Cost brake initiative rejected according to trend calculation
Published: Sunday, Jun 9th 2024, 12:20
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The Federal Constitution does not include a cost brake in the healthcare system. According to trend calculations by the research institute gfs.bern on behalf of the SRG, the corresponding popular initiative by the Center Party was rejected. Cost targets will come into force instead.
The No to the initiative comes as no surprise. The approval ratings had recently slumped 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. "The population is of the opinion that the healthcare system is no longer capable of reforming itself," said Center Party President Gerhard Pfister during the referendum campaign.
He pointed out that the online comparison service Comparis had recently forecast a further average premium increase of 6 percent. This is well above the long-term average of 3.8 percent. "Targeted measures could save up to six billion Swiss francs a year without any loss of quality," said Pfister.
Fear of two-tier medicine
The Federal Council, cantons and most healthcare stakeholders recognize the importance of cost containment in the healthcare system, but rejected the initiative. Among the major parties, representatives of the SVP, SP, FDP, GLP and the Greens are involved in the "no" committee. The Professional Association of Nursing Staff and the General Practitioners' Association were also against the initiative.
Opponents argued that the cost brake initiative would jeopardize good, modern healthcare for all. They argued that 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
The list of ideas for curbing healthcare costs is long: a functioning electronic patient file, national hospital planning and the capping of certain tariffs were repeatedly mentioned in the referendum campaign.
Both supporters and opponents of the cost brake initiative stated that pharmaceutical prices and unnecessary treatments by specialists must also be addressed. All stakeholders must take responsibility for the development of costs.
Several reform packages have either failed or been watered down by parliament in recent years.
©Keystone/SDA
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