Efas vote: Eveline Widmer-Schlumpf advocates yes

Interview with Pro-Senectute President –

“Seniors are being used for the No campaign – we are resisting that.”

Former Federal Councilor Eveline Widmer-Schlumpf joins the vote on Efas. The reform enables people to stay at home longer thanks to Spitex care.

BotTalk

Ms. Widmer-Schlumpf, why are you, as Pro-Senectute President, getting involved in the voting campaign for Efas?

We notice that senior citizens are now being used for the counter-campaign. The opposition claims that Efas brings disadvantages for people in long-term care and that they are particularly affected by the reform. We cannot let this stand because it is simply wrong. Pro Senectute is committed to ensuring that older people are allowed to live at home as long as they can and want to do so with the necessary support and care.

What does this have to do with Efaz?

The Efas template will strengthen the entire outpatient sector because the cantons will also contribute to these costs. The outpatient sector in particular plays a major role for older people. Spitex care helps seniors to live at home independently and with a good quality of life for as long as possible. We are of the opinion that Efas brings a big improvement.

They say Efas promotes care at home. Is there really financial pressure today that people are being moved into homes even though they actually want to stay in their apartment?

Today, long-term care in a home is financially preferred by health insurance companies. This can lead to old people being encouraged to move into a nursing home instead of staying at home with more Spitex support. In the home, more than half of the financing is borne by the canton.

However, Efas opponents warn that if long-term care is increasingly financed through health insurance premiums, the pressure will increase to provide care more cost-effectively than today.

First I would like to say something about Efas in general. The reform will curb the increase in health care costs at the expense of premium payers. Outpatient medical treatment will continue to increase steadily in the future compared to inpatient hospital treatment. In Switzerland, only around 20 percent of medical procedures are carried out on an outpatient basis; abroad the proportion is much larger. This development, the shift in medical treatment from inpatient to outpatient, will also take place in Switzerland. With Efas, the cantons have to participate financially in this rapidly growing area and thus relieve the burden on premium payers.

But even if the care of older people largely has to be paid for by the health insurance companies, the insurers will push for care to be as efficient as possible. Isn’t that at the expense of the quality of care?

No. Here, yes the care initiative that now needs to be implemented. This requires good working conditions for the carers. On the contrary, I am convinced that the nursing staff will be relieved if more people are cared for at home by Spitex employees and relatives. Because fewer nursing staff will be needed in the homes.

For long-term care, a collective agreement will be needed in the future in order to bill the health insurance companies. In the future, human attention in nursing homes should be measured in tax points and time units. This means that the nursing staff is under even more pressure.

The question of the collective agreement for long-term care must be discussed with or without Efas. I don’t think it makes sense if all the other questions that arise are mixed up with the discussion about Efas. Now we first have to regulate the question of financing with a uniform distribution key.

The health insurance association Santésuisse was against increased financing of care through health insurance and warned of sharp increases in premiums.

I don’t share this fear. Long-term care will not have as much of an impact. The uniform financing leads to more transparency and will show where there are still hidden costs in the system. This will help reduce the burden on those paying premiums.

The discussions in the councils about this proposal lasted 14 years, mainly because the cantons only agreed when care was integrated into Efas. This fuels the suspicion that the cantons want to reduce the financial burden and save money on long-term care. As the former cantonal finance director and finance minister, what do you say about this?

I would like to contradict this based on my experience. The cantons are directly responsible to the population and they carry out their tasks. In the future, the cantons will also cover the medical costs in the outpatient sector. So overall, with Efas, more services are financed through tax money. We have to look at the entire system. If the cantons contribute more, that is what is wanted. This will mean that the cantons will also have an interest in controlling the offer and development in the outpatient sector.