Government health plans generate ill feeling

Severin Nowacki

The cabinet wants to impose a controversial fee for patients who consult a doctor and to introduce phone consultations by health insurance companies.

This content was published on May 29, 2009 minutes

The planned cost-cutting measures, which were widely criticised on Friday, include a SFr200 million ($185 million) state contribution towards the reduction of mandatory health insurance premiums for low-income earners.

Tighter regulations for outpatient services at hospitals and restrictions on the patient's right to choose the type of health insurance are also part of the package of measures.

They are subject to parliamentary approval and would be valid for three years.

Under the proposal patients would have to pay a standard fee of SFr30 for each of the first six consultations at a doctor's practice. Children and pregnant women would be exempted.

Interior Minister Pascal Couchepin, in charge of public health, rejected widespread criticism about the charge.

"We do not live in a land of plenty; consumers have to pay for a service, " he said at a news conference on Friday.

He admitted that not all of the measures were pleasant, but he said they were necessary.

"Health insurance premiums are due to rise considerably this year. Costs and premiums will continue to increase if we fail to act," Couchepin warned.

The Federal Health Office expects a 15 per cent increase on average in premiums for mandatory health insurances. The announcement has sparked a public outcry.

Price cuts

The interior minister on Friday also pledged to announce further details about planned price cuts for drugs in the next few weeks.

However, he refused to speculate on savings achieved by the new measures.

"Let's see what impact they have," Couchepin cautioned, insisting there was no simple remedy.

"There is no magic solution. We have to make do with the means available."


The government's proposals were almost unanimously rejected by political parties and health associations.

The centre-left Social Democrats and the Greens accused Couchepin of ignoring the input by participants at a round table earlier this month.

They described the fee as irresponsible and unfair and slammed Couchepin for "knuckling under the pharmaceutical industry".

The rightwing Swiss People's Party and the centre-right Christian Democrats said the measures failed to get to the root of the problem.

Couchepin's own centre-right Radical Party praised his personal efforts but criticised the patient's fee and government funds for low-income earners.


Doctor and patient organisations, as well as the association of hospitals, all roundly reject the patient's fee and described the package as disappointing.

The health insurance association, Santésuisse, pointed out that there were interesting elements in the package, but they did not go far enough and would have to be implemented very quickly to be effective.

The government and parliament have been grappling with several health reforms over the past few years. Most attempts were blocked in parliament or failed in nationwide votes.

During the current summer session, parliament is due to approve the continuation of a freeze on new doctors' practices beyond 2009.

Urs Geiser,

In brief

Last year voters rejected a proposal aimed at simplifying the hospital funding system putting private insurance companies in charge of hospital care.

Five previous attempts included an overhaul of the insurance system, the financing of hospital and hospital care as well as cutting costs of medicines.

Parliament is due to approve the extension of a freeze on new doctors' practices during the current summer session.

Premiums for mandatory health insurance are expected to increase by an average of 15% next year.

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Health system and costs

Switzerland has compulsory health insurance coverage, giving access to a broad range of medical services.

Switzerland spent SFr55.3 billion ($51.1 billion) – 10.8% of GDP – on health in 2007, making it one of the most expensive health systems, behind the US and France.

The increase in health cost for 2007 was above the 3.1% average rate of the previous years.

Nearly 43% of the total costs are covered by social security, 40% by individual patients and 17% by the state.

Around 482,000 people worked in Switzerland's health sector in 2005. One in four was an immigrant.

The number of practices has been on the increase since the 1990s and reached 2.08 per 1,000 inhabitants in 2006.

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