Mon, Oct 31st 2022
Today marks the one-month countdown until Swiss residents are locked into their current health insurance plans for the year – some of the best, but also most expensive plans in the world. Our writer, Annabel Beard, takes a deeper look at the complicated world of Swiss health insurance.
More money, more problems: Swiss residents pay 50 percent more than their neighbors for meds.
The lowdown on Swiss healthcare
The Swiss healthcare system provides excellent medical coverage. So much so, that it ranks first in the World Index of Healthcare Innovation out of 31 countries. Swiss health care offers unconventional therapies and medicines that are often considered atypical under other health plans. For example, mental health counseling, massage, acupuncture, medical cannabis, and even physician-assisted suicide are all available via a prescription pad. However, good service comes at a price – Swiss health costs regularly rank in the top three most expensive in the world.
Unlike its European neighbors, Switzerland enforces standardized health insurance via private insurance companies. Every citizen of Switzerland is required by law to take out a “basic” health insurance policy – a policy that is the same for every person – but is offered by one of many, different health insurance companies.
Rates are calculated on gender, age and place of residence. When choosing which provider to go with, aside from price, other factors include the rapidity of reimbursement, the level of customer service provided, languages spoken, and general reputation. Once the health insurance contract is signed, one can only change their provider again on November 30th. On average, only 10 percent of Swiss residents go through the arduous process of changing health insurance providers for the following year.
Swiss voters in 2009 approved a measure to have compulsory health insurance cover alternative medicine and therapies such as massage and acupuncture.
Why is Swiss health insurance making headlines?
The findings from a recent Tamedia Survey show that the rising cost of health insurance is the number 1 concern across all populations and political parties in Switzerland. While annual premiums have consistently risen over the last 10 years (with the exception of 2021), for the first time there is talk of a double-digit percentage increase.
Residents of Ticino are expected to experience the greatest increase in monthly payments. Those in Neuchatel, Geneva, Vaud and in Suisse Romande are also expected to feel the impact. According to Swiss law, firms are not allowed to make a profit from basic health insurance. However, as costs rise, insurers have overall bottom lines to protect. It’s estimated that rates must increase by 5.4 percent at a minimum to cover increasing costs.
How Switzerland dealt with the Covid-19 pandemic is the number one reason health care costs have increased in recent years.
How did Swiss healthcare become even more expensive?
For perspective, from 2015 to 2020, healthcare costs increased at an average of 2.3 percent per person annually. In 2021, costs jumped by 6.4 percent. This year and the next are expected to bring 4 percent increases each. So where are the additional costs coming from? The Covid-19 pandemic for starters.
Over the past two years, the Swiss government ensured that health insurance premiums were protected from steep increases. In fact, in 2021 they were even decreased (by 0.2 percent) for the first time in 14 years. Now, due to a backlog of treatments that were postponed while COVID patients were prioritized, those seeking treatments are paying more than ever before. And while the vaccination rollout supposedly reduced the number of patients being treated in hospitals, the rollout itself was an additional unexpected cost.
The second cause is the high price of medications in Switzerland. For reference, generic drugs cost nearly 50 percent less in other European countries. (Read more: In the land of pharma, why the Swiss turn to natural meds).
Christoph Kilchenmann of Sante Suisse explained that insurance “premium payers spend much too much on medicines, which has a direct repercussion on rising premiums.” There are calls for Switzerland’s parliament to introduce limits to cap prices as it is claimed that Swiss consumers overspend by CHF 750 million. In fact, between 2010 and 2020, drug prices rose by nearly 37 percent in Switzerland.
In addition, the cost of basic health insurance increased at three times the rate of GDP over the same period. A lack of generic drugs, excessive margins, and inflated factory prices were found to be the main causes. It is no wonder then, that healthcare remains at the top of voters’ interests across the political party spectrum.
A birthing room at one of Geneva’s private clinics. This level of health care requires supplementary health insurance. (Read more: What it’s like giving birth in Switzerland).
Why do rates vary by canton?
Switzerland empowers cantons to make independent decisions through the federal government set up. In this instance, each canton differs in the economic strategy it has adopted to finance the health care system which leads to different levels of equity among them.
In addition to the cantonal decisions, large cantons can be classed as “premium” cantons. Essentially, the Federal Department of Home Affairs (FDHA) divides larger cantons, within which costs vary widely, into two or three premium regions. The FDHA also ensures that the price differences between the premium regions of a canton remain within a fixed percentage. Between Regions 1 and 2, there is a cap of 15 percent. Between regions 2 and 3 there is a cap of 10 percent. Ticino and Vaud are each made up of two premium regions, which will also make them susceptible to the additional price increases.
Where it hurts: Living in a ‘premium’ canton like Zürich or Geneva means higher health insurance costs.
Where do we go from here?
The Federal Internal Department (FDI) are currently reviewing the prices charged for each and every laboratory analysis. Once complete, this audit should save 140 million CHF each year. However, with a conclusion not expected before 2025, laboratory testing prices have been temporarily reduced across the board by 10 percent.
Other measures are less reassuring. As of July first, it is no longer possible to check vitamin D levels under the basic health insurance policy (aside from certain exemptions). In the canton of Vaud, this simple blood test now costs an individual 74 CHF. But it is saving the government a cool CHF 30 million CHF.
If the Federal Office of Public Health is choosing to refocus on cure rather than prevention for the sake of budgetary requirements, will Switzerland’s high standard of healthcare be maintained?
With a likely spike in COVID and flu cases as we head into the winter months, it remains to be seen how the next chapter of Swiss healthcare unfolds. As for the percentage of individuals who choose to change health insurance policies this year, that is one figure which should be increasing.
To change your health insurance policy by 30th November, download a template cancellation letter from Comparis.
This article may be freely shared and re-printed, provided that it prominently links back to the original article.
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