Health costsThe Council of States makes a new attempt to increase deductibles
SDA
26.9.2024 - 12:10
The Council of States wants to increase the minimum health insurance deductible. On Thursday, it approved a corresponding motion from the SVP. The deductible adjustment is intended to better reflect the current cost situation in basic insurance.
26.09.2024, 12:10
26.09.2024, 12:19
SDA
On the very day that the health insurance premiums for the coming year were announced, the small chamber made a new attempt to increase the deductible. By 25 votes to 11 with 5 abstentions, it adopted a motion by SVP member of parliament Esther Friedli (SG).
Five years ago, it was the SVP, of all parties, that brought down an ongoing adjustment of deductibles in line with healthcare costs. It had initially supported the necessary amendment to the Health Insurance Act (KVG), but changed its mind at the end of the deliberations. The bill failed in the final vote in March 2019.
"Strengthening personal responsibility"
In the meantime, premiums have continued to rise - and the wind has changed. SVP member of the Council of States Esther Friedli (SG) justified her motion by stating, among other things, that the minimum deductible had not been increased since 2004. It amounts to CHF 300 for basic insurance. Patients have to pay this proportion of their treatment costs themselves each year.
Friedli said that an increase was necessary due to the cost trend in recent years and that a periodic adjustment was required. In addition, the indirect counter-proposal to the rejected premium relief initiative would require the cantons to distribute significantly more premium reductions. This would relieve the burden on a broader group of premium payers.
"We must strengthen the personal responsibility of the insured," said Josef Dittli (FDP/UR), who dropped a similar proposal in favor of Friedli's motion. More thought should be given to visits to the doctor in order to prevent unnecessary treatment.
According to Friedli, however, the mechanism for increasing the minimum deductible should be moderate so that the same deductibles can be chosen over several years. Children's deductibles should not be subject to the adjustment mechanism.
"Frontal attack" on poor people
The Federal Council agrees with the motion, as Social Affairs Minister Elisabeth Baume-Schneider said in the Council of States. The Left in the Council of States said no, arguing that more and more people were foregoing visits to the doctor because they could not afford them.
Baptiste Hurni (SP/NE) pointed out that chronically ill and elderly people in particular would suffer from the increase in deductibles. The proposal was "a frontal attack and a slap in the face for patients". Flavia Wasserfallen (SP/BE) referred to an OECD comparison, according to which insured persons in Switzerland already pay the majority of healthcare costs out of their own pockets.
The proposal will now go to the National Council. An identical motion by SVP National Councillor Diana Gutjahr (TG) is pending there. If the National Council also says yes to the motion, the Federal Council must change the legal framework for cost sharing so that the standard deductible better reflects the current cost situation in compulsory health insurance (OKP).
Twenty years of standstill
Since the KVG came into force in 1996, gross costs charged to the OKP have more than tripled. This is due to the ageing population, advances in medical technology, existing disincentives, particularly in the outpatient sector, and the increasing use of medical services by the insured.
In the wake of the sharp rise in costs, a panel of experts developed a total of 38 measures and recommended their implementation in order of priority. The cost-cutting measures to date have focused primarily on service providers, the cantons and insurers.
Measures that focus on the personal responsibility of insured persons - namely the strengthening of health literacy or the adjustment of the standard deductible - have hardly been an issue to date. Since the introduction of the KVG, the Federal Council has increased the standard deductible several times, but the last time was twenty years ago. The minimum deductible was CHF 150 in 1996 and was increased to CHF 230 in 1998. The last increase to CHF 300 took place in 2004.