Too harsh for some, not at all enough for others: the proposed tax for mild cases treated in the Emergency Department does not please anyone. And yet, still talking about a “tax” has become an abuse of language, as the basic idea, which was to make the people concerned pay 50 francs directly, has been modified to the point of only affecting a handful of patients ( read box).
“Ineffective” and with “a minimal deterrent effect”, this is the judgment of the UDC, which participated in the consultation which ends on January 10. The party would like a much stricter application with a direct tax of 50 francs for consultations for minor cases, but also a “doubling of the price for people for whom health insurance is entirely covered by the taxpayer”, as asylum seekers.
The umbrella organization for insurers Santésuisse was also in favor of the initial idea, namely the tax of 50 francs to be paid on site. But the chosen project, which ultimately only affects patients' co-payment once they have exceeded their exceeded deductible, is too bureaucratic for hospitals. “The goal should be for the patient to contribute directly financially to every minor case or unnecessary treatment,” the association writes.
Conversely, many people contest the very principle of overcharging mild cases in Emergency Departments, primarily the cantons. “A priori benign pathologies (chest pain, headaches) can turn out to be serious following the evaluation of emergency doctors, which is why a financial penalty should in no case dissuade consultation,” says for example the Vaud State Council, which also criticizes the fact that “this project does not take into account the proven difficulties of finding a treating doctor”.
If the project currently favored by the parliamentary committee in charge comes into force, very few patients will have to worry about a tax. Charging 50 francs directly to patients has been abandoned. All people sent to the Emergency Department by their doctor, a pharmacy or a telemedicine center will be exempt, as will pregnant women and children. The cases which would give rise to the tax would in fact operate as follows: the ceiling of the share, that is to say the costs to be paid after having exceeded its deductible, would be raised by 50 francs each time. However, as the FOPH noted, only 10% of policyholders in Switzerland reach the quota ceiling during the year.
