Swiss university hospitals demand increase in tariffs
Published: Thursday, Nov 14th 2024, 13:00
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Swiss university hospitals are demanding higher compensation for their services. This is the only way to withstand the investment pressure from new construction projects, digitalization and the implementation of the care initiative. Without higher tariffs and stable prospects, highly specialized medical care threatens to become a pure cost factor.
Representatives of the university hospitals and medical faculties made it clear at a media conference in Bern on Thursday that they are under considerable financial pressure. Last year, all university hospitals posted negative annual results. The cumulative deficit amounted to 210 million francs.
"2023 was characterized by a massive shock to the hospital system, despite rising patient numbers," said Werner Kübler, President of University Medicine Switzerland and Hospital Director of the University Hospital Basel (USB). The situation is becoming more acute, which is why the decision was made to take action now.
At the same time, the pressure to invest is high, according to the press release accompanying the media conference. On the one hand, this is because new, modern buildings are needed. On the other hand, resources are also needed in connection with digitalization - specifically the development of the data infrastructure. Corresponding steps are also being demanded by politicians in order to increase efficiency.
There is currently no plan to specifically support the university hospitals in this area, said Antoine Geissbühler, Dean of the Faculty of Medicine at the University of Geneva and Director of Teaching and Research at Geneva University Hospital. Without support, the transformation will not be achieved.
"Existential questions" due to the care initiative
The investments mentioned are necessary, but are not reflected in the tariffs. This puts pressure on the hospitals and ultimately on the staff.
The second stage of implementing the care initiative is also a challenge. This involves improving the working conditions for nursing staff.
The university hospitals shared the goal of strengthening nursing, said their representatives. Paula Abromeit, Director of Nursing at the Insel Group in Bern, said that it was particularly important to keep more people in the profession and to avoid people dropping out of training. However, the financial viability of the planned measures still raises "big, existential" questions for her.
The university hospitals also emphasized their role in the training of doctors and nurses. Numerous specializations are located at the university hospitals. According to Kübler, university hospitals account for the majority of training in human medicine.
According to the communiqué, support is needed to maintain their attractiveness as training centers. This is particularly important because the demand for medical staff will continue to increase over the next twenty years.
Tariffs do not cover costs
According to the information provided, inflation and wage-related additional costs are responsible for last year's deficits. The university hospitals terminated the collective agreements with the insurers in the summer of 2023 and said they had achieved improvements. Nevertheless, the situation remains tense, they emphasized on Thursday.
Specifically, the university hospitals are demanding that their specific cost structure be taken into account.
Monika Jänicke, CEO of the University Hospital Zurich, criticized that the revision of the Health Insurance Ordinance would treat university hospitals the same as all other clinics. In reality, however, they would have to provide additional services, for example for people with severe burns.
The other hospitals do not have to provide an Ebola ward if required, Bernhard Pulver, Chairman of the Board of Directors of the Insel Gruppe, echoed this sentiment.
The situation in the outpatient sector, which is becoming increasingly important, is even more alarming. The tariffs there do not cover costs and have not been adjusted for twenty years. Only with a rapid increase could the expectations of the population be met. Otherwise, there was a risk of the tariff partnership being undermined.
"No progress without research"
The university hospitals also emphasized the great importance of the five university hospitals for medical research. In order for it to remain attractive to conduct research, the framework conditions must be defined correctly.
"Without the research carried out in our institutions, there would be no medical progress," Geissbühler was quoted as saying in the communiqué.
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