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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