VPOD union fights against health financing reform
Published: Friday, Jan 12th 2024, 11:10
Updated At: Friday, Jan 12th 2024, 11:10
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The Swiss Association of Public Service Employees (VPOD) is against the fundamental restructuring of healthcare funding. On Friday, it launched its referendum campaign against a bill passed by parliament in December.
The aim of the so-called monism proposal is to finance outpatient and inpatient healthcare services from a single source in future. Today, outpatient treatment is paid for by the health insurance companies alone, from premium money. At least 55 percent of inpatient services are covered by the cantons. The rest is paid by the health insurance funds.
At the end of the winter session, Parliament clearly approved the "Uniform financing for outpatient and inpatient care" (Efas) package - the National Council by 141 votes to 42 with 15 abstentions, the Council of States by 41 votes to 3 with 0 abstentions.
Immediately afterwards, the VPOD trade union announced a referendum against the bill. It has now officially launched its campaign to collect signatures. The referendum deadline is April 18.
"I am very worried"
Opponents of the bill argue that it is dangerous for nursing staff, the quality of care and for the insured. The reform would shift power away from the cantons and towards the health insurance companies. In future, they will manage eleven billion francs of taxpayers' money and determine who receives money for care services and operations.
"The health insurance companies, and therefore the premium payers, will now have to pay 73.1 percent of all costs, the lion's share," VPOD Central Secretary Beatriz Rosende told the media in Bern. Viviane Hösli, Central Secretary for Health at VPOD, concluded that Efas therefore threatened to increase premiums and cost sharing even more.
This will further increase the cost pressure in the entire healthcare sector. "I'm very worried," said nursing specialist Deniz Killi. Many of her colleagues have paid for the increasing cost pressure in recent years with greater commitment and stress.
This is also reflected in the consistently high number of people leaving the profession. Increasingly, there are situations in which the needs and safety of patients can no longer be guaranteed.
Doubts about the usefulness of the template
Cristina Vais, a healthcare specialist, also pointed out the precarious conditions in the nursing profession. "Insurers are putting staff under enormous pressure to work even faster." The Efas proposal will give the health insurance companies additional weight. This represents "an enormous risk for the population, patients and healthcare staff".
The proponents of Efas argue that the bill could reduce healthcare costs by treating as many sick people as possible as outpatients rather than inpatients. Nursing specialist Friederike Flückiger doubts this. "In reality, it's not about any savings, but only about a different distribution of costs in favor of the private sector."
For him, it is clear that public healthcare must be financed socially via taxes in particular and not via the per capita premiums of health insurance companies, said nursing specialist Heinz Lanz. "This is the only way to ensure that everyone contributes to the valuable asset of a public healthcare system according to their means."
The opposite is happening with Efas, said Geneva SP National Councillor and VPOD President Christian Dandrès. "Santésuisse estimates that the additional share of costs covered by compulsory health insurance will amount to ten billion francs by 2040."
VPOD seeks allies
The monism bill was debated for 14 years. In the end, the majority in parliament spoke of a workable compromise that had been found.
Accordingly, the cantons should now pay at least 26.9% and health insurers a maximum of 73.1% of service costs through premiums. Insured persons must continue to pay a specific contribution for long-term care services, whether outpatient or inpatient. The cantons can assume the contribution.
It is not yet clear whether other groups besides VPOD will oppose Efas. According to Dandrès, various talks are currently taking place.
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