Cost brake initiative: the most important facts about the proposal in brief
Published: Friday, Apr 5th 2024, 10:10
Updated At: Sunday, Jun 9th 2024, 05:00
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Today, Sunday, the people and cantons will decide on the popular initiative "For lower premiums - cost brake in the healthcare system (cost brake initiative)". The initiative was launched by the Center Party. Here are the most important facts about the proposal in brief:
The initial situation
Over the past ten years, the costs of compulsory health insurance have risen by around 31 percent, while wages have only increased by around 6 percent in the same period.
There are several reasons for the rise in healthcare costs: Firstly, the number of older people is increasing and with it the number of chronically ill people who need more medical treatment. In addition, medical and technological advances can increase costs because there are more and better treatment options and these are also being used more.
There is also duplication, misguided incentives and inefficient structures in the healthcare system, which lead to many treatments being carried out that are not medically justifiable. The federal government estimates that there is potential for savings of several billion francs here. However, several reform packages aimed at curbing the rise in healthcare costs have either failed or been watered down by parliament in recent years.
This is what the initiative
The referendum calls for the introduction of a cost brake in compulsory health insurance and wants to resolve the reform backlog.
If the increase in average costs per insured person and year in compulsory healthcare insurance is more than a fifth higher than the increase in nominal wages two years after the initiative is adopted and the tariff partners - i.e. cantons, hospitals, doctors, health insurance companies and the pharmaceutical industry - have not taken any measures by this time, the federal government and cantons must decide on cost-containment measures.
The measures must take effect in the following year. The extent to which costs may rise in the longer term must be determined by parliament in the law. The exact form of the cost brake and the measures with which the federal government and cantons are to curb costs are not specified in the text of the initiative.
The initiative committee/the supporters
The centrist party submitted the cost brake initiative in 2020. In order to finally change things and stop the explosion in premiums, the credo was that pressure from a popular initiative was needed now. The centrist party claimed that several cost-saving proposals in the healthcare system had long been known.
These include, for example, medicines that are too expensive. These sometimes cost five times as much in Switzerland as abroad. This amounts to CHF 400 million per year for premium payers. According to the initiators, a further billion francs could be saved each year by increasing outpatient treatment instead of inpatient treatment.
"With the cost brake, we are putting pressure on people to finally take action," says the centrist party. All stakeholders must take responsibility for the development of costs. False incentives and cost drivers in the healthcare system should be tackled structurally.
The opponents
The Federal Council, Parliament and the cantons recognize the importance of cost containment, but reject the initiative because linking the braking mechanism exclusively to economic and wage trends is too short-sighted and too rigid. Furthermore, the cost brake does not take into account factors such as the ageing population or advances in medical technology.
Opponents would prefer the indirect counter-proposal adopted by Parliament, which would come into force if the initiative is rejected. This provides for the Federal Council, in consultation with healthcare stakeholders, to determine every four years how much the costs of compulsory health insurance may increase at most.
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 monitors the development of costs and makes recommendations to the federal government and the tariff partners on suitable cost containment measures.
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