Opponents fear rising premiums due to Efas proposal
Published: Tuesday, Oct 1st 2024, 11:00
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Opponents of the bill for the uniform financing of all outpatient and inpatient healthcare services (Efas) started the voting campaign on Tuesday. The amendment to the Health Insurance Act passed by Parliament would result in a deterioration for the population. The inclusion of long-term care in particular would lead to a further increase in premiums in the long term.
These were the arguments put forward on Tuesday by the Swiss Federation of Trade Unions (SGB), the Swiss Association of Public Service Employees (VPOD), the Unia trade union and representatives of the Greens and SP. The VPOD had launched a referendum against the amendment to the Health Insurance Act (KVG) passed by Parliament in December 2023.
Due to the ageing of society, expenditure in long-term care (homes and Spitex) is increasing particularly sharply. It is precisely this expenditure that premium payers should increasingly contribute to in future, according to the media conference. This is because the current cost-sharing cap will be removed from the law as part of the amendment to the KVG.
"After a transitional period of four years, the Federal Council can continuously increase contributions, both for care at home and in nursing homes," said National Councillor David Roth (SP/LU). The bottom line is that this threatens a further increase in premiums in the longer term, as well as an increase in costs that patients will have to bear themselves.
Opponents fear "takeover"
Opponents also fear that the cantons would relinquish responsibility for care in nursing homes or through Spitex with the introduction of a nationwide, uniform financing key. "With Efas, in addition to the 35 billion in premiums, 13 billion of our tax money would be managed by private funds every year, without democratic legitimacy and without transparency," said SGB President and member of the Council of States Pierre-Yves Maillard.
If the cantons were to withdraw from responsibility for financing and organizing nursing homes and Spitex, the "red carpet" would be rolled out for private, profit-oriented players. According to opponents, the latter would be able to choose the most lucrative patients. At the same time, the insurers would have an interest in rationing basic care in order to sell more supplementary insurance. The losers would be all those with normal insurance.
In the view of opponents, the reform would allow health insurance companies to take control of the entire healthcare system. "The revision would result in a huge shift of power towards the health insurance companies and away from democratic control, but also away from medical decisions and the needs of patients," said Katharina Prelicz-Huber, member of the Green Party National Council in Zurich.
Pressure on carers and patients
A new standard tariff would have to be negotiated with the health insurance funds. Where this would come from is completely open. The only thing that is clear is that the public institutions, which already have to bear many additional burdens today, would come under pressure first and foremost.
"The quality of care would inevitably decline. People with high care needs would no longer receive the same level of care as they do today," said Natascha Wey, General Secretary of VPOD. For patients without expensive supplementary insurance, this would mean a deterioration in the quality of care.
According to opponents, carers would also be victims: The reform would in fact increase the pressure on nursing staff, in open contradiction to the care initiative adopted by the people. "The abolition of the existing funding mechanisms will increase the existing pressure on staff. The result will be an accelerated exodus of staff from long-term care," said Véronique Polito, Vice President of Unia.
Federal government hopes for cost savings
Federal Councillor Elisabeth Baume-Schneider argued in the Federal Council's Yes recommendation that the bill would ease the burden on premium payers. According to the Federal Office of Public Health (FOPH), uniform funding removes obvious disincentives, promotes outpatient treatment and helps to avoid unnecessary hospital stays.
The federal government is hoping for an improvement in the quality of care and cost savings. The referendum will take place on November 24. The Federal Council and Parliament recommend that the amendment to the KVG on the uniform financing of services be adopted.
©Keystone/SDA
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