Calls for savings do not fall silent after No to the cost brake initiative
Published: Sunday, Jun 9th 2024, 19:00
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The Federal Constitution does not include a cost brake in the healthcare system. After the clear "no" to the cost brake initiative of the center party, other recipes for curbing rising health insurance premiums must now be found.
On Sunday, a total of 62.8% of voters rejected the popular initiative "For lower premiums - cost brake in the healthcare system (cost brake initiative)". The turnout was 45.4 percent.
A look at the voting map showed a linguistic divide. Four cantons in French-speaking Switzerland and Ticino supported the cost brake initiative. In the German-speaking part of Switzerland, all cantons rejected the initiative - with 60 percent and more voting against.
The No to the initiative came as no surprise. The approval ratings had recently plummeted in various surveys. The starting position for the proponents was difficult from the outset: the centrist party was only supported by the health insurance association Santésuisse and the small parties EVP and EDU.
Initiative wanted to put pressure on
The popular initiative "For lower premiums - cost brake in the healthcare system (cost brake initiative)" demanded government measures if the contributions for health insurance premiums had risen more than wages and gross domestic product in one year. The text of the initiative left open what measures should have been taken.
The centrist party claimed that several savings proposals in the healthcare system have long been known. In order to finally change things and stop the explosion in premiums, pressure from a popular initiative is now needed. Targeted measures could save up to six billion francs a year without any loss of quality.
Fear of two-tier medicine
The Federal Council, cantons and most players in the healthcare system recognize the importance of cost containment in the healthcare sector, but rejected the initiative. Opponents argued that the cost containment initiative would jeopardize good, modern care for all. It ignores the fact that some of the cost growth is justified and results from the ageing population and medical progress.
Opponents also warned of a reduction in services if the initiative is accepted. They spoke of the threat of two-tier medicine. In addition, the working conditions of healthcare staff would deteriorate.
New cost targets
The opponents of the initiative stated that no new constitutional article was needed to adopt cost-cutting measures. The counter-proposal adopted by Parliament, which is now coming into force, is sufficient.
In future, the Federal Council, in consultation with healthcare stakeholders, will determine every four years how much the costs of compulsory health insurance may increase at most. The players in the healthcare system must first justify why and how much the costs per area will increase.
The cantons can also set their own cost and quality targets, taking into account the guidelines of the Federal Council and consulting insurers, insured persons and service providers in advance. A commission for cost and quality monitoring will monitor the development of costs and make recommendations to the federal government and the tariff partners on suitable cost containment measures.
Recipes on the table
Further proposals to curb the rise in costs are needed quickly, said Health Minister Elisabeth Baume-Schneider on the evening of the referendum Sunday. "The population expects measures against the rising premium burden - and rightly so." Unnecessary services and duplication must be eliminated.
"I urge all stakeholders: Take your share of the responsibility and submit concrete savings proposals that are acceptable to a majority," said Baume-Schneider. She announced the next round table on curbing healthcare costs for the fall.
The list of ideas for curbing healthcare costs is long. However, several reform packages have either failed or been watered down by parliament in recent years.
©Keystone/SDA
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