Slowing down the rise in premiums and strengthening care: both

Currently, health services covered by compulsory health insurance (AOS) are financed differently depending on the type of treatment:

• For inpatient services (in hospital with overnight stay), the patient’s canton of residence contributes at least 55% of the costs. This participation is financed by taxes. The balance is covered by the health insurer.
• Regarding the outpatient sector (doctor’s office, therapist or hospital without overnight stay), the services are covered in their entirety by the AOS.
• Finally, third type of care, long-term care (EMS and home care), 54% supported by insurers and 46% by the canton or municipality of residence.

According to figures from the Federal Office of Public Health, for the year 2022, the costs of AOS services cost 44 billion francs distributed as follows: 23 billion for outpatient, 15 billion for stationary and 6 billion for long-term care.

Without the reform, insurers paid out 32.99 billion francs. The cantons, 11.01 billion.

With the reform, insurers’ expenses would have amounted to 32.16 billion compared to 11.84 for the cantons. Which means that the difference would therefore have been 826 million, payable by the cantons.

The committee says that with the reform, the canton will increase its spending by such an amount each year. According to him, it is the costs of policyholders, and therefore the premiums, which will drop by 14 million francs for the canton of Valais.