2,000 people die each year from diseases caused by air pollution.

Liberal-Radicals (PLR)

The party supports the system where patients voluntarily choose generic rather than brand-name drugs in return for lower health insurance premiums.

Under the current scheme, those who choose generics are only responsible for a 10-percent co-pay, while it is 40 percent for brand medicines. 

But “if policyholders can actually choose the model they want, we can definitely consider [this option],” said health economist Willy Oggier.

Swiss People’s Party (SVP)

Perhaps the most radical proposal comes from the party that is most right-wing.

Its proposal: the compulsory health insurance must be abolished altogether.

Not only is this idea drastic, but it is not implementable under the current law.

That’s because the current legislation is the outcome of the 1994 referendum, when voters accepted a general obligation for health insurance.

To repeal it, another referendum would have to be held, with the majority voting to scrap this law.

But even if the compulsory insurance were to be abolished, people would have to pay even more for health care, Oggier said.
 

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