Barring a major upset, Swiss voters will throw out a proposal to introduce a single health insurance company on Sunday. It is the third attempt by the political left in ten years to reform the healthcare insurance scheme.
The latest proposal by centre-left political parties, patients and consumer groups wants to replace the more than 60 private company insurers by a single payer system offering mandatory basic health insurance coverage.
Supporters argue the current system is too costly and consumers lose out as it is not competitive enough among insurers. Critics accuse insurance companies of trying to attract young and healthy customers, undermining the principle of solidarity with the old and infirm.
Initiative promoters argue that up to CHF350 million ($372 million) could be saved on administration, and total health expenditure could be reduced by about 10% over the next few years.
However, most political parties, the government and the business community recommend rejection of the initiative. They say Switzerland has one of the most successful healthcare systems in the world.
Opponents have warned of an inefficient bureaucratic organisation if citizens are no longer free to decide on the health insurer of their choice.
Basic health insurance coverage was made mandatory for Swiss residents in 1994.
Costs for individual health insurance premiums have been increasing steadily over the past decades. Total expenditure for healthcare reached a total of CHF68 billion, with just over a third going towards the basic insurance coverage.
On Thursday, Interior Minister Alain Berset, whose portfolio includes health matters, announced an average increase of 4% for the insurance premiums next year.
He said the hike was the result of technological progress and the ageing population and was likely to continue in the foreseeable future.
Supporters of a single insurance company said the latest increase shows the serious flaws in the Swiss health insurance system.
Claude Longchamp of the leading GfS Bern research and polling institute says a majority of citizens prefer the status quo. Their main concerns are the continuing rise in health premiums costs or a possible reduction in healthcare services.
Longchamp expects most voters in the majority German-speaking part of the country to throw the initiative out. However, the French- and Italian language regions are likely to accept the proposal.
Such an outcome would be in line with previous ballots on social issues, when the country’s minority language groups wanted to give the state a greater role on health matters.
Experts say promoters of the single payer principle virtually stand no chance of winning Sunday’s ballot. A score of more than 40% yes votes would be a relative success, according to Longchamp.
The issue at stake has sparked heated debates between supporters and opponents ahead of voting day. Insurance companies have been accused of running a propaganda campaign.
Turnout on Sunday is expected to be average, around 45%. Pollsters say a certain voter fatigue could reduce the political mobilisation despite broad public interest in the issue.
September 28 vote
Beside the issue on a single health insurance company, voters also have the final say on a separate initiative aimed at reducing VAT for the restaurant sector.
Votes also take place on a wide range of issues in many cantons and communes across the country.
It is the fourth and final set of ballots scheduled for this year.end of infobox