Legal loopholes exploited Hospitals use these brazen tricks to drive up premiums
Health insurance premiums are rising again by six percent. Meanwhile, hospitals are using legal loopholes to make huge profits - at the expense of the insured.
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- Hospitals are using a number of tricks to maximize their profits in the face of rising healthcare costs.
- For example, some clinics use list prices instead of net prices and retain high discounts.
- In addition, radiology practices have X-ray images analyzed abroad at low cost, but charge Swiss rates.
Expenditure on the Swiss healthcare system seems to have risen inexorably over the last three decades. Health insurance premiums will rise for the third time in a row in 2025, with an above-average increase. On average, insured persons will have to pay six percent more next year.
Politicians have been looking for solutions for some time. However, reforms have been difficult so far. The need to cut costs is undisputed in all political camps. However, media reports now show that hospitals and medical practices are using various tricks to earn as much money as possible, causing healthcare costs to continue to explode.
For example, certain hospitals have been massively overcharging health insurance companies for medical products for a few months, as reported by the Tages-Anzeiger newspaper. The hospitals are charging the insurance companies much higher prices than they pay the suppliers in purchasing.
List prices instead of net prices
Several players in the healthcare sector are taking advantage of a change in the law that was actually enacted to reduce costs: since 2022, hospitals and medical practices have been allowed to keep up to 49% of discounts on medical devices in the outpatient sector if they use this money to improve the quality of treatment. The rest must be passed on to the health insurer.
In contrast to medicines, the pricing system for medical devices is not transparent. In addition, a distinction is made between the list price and the net price. The former is set when a product first comes onto the market. However, the price actually paid, i.e. the net price, is in most cases significantly lower.
Since they have officially been allowed to keep 49 percent of the discounts, list prices are now increasingly appearing on hospital delivery bills. This quickly results in enormous discounts, although in reality only the net price, which is often many times lower, was paid.
According to the Tages-Anzeiger newspaper, the Hirslanden Group in particular is using this trick, with one clinic charging almost CHF 1,500 for a balloon to open narrowed blood vessels, which actually costs CHF 60. A pacemaker that was purchased for 3,700 francs was charged at over 14,500 francs.
Foreign line at Swiss rates
Local radiology companies are using another trick to exploit the local healthcare system, report the CH Media newspapers. The trick is simple: hospitals and practices have X-ray images analyzed abroad - but charge Swiss rates.
According to the report, some private hospitals use the services of companies in much cheaper countries such as Germany, France or Hungary. The Hirslanden Group is also mentioned in this context.
However, the companies charge the rates for diagnoses according to Swiss standards, although they have to pay the doctors employed abroad much less. This leaves more profit for the hospitals.
Hirslanden Group takes a stand
The practice is not illegal. "There are no requirements under radiation protection law," says Daniel Dauwalder, spokesman for the Federal Office of Public Health, to CH Media. International teleradiology is not regulated by law.
The Hirslanden Group is keeping a low profile. Two of the 17 radiology institutes have external partners who are not excluded from using international teleradiology.
Regarding the first trick, the group says that the list prices are determined by the suppliers without Hirslanden's influence. An external, specialized law firm was commissioned with an investigation at the beginning of December.
