Sickness premiums, a Swiss particularity which ignites the debate – rts.ch

Basic care is expensive for the population: nearly 500 francs per month per person, for services reimbursed by basic insurance. The bill represents a significant part of the household budget and increases from year to year.

Funding method

Every September, the population and the political world are choked at the announcement of increases in health premiums. The recurrence of these heated debates can be explained in particular by the financing system chosen three decades ago.

The UK model, which relies solely on taxes, is no fairer. The country probably has one of the worst health systems in Europe.

In Switzerland, care is largely based on contributions distributed evenly among its inhabitants, called premiums. Only the Netherlands has a similar system. Other countries have focused on taxation or social contributions, generally linked to salaries.

The liberal-radical national councilor Philippe Nantermod, who fights the capping initiative, believes that the Swiss exception must be preserved: “The current distribution of costs is not a problem. Health insurance is based on solidarity between people healthy and sick It is important not to tax everything The United Kingdom’s model, which relies solely on taxes, is not fairer. The country probably has one of the worst health systems in the world. Europe. The richest finance quality care out of their own pockets, the less fortunate benefit from poor services.

The socialist Pierre-Yves Maillard, advisor to the States who is leading this initiative, disputes this assertion: “We must compare comparable things. Switzerland is putting a lot of money into its health system and this will continue. The weight carried by families and the middle class is unfair. Some people pay up to 20% of their income in premiums and this without benefiting from care, since they cannot finance the part of the consultations that they have to pay out of their own pocket.

>> Read also: Would you take advantage of the initiative to limit premiums? Our calculator

Mandatory expenses

The burden borne by policyholders cannot be explained by higher mandatory costs in the Swiss system. Throughout Western Europe, basic health care is guaranteed by contributions imposed on the entire population.

According to figures from the OECD (Organization for Economic Co-operation and Development), this compulsory financing exceeds that of Switzerland in eight countries.

Thus, the resources requisitioned per capita in Germany are 25% higher. Due to the different sharing of the bill, the financial burden is less perceptible there than in the average Swiss household.

Modified balance

The initiative proposes to modify the sharing of the bill. She wouldn’t change him radically. If we stick to the OFSP scenario, capping charges would transfer up to 5 billion francs per year from our premiums to our taxes. This represents less than 10% of all mandatory costs.

Mandatory premiums would continue to finance the system much more than in other European countries. Philippe Nantermod admits that capping premiums would not completely change the situation. “On the other hand, it would have a catastrophic effect on the finances of the Confederation. It would also create a bad incentive for the cantons, like Geneva and Vaud, which poorly manage their healthcare system. They would benefit from cross-financing from the Confederation and other cantons.” As costs continue to increase, the share of taxes could also increase.

Nothing happens because premium increases are an easy solution, without the political world or pricing partners taking responsibility for them.”

Pierre-Yves Maillard does not believe that capping premiums will create injustice between cantons: “The part controlled by the cantons, the stationary [les soins lors des hospitalisations, ndlr], was rather well mastered. Where there is an increase is in the outpatient department. The initiative will force the Confederation to take its responsibilities and negotiate with service providers. It is unacceptable that Tarmed [le système de rémunération des médecins, ndlr], which was deemed illegal by the Federal Audit Office 14 years ago, is still in force. Nothing happens because premium increases are an easy solution, without the political world or pricing partners taking responsibility for them.”

The elected official therefore hopes that, in turn, the initiative will influence the other aspect of this problem: health increasingly weighs on the economy. Like Switzerland, many countries spend more than 10% of their GDP to finance medical care: France, Germany, Austria, not to mention the United States, far ahead of all the others.

Whatever the financing method chosen, this growing bill increasingly eats into household budgets.

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Tybalt Felix