Thunderclap in the Swiss health system. Many group practices and private medical clinics are in danger, following a recent decision by the Federal Court (TF). And, without them, hospital emergencies risk collapsing very quickly. Political agitation is therefore great at the moment, with elected officials from all sides making this issue a priority.
The threat to these medical structures comes from health insurance companies. They are now demanding millions from them. To understand, we have to go back to July. This summer, we announced to you, insurers had the TF recognize that the emergency tax, of around 40 francs, was often collected unduly. And, ultimately, it was no longer to be perceived in the future.
But the insurers did not stop there, “Le Temps” discovered. With the support of the TF, they are now demanding reimbursement of taxes paid by patients over the last five years (the legal maximum), when they were treated at night, on weekends or on public holidays. Depending on the size of the structure, the amounts claimed by each insurer represent tens, or even hundreds, of thousands of francs. Note that, for the moment, some insurance companies have not yet claimed anything.
For the umbrella organization SantéSuisse, there is no doubt, this colossal windfall must increase insurance reserves. But for national councilor Thomas Bläsi (UDC/GE), this is out of the question. In a motion tabled on Thursday, he demands that “the Federal Council intervenes and ensures that this tax is directly reimbursed to policyholders and not integrated into the reserves of the health funds which belong to them.”
Several threatened structures also spoke out in the media. Some explain that they no longer collect the tax, while others have not yet found a way to do without it. But when it comes to reimbursements, no one really sees how to raise such sums. A standoff has therefore taken place behind the scenes, with certain insurers having stopped reimbursing the tax, in cases where it continues to be invoiced. Please note that each insured person should also carefully check each of their invoices.
Only for real emergencies
When it was introduced in TARMED, the emergency charge was aimed at the GP who gets up in the middle of the night to go to their patient’s bedside. Or to the specialist we call on a Sunday, in the middle of a barbecue. However, it is now only for this type of case that it can be collected. In short, if it is written on the door of a private medical facility that it is open at night and on weekends, these hours are part of its normal operation. According to the TF, it therefore has no reason to collect an exceptional tax.
