Surveys indicate that consistently rising health insurance premiums are one of the Swiss population's top five concerns. Kerstin Vokinger, Professor of Law and Medicine, presents a few potential solutions.
"Health can evoke strong emotions that impact everyone, including friends and family. At the end of the day, it affects us all. Many stakeholders are involved in the healthcare system - and there is a lot of money at stake. Healthcare costs totalled 94 billion Swiss francs in 2023, according to the Federal Statistical Office (FSO), and our health insurance premiums continue to soar.
The expert
Kerstin Vokinger is a doctor and lawyer. She is a dual professor and holds the Chair for Regulation in Law, Medicine and Technology at ETH Zurich and the University of Zurich. Her goal is that her research findings, along with those of her team, benefit society.
The question is: where can we reduce costs without sacrificing progress and quality? I see potential in several areas, some of which I would like to highlight:
We should, for example, improve digitalisation in the health care sector. While this requires initial investment, implementing it will improve healthcare quality, enhance efficiency and result in significant cost savings. If we had an effective electronic patient record system, for example, doctors could conduct examinations more efficiently and reduce diagnostic redundancies.
Improved digitalisation would also enhance communication between the departments of a hospital, between hospitals and between hospitals and GPs, making it more efficient and increasing its quality. Sending patient appointments, findings and invoices electronically instead of by mail would save millions in costs alone.
Switzerland has one of the highest densities of hospitals in the world. Nevertheless, medical procedures tend to have higher success rates the more frequently they are performed. Having a high density of hospitals can undermine quality and safety, result in inefficient structures and push up operating costs. A greater centralisation of hospitals is a contentious political issue - but I believe it would be beneficial.
Engaging in discussions on the issue of excessive healthcare also makes sense in my view. In fact, research shows that certain examinations and treatments are unnecessary or may even be harmful in some cases. Examples include unnecessary vitamin D measurements and excessive iron supplementation. It is also debatable whether specific surgical procedures on the knee or hip constitute excessive healthcare.
The Federal Office of Public Health (FOPH) is collaborating with relevant stakeholders to create a master plan for establishing a unified framework for appropriate patient care. Evidence-based studies could help determine when medical interventions are excessive and should be avoided.
Prescription drugs play an essential role in the treatment of disease, with new medicines providing patients with additional treatment options. The FOPH notes that rising medicine prices are also contributing to soaring insurance premiums, accounting for the second-largest cost factor in basic health insurance. Over the past decade, these expenses have risen by fifty percent. This situation is one of the factors prompting discussions about potential adjustments to the price-setting system.
One consideration I would like to highlight is the role played by international reference pricing. Given that many countries work with confidential rebates, Switzerland sometimes compares its prices with excessively high list prices. This approach should be revised in my view.
We can all make a contribution, whether by adopting a healthy lifestyle, taking generic drugs instead of brand name drugs (provided this is not medically contraindicated) or consulting a GP instead of going to the hospital emergency department when we have minor, non-acute medical problems.
Switzerland boasts an excellent healthcare system that is highly regarded on a global scale. However, healthcare costs are elevated and continue to increase. It would be beneficial for healthcare stakeholders to prioritise patient care and make faster progress with these solutions."
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