Eveline Widmer-Schlumpf supports the reform of the LAMal

Interview with Eveline Widmer-Schlumpf –

“Seniors are being exploited, we oppose it”

The former federal councilor, and current president of Pro Senectute, is involved in the voting campaign on the modification of the LAMal.

BotTalk

Ms Widmer-Schlumpf, why are you involved in the voting campaign against the amendment to the LAMal as president of Pro Senectute?

We see that seniors are being used in the counter-campaign. Opponents say EFAS has disadvantages for people in long-term treatment and that they are particularly affected by the reform. We cannot let this go, because it is wrong. Pro Senectute is committed to ensuring that elderly people can stay at home as long as they can and want, with the necessary support and care.

What does this have to do with EFAS?

The project strengthens the entire outpatient sector, as the cantons will contribute to these costs. The outpatient sector is essential for the elderly. Home care helps seniors remain independent and live at home as long as possible. We believe that EFAS has real added value in this area.

You say that EFAS favors staying at home. Is there real financial pressure for people to be moved to retirement homes when they want to stay at home?

Today, long-term institutional care is favored by health insurance funds for financial reasons. This encourages older people to move to a medico-social establishment rather than stay at home with increased support from home care. In EMS, more than half of the funding is provided by the Canton.

But opponents of EFAS warn. If long-term care is financed more by health insurance premiums, the pressure to provide services cheaper than today will increase.

I would first like to say a few words about EFAS. The reform will help curb the rise in health costs to the detriment of policyholder premiums. Indeed, outpatient medical treatments will continue to increase in the future compared to inpatient hospital treatments. In Switzerland, only around 20% of medical interventions are carried out on an outpatient basis, whereas abroad, this proportion is much higher. This rapidly growing trend, the transfer of medical treatments from hospital to outpatient settings, is inevitable in Switzerland too. EFAS requires the cantons to participate financially, thus reducing the burden on policyholders.

However, if care for the elderly must be largely covered by funds, insurers will push for it to be as efficient as possible. Won’t this be to the detriment of their quality?

No way. This is where the care initiative that needs to be implemented comes in. It requires good working conditions for nursing staff. On the contrary, I am convinced that there will be less demand if more people are cared for at home by Spitex employees or relatives. Retirement homes will therefore need fewer medical personnel.

For long-term care, a collective agreement will be required in the future to be able to bill the funds. Human presence in retirement homes will be measured in tax points and time units. This will put nursing staff under even more pressure.

The question of the collective agreement for long-term care must be discussed with or without EFAS. I do not think it is wise to mix all the questions that arise in this area with the discussion around reform. We must first resolve the question of financing with a uniform distribution key.

SantéSuisse, the main organization in the social health insurance sector in Switzerland, has opposed the increased financing of care by health insurance and is warning of a sharp increase in premiums.

I do not share his fear. Long-term care doesn’t weigh that much. Uniform funding will increase transparency and highlight hidden costs that remain in the system. This will help ease the burden on premium payers.

Discussions within the Chambers have lasted for fourteen years, mainly because the cantons only gave their agreement after the integration of care into EFAS. We therefore suspect them of wanting to reduce their financial burden and save money on long-term care. What do you think about it as former cantonal director of Finance and Minister of Finance?

I do not share this view, based on my experience. The cantons are directly responsible to the population and they assume their role. They will contribute to medical costs in the outpatient sector in the future. Overall, EFAS will allow more benefits to be financed with taxpayers’ money. We need to look at the system as a whole. If the cantons participate more, it is by design. As a result, it will be in their interest to manage the offer and development in the outpatient sector.