In Bern on Monday, discussions at the fifth Swiss national conference on health centred on one major bugbear: costs. Attendees were divided on how to halt the rise.
“For years, healthcare costs have been rising faster than salaries and the cost of living,” said Swiss president and health minister Alain Berset, before revealing that the quote in fact came from a Federal Council statement of 1991.
In 2018 the major question debated by the 300 expert participants remains the same: how to understand the continuing rise in costs and how to combat the trend.
The basis of discussions in Bern was an October 2017 report on the feasibility of lowering costs in the health sector, which laid out 38 measures that provided, in Berset’s words, a “wake-up call”.
Two particular measures came under close scrutiny.
The first was the so-called “experimental article” that could be introduced into the existing legislation on health insurance, something that would allow cantonal and local actors to introduce innovative projects without waiting for a change in regulation at the federal level.
Such a system would, for example, allow the testing of single cantonal health insurers (rather than the current range of over 60 private providers).
Secondly, and more controversially, the idea of cost ceilings and a limited overall health budget was debated. This would halt the current piecemeal approach and constant hikes in premiums, said Vaud politician Pierre-Yves Maillard.
Opponents said that such limitations could lead to a “two-speed” health system with long waiting lists.
Speaking to Swiss public television, RTS, President Berset also fulminated against the alleged high salaries of specialist medics such as surgeons: “annual salaries of CHF1 million for a doctor is unacceptable,” he said.