The guests –
EFAS, or the disengagement of the cantons from their elders
The two Vaudois co-presidents of Avivo explain why they are opposed to the reform of uniform financing of care.
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Today, no one is unaware that the main components of health are associated with personal, social, economic and environmental factors. Social factors thus designate the conditions in which individuals are born, grow up, work, and then age.
The economic factors are for their part, and in the case that interests us, those elements which will allow the same individuals, of their own free will or against their own will, to promote or on the contrary restrict, their chances of benefiting from a good health. The level of training, access to work, income, access to housing, poverty, unemployment, influence health, and for certain people, guide or determine the choice of benefits.
No one is anymore unaware that the demographic evolution of our industrialized societies is moving towards an aging of the population. In 2023, Switzerland will have 1.2 million people aged 65 to 79, and 503,000 aged 80 and over.
In the canton of Vaud, the proportions rise to more than 99,000 for the first, and almost 43,000 for the oldest. If in recent years life expectancy and the number of years of healthy life have increased for the entire Swiss population, we also note that half of people over 65 suffer from chronic illnesses, and that from the age of sixty, the number of hospitalizations (general care, specialized psychiatric clinics, rehabilitation) increases both for men (up to 70-74 years) and for women (up to 80-84 years), before dropping again.
EFAS (for Uniform financing for outpatients and inpatients) unfortunately says nothing about the components of health, or the demographic evolution in our country. It only targets a major modification of the LAMAl: the uniform financing of healthcare services.
However, what is being discussed in this reform risks first of all, and very clearly, causing the cantons to disengage from financing hospitals, care for the elderly, and outpatient medicine.
Secondly, by handing over to health funds the responsibility for managing these services, as well as the money that comes from them (through a new funding distribution key), without any control or monitoring, this reform could have serious consequences. consequences for the population in general, and the most vulnerable in particular.
Indeed, insurers could either increase premiums or reduce the provision of care, to reduce their costs – this leading to a major loss of previous social and health gains.
Evolution of needs
Taking into account demographic prospects, technological progress in medicine, and the resources available to our country, the idea of adapting models of care (including their financing) for people with health problems – particularly through chronic diseases – is not without interest.
Indeed, from stationary to outpatient, through the use of mobile structures or emergency devices, home care, or in institutions, the needs of the population in terms of health services are evolving.
But the adaptation of care methods, and their financing, cannot be done either at the expense of patients, nor at the expense of health professionals. Because if this reform is accepted, it is they, we, who will have to pay the price – insurers only seeking profitability, or even profit, with this new model.
It is for all of these reasons that Avivo recommends voting no to EFAS on November 24.
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