Council of States approves new package to combat rising healthcare costs
Published: Thursday, Jun 13th 2024, 12:50
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The Council of States wants to get a grip on constantly rising healthcare costs with increased coordination, confidential pricing models and cheaper medicines. It has adapted a corresponding reform package. However, not everyone is convinced of its effectiveness.
Four days after voting no to the premium relief and cost brake initiatives, the Council of States, as the second chamber, dealt with a further package to curb healthcare costs on Thursday morning. In addition to many smaller revisions to the Health Insurance Act (KVG), this is the third major reform package since a group of experts outlined dozens of measures to combat the explosion in costs in 2017.
However, several proposals have either failed or been watered down in parliament in recent years. There was also a consensus in the Council of States on Thursday that, in view of the sharp rise in premiums, it was essential to further reform the Swiss healthcare system with targeted measures in order to curb the growth in healthcare costs.
Criticism of the package of measures
Healthcare costs have tripled since the introduction of the KVG in 1996, said Health Minister Elisabeth Baume-Schneider in the Council of States. It was now time to move forward, said Flavia Wasserfallen (SP/BE). Meanwhile, Damian Müller (FDP/LU) called for a pause and an overall view with all stakeholders before further revisions are tackled.
However, many members of the Council of States do not expect any major leaps from the current cost containment package - even though it is also intended to implement earlier parliamentary mandates. Although individual measures could lead to savings, others would cause additional costs, noted Peter Hegglin (center/ZG).
Hannes Germann (SVP/SH) criticized the "mostly bureaucratic measures" - and, like Pirmin Bischof (centre/SO), urged the Federal Council to implement the new Tardoc tariff model instead. Baume-Schneider promised that the Federal Council would discuss this soon.
Potential to save millions on medicines
Commission spokesman Erich Ettlin (center/OW) calculated that the present package could save around 800 million francs according to the administration's estimates. "That's not nothing."
Half of the savings potential - CHF 400 million - relates to the price of medicines. In future, the federal government should be able to set volume discounts for medicines with a large market volume. According to Ettlin, this measure is aimed at a small number of established products which, however, account for a significant proportion of medication costs. This proposal has not yet been discussed by the Federal Council or the National Council.
Furthermore, the Council of States - in agreement with the National Council - spoke out in principle in favor of confidential pricing models for high-priced medicines. The administration has identified further savings potential of around CHF 200 million per year here. There are still differences between the Councils on the details.
Majority for coordination networks
According to the Council of States, further money is to be saved with the introduction of networks for coordinated care. The administration sees potential cost savings of around CHF 250 million per year here.
Compared to the Federal Council's proposal, however, the small chamber wants to specify the conditions for this. These networks are to be approved in a two-stage procedure. To make the networks attractive to insured persons, it should be possible to reduce the co-payment for their services.
The Grand Chamber was the first chamber to clearly reject the networks for coordinated care. There were also numerous critics in the Council of States who spoke of a "bureaucratic monster". However, the committee majority prevailed by 25 votes to 17 with 2 abstentions.
Pharmacies with more expertise
As a further addition to the latest cost containment package, the Council of States wants to instruct the Federal Council to limit the tax points that can be billed per day in the medical part of the outdated Tarmed tariff structure as of January 1, 2025.
The package also includes measures that will not result in a direct reduction in costs. During pregnancy, childbirth and the postpartum period, midwives will be able to administer medication without a doctor's prescription under certain conditions.
Pharmacies are also to be given more powers to prevent doctors from providing more expensive services. The digital insurance card is also to be equated with the physical card, thus promoting digitalization.
In the overall vote, the small chamber approved the package of measures by 39 votes to 4. The bill now goes back to the National Council.
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