Council of States wants to relax compulsory contracts for health insurance companies
Published: Thursday, Sep 26th 2024, 10:40
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The contractual obligation between health insurers and doctors and hospitals is to be relaxed in the outpatient and inpatient sectors. The corresponding amendment to the Health Insurance Act (KVG) is intended, among other things, to counteract the rising costs in the Swiss healthcare system. This is what the Council of States wants.
On Thursday, the small chamber adopted a corresponding motion by Peter Hegglin (center/ZG) by 30 votes to 12 with one abstention. The Council thus followed the majority of its Social Security and Health Committee (SGK-S), which recommended that the motion be adopted.
Today, health insurers are obliged to conclude a contract with every licensed service provider. Only formal criteria are relevant for approval. In reality, quality and cost-effectiveness therefore only play a subordinate role, said Hegglin as majority spokesperson for the SGK-S.
Better supply expected in the periphery
Existing oversupply or inefficient services are irrelevant for inclusion in a collective agreement. The cantons are also reluctant to use the means of admission control for the distribution of doctors. The fact that the majority of service providers are free to choose their location leads to concentrations in urban regions and an undersupply in rural areas.
"With freedom of contract, insurers could contribute to better care in peripheral areas," said Hegglin. According to the model of the Federal Office of Public Health (FOPH), where there is overprovision, the obligation to contract should be relaxed. Ultimately, this would strengthen competitive incentives to practice in areas where care does not exceed the maximum numbers, explained Hegglin.
Hospital planning in the cantons is also subject to great political pressure. As a result, there is only selective cooperation between the cantons. Many hospitals do not reach their minimum number of procedures, which has an impact on the quality of treatment.
End of free choice of doctor feared
A left-green minority in the small chamber opposed the proposal on Thursday - as did Federal Councillor Elisabeth Baume-Schneider - without success. "With this motion, it will no longer be the cantons or patients who choose who gets the money from taxes and premiums, but the insurers," said minority spokesperson Pierre-Yves Maillard (SP/VD).
Acceptance of the proposal would lead to the end of free choice of doctor for patients. However, this choice must remain with the patients, as the relationship between doctor and patient has a major influence on the quality of treatment. In addition, instead of 26 democratically legitimized cantons, the 60 private insurers would be responsible for hospital planning in Switzerland, Maillard continued.
The next step is for the National Council to decide on the motion.
©Keystone/SDA
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