“Higher premiums, lower quality care? No!”: opponents of the uniform financing project for outpatient and inpatient health services (EFAS) launched their campaign on Tuesday in view of the vote on November 24. According to them, the modification would cause a further increase in premiums.
The reform provides the same funding key for inpatient care (hospitals and EMS) and for outpatient care (medical practices, hospital outpatient services and home care). The cantons will have to pay 26.9%.
Currently, they finance inpatient services up to at least 55%, the rest being covered by health insurers. In the outpatient sector, services are covered 100% by compulsory healthcare insurance.
There would be nothing wrong with uniform financing in itself if it made it possible to lighten the burden on premium payers without making concessions on quality
The referendum is supported by the Swiss Public Services Union (SSP), the Swiss Trade Union Union (USS), the Unia union, as well as representatives of the Vert-es and the PS. There would be nothing wrong with uniform financing in itself if it made it possible to lighten the burden on premium payers without making concessions on quality, according to MP Katharina Prelicz-Huber (Les Vert-es/ZH) .
It is in fact not easy to understand why the outpatient sector must be financed solely by premium payers, without the participation of public authorities, she noted. However, EFAS will not keep its promises. The review will either lead to an increase in premiums or a reduction in benefits.
Long-term care
The referendums focused on the long-term care sector (EMS and home care). You don’t have to be a health expert to know that long-term care will continue to grow rapidly with an aging society and that this will have a severe impact on health insurance premiums, said National Councilor David Roth (PS/LU).
The reform plans to make greater demands on premium payers, given that the cost-sharing ceiling, currently in force, will be removed. The share financed by EMS residents or home care beneficiaries will also increase, added Véronique Polito, vice-president of Unia. The insured will therefore be doubly penalized, as payers of premiums and as recipients of benefits. She denounced a “transfer of the financial burden to premium payers”.
Private funds, without democratic legitimacy, without transparency, will manage the tax revenues of their citizens in their place.
With the reform, the cantons not only abandon responsibility for EMS or home care, but also effective planning and management in favor of the population, according to opponents. They would then pay 13 billion francs in taxes directly to health insurance companies.
“Private funds, without democratic legitimacy, without transparency, will manage the tax revenues of their citizens in their place,” declared State Councilor Pierre-Yves Maillard (PS/VD), president of the USS. Public authorities are ceding their sovereignty to private actors, added Natascha Wey, general secretary of the SSP.
A “red carpet” for health insurance
Patients who do not have expensive additional insurance risk seeing the quality of care deteriorate, according to opponents. The reform rolls out a “red carpet” for health funds, which will have an interest in “rationing basic care in order to be able to sell more complementary insurance”.
Underfunding of public hospitals will also increase pressure on healthcare workers, the referendum further argued. National councilor Christian Dandrès (PS/GE), president of the SSP, spoke of “contempt thrown in the face of the population”, while the people accepted the initiative on nursing care in 2021.
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