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June 9 votes in Switzerland: how can healthcare costs be reined in?

Hosted by: Katy Romy

Health insurance premiums are a growing burden for Swiss households. This year alone, they increased by 8.7% on average. As a result, a large part of the population is unable or difficult to pay the compulsory monthly premiums.

On June 9, the Swiss voted on two initiatives aimed at capping health costs. While the Social Democrats wanted to limit health insurance premiums to 10% of a household’s income, the Centre Party sought to introduce a mechanism to force the state to curb the rising costs.

Do these two initiatives convince you? What measures do you think would be most effective to put an end to the ongoing rise in healthcare costs? Should financial help for households be boosted, or should the procedures covered by health insurance be reduced? Let us know in the conversation below.

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Rafiq Tschannen
Rafiq Tschannen

I know this may be difficult, but please 'just switch off the machines'. I have observed recently among our circle of friends how the doctors 'prolonged life' at a huge cost for someone after a severe stroke. Three months in hospital unconscious being artificially kept alive. Also with less severe cases a lot of unnecessary treatment just for treatment's sake. Please just switch off the machine and save us from extended sufferings (and costs).

rossat.jf
rossat.jf
The following contribution has been automatically translated from FR.

The problems with health and accident insurance are inherent in their structure.
They should not be public limited companies or similar, with the obligation to make a profit and pay very high salaries to directors and all the bureaucracy that goes with it.
Just look at the local buildings and the insurance companies.
Then the State (canton or rather federal) should agree to take charge of the health of its citizens while deducting a premium proportional to the salaries or incomes and just like the AVS manage the sector.

Le problèmes des assurances maladie/accident sont inhérents à leur structure.
Ce ne devraient pas être des SA ou autres, avec l'obligation de tirer des profits et payer très cher des membres de direction et toute la bureaucratie attenante.
A voir les immeubles locaux et el des assurances.
Ensuite l'Etat (canton ou plutôt fédéral) devrait accepter de prendre en charge la santé de ses citoyens tout en prélevant une prime proportionnelle avec mesure aux salaires ou revenus et tout comme l'AVS gérer le secteur.

Mutsumi Saitoh
Mutsumi Saitoh
The following contribution has been automatically translated from JA.

How the public perceives medical futility is one of the most important things.

医学的無益 medical futility を国民がどう認識するかも大切なことの一つだと思います。

dario_gia
dario_gia
The following contribution has been automatically translated from IT.

The subject is too complex to deal with in a forum, because the interrelationships that play an important role between patients, doctors, insurance companies, and the state are intricate and non-transparent. Nobody apart from the patient has an interest in creating transparency. Nobody is willing to give anything up. Cutting unnecessary benefits is almost impossible (too many people would have to change jobs). Moving to a single fund would produce a lot of unemployed (about 10% of administrative costs are basically redundancies, wages, jobs). The single fund would only be manageable with a huge, uncontrollable, inefficient apparatus like the current private insurances. Decreasing private insurance would lead to de-lobbying and displeasing many politicians who have their hands in the pie. Touching the medical caste (dog doesn't bite dog) would be very difficult. Healthcare is business. Touching the pharmaceutical industry is a business. Too many politicians with their hands in the cookie jar (lobbying). The issue is political, not soci-scientific!

Il tema è troppo complesso da trattare in un forum, perché le interrelazioni che giocano un ruolo importante tra pazienti, medici, assicurazioni, stato sono intricate e non trasparenti. Nessuno, a parte il paziente ha interesse a creare trasparenza. Nessuno è disposto a rinunciare a qualcosa. Togliere le prestazioni inutili è quasi impossibile (troppe persone dovrebbero cambiare lavoro). Passare a una cassa unica produrrebbe moltissimi disoccupati (circa il 10% dei costi amministrativi sono fondamentalmente ridondanze, salari, posti di lavoro). La cassa unica sarebbe gestibile solo con un apparato enorme, incontrollabile, inefficiente come le attuali assicurazioni private. Diminuire le assicurazioni private porterebbe a de-lobbizzare e a scontentare moltissimi politici che hanno le mani in pasta. Toccare la casta dei medici (cane non morde cane) sarebbe difficilissimo. Sanità è business. Toccare l'industria farmaceutica è un'impresa. Troppi politici con le mani in pasta (lobbyng). Il tema è politico, non soci-scientifico!

bmohlenbrock@gmail.com
bmohlenbrock@gmail.com

Value-Based Healthcare
A market-based delivery system can refocus an inefficient healthcare model and improve patient satisfaction by facilitating providers’ ability to deliver value, which is the intersection of quality and costs. Physicians’ ordering preferences initiate virtually every medical service and resource deployed. A practical solution must be clinically reliable and physician-specific when documenting their effective and efficient ordering patterns.
Fortunately, this solution is not just a theory. It has been successfully implemented and proven effective. As the Wall Street Journal reported, physicians adjusted their practice patterns by adopting statistically reliable clinical processes, leading to substantial cost savings of $200,000,000 in 14 hospitals within a single city over two years. These are not just numbers, but a testament to the potential of this solution. Similar outcomes can be achieved to benefit every hospital and community in Switzerland. If these documented results interest you in your present situation, I would be eager to discuss an initiative with you at your convenience.
W.C. (Bill) Mohlenbrock MD, FACS
(858) 354-0415 (m)
bmohlenbrock@alliancecaretech.com

hrh6@cornell.edu
hrh6@cornell.edu
The following contribution has been automatically translated from DE.

It is impossible to fulfil all the objectives of health policy, namely
1. no 2-class medicine
2. optimal health protection for all, including medical progress
3. no excessive increase in healthcare costs
under one roof. Consumers (citizens) are prepared to spend a high proportion of their income on healthcare, which is rational because they only have a limited lifespan. This is why they accept the disproportionately high rise in healthcare costs.

Even if efficiency gains of perhaps 30% are still possible, the costs will continue to grow disproportionately due to medical advances and the lack of elasticity of demand and may one day reach a level that is no longer acceptable. However, this will then lead to rationing and thus to two-tier medicine.

Es ist unmöglich, alle Ziele der Gesunheitspolitik, nämlich
1. Keine 2-Klassenmedizin
2. Optimalen Gesundheitsschutz für alle unter Einbezug des medizinischen Fortsschrittes
3. Kein überdimensionierter Anstieg der Gesundheitskosten
unter einen Hut zu bringen. Der Konsument (Bürger) ist, was rational ist, weil er ja nur ein zeitlich beschränktes Leben hat, bereit, einen hohen Antel seines Einkommens für die Gesundheitsvorsorge und -pflege auszugeben. Deshalb nimmt er die überproportional zur Teuerung wachsenden Gesundheitskosten in Kauf.

Selbst wenn noch Effizienzgewinne von vielleicht 30 % möglich sind, werden die Kosten wegen der medizinischen Fortschritte und der fehlenden Elastizität der Nachfrage weiter überproportional wachsen und vielleicht irgendeinmal ein Niveau erreichen, das nicht mehr akzeptiert wird. Dann aber wird es zu Rationierungen und damit zu einer 2-Klassenmedizin kommen.

kkckkc
kkckkc

So I voted, but I was unhappy with the substance of the vote. How can healthcare be a fundamental right, when it is managed by profit driven entities?

What we should really be doing is (1) encouraging people to lead healthier lifestyles. Treatment costs should be separated into buckets e.g. disease due to unhealthy habits and other. One target would be to reduce costs gradually in the 1st bucket and use it to encourage healthier lifestyles.

(2) In parallel, make the food chain produce and deliver healthier choices (supermarkets, the push for organic, less meat in diets etc should have a greater emphasis)

(3) we should look at how healthcare is delivered but with a fresh set of eyes. On recent trips to hospitals, I was astounded at how much one time use items are used. Just washing bed linen daily involves 2 sheets and 3 pillow cases, for a 2000 bed hospital that's 10,000 items daily and for the most part it is not necessary. Common sense has been replaced by to-do lists, check lists. Even the curtains that separated beds are made of disposable sheets. This all adds up to a high cash out.

Emma
Emma
@kkckkc

You are right except one thing, less meat for you may be healthy but this does not apply for everyone. Also should you exclude broken leg surgeries from skiiing? I mean thats self inflicted. So be careful with generalising about the concept of “healthy” diet or habits. For some people it is healthier to smoke rather than to consume meth. Smoking habit has a cause and it is not just for fun. Drugs and sugar binging which causes diabetes is caused by anxiety, stress which can only be reduced by changing entirely our work culture, structure and economy. So in ideal world, what you say it make sense, but it is not as simple as denying health care to those who broke simply need it.

BMF
BMF

The Swiss system is still a better alternative than what the US struggles with. Health care is considered a privilege in the US, and not a right. I reside in Australia at the moment, and healthcare options like Medicare is readily available and allows patients to pick their own physicians. Yes, you do need private coverage like Switzerland and the US. At the end of the day it's the business of medicine.

Augusto UCV History
Augusto UCV History
The following contribution has been automatically translated from ES.

You are historically one of the best countries with policies that work, your excellent geography helps you, you look like a world power, or you are, famous for the policy of banks and management of funds, I call on you: you are going to get involved with HEALTH, which is essential for the human being, for the citizen with rights, in my opinion you should increase more taxes in other branches, such as in the business sector (commercial sectors, bankers, etc. or tourism). It is a question of the people to allow new laws and new policies, why have revolutions existed, why the thousands of battles that the Saxons and the Europeans lived through, if as a continent they are already a first world continent. Please, come to your senses and give priority to health, not by increasing premiums, but to look for a solution to the crises (which always occur at any stage or decade) by another way, either by moving or removing bureaucratic institutions that are sometimes only for decoration, because their function has become monotonous. Call on citizens to come together and establish a plan that will help everyone as a country. Venezuela Caracas Central University.

Ustedes historicamente son unos de los mejores paises con politicas que funcionan, la geografia tan excelente de ustedes los ayuda, parecen una potencia mundial, o lo son, famosos por la politica de bancos y manejo de fondos, les hago un llamado: van a involucrarse con la SALUD, que es lo primordial para el humano, para el ciudadano con derechos, al mi parecer deberias incremetar mas impuestos en otras ramas, como en el sector empresarial (rubros comerciales banqueros etc o turisticos). Es cuestion del pueblo permitir nuevas leyes y nuevas politicas, para que han existido las revoluciones, para que la miles de batallas que vivieron los sajones, los europeos si ya como continente son un continente de primer mundo. Porfavor, recapaciten y denle prioridad a la salud no incrementando las primas, sino buscar la solucion a las crisis (que siempre se presentan en culquier etapa o decada ) por otra via, sea moviendo o removiendo instituciones burocraticas que a veces son solo de aornos, porque su funcion ya se hizo monotona. Llamen al ciudadano a reunirse y establecer un plan que ayude a todos como pais. Venezuela Caracas Universidad Central.

Germaine
Germaine
The following contribution has been automatically translated from DE.

But there is an alternative to the horrendous healthcare costs!!!
The abolition of the 4500 TARMED tariff items, which are shamelessly abused by doctors

Doch es gäbe eine Alternative bei den horrenden Gesundheitskosten!!!
Die Abschaffung der 4500 TARMED Tarifpositionen, die von den Ärzten schamlos missbraucht werden

Schweiz
Schweiz
The following contribution has been automatically translated from DE.

Why has it never been discussed until today that the citizen with a deductible of 2500 could contribute the most. Are the lobby doctors to blame or????
LGTrudi

Warum wurde bis heute nie darüber geredet, dass der Bürger mit einem Selbstbehalt von 2500 am meisten beitragen könnte. Sind die Lobby Arzte daran schuld oder????
LGTrudi

MaximusNumerous
MaximusNumerous

Perhaps you should consider what other countries do for their healthcare systems. The Swiss are athletic and very active. This is the biggest thing the Swiss—or anyone—could do to keep healthy, so focus more on fitness.
Can the Swiss set up standard procedures for specific ailments that the individual or companion can treat? Suppose a person acts responsibly, follows a healthy lifestyle, maintains a good weight, does not smoke, gets good sleep, exercises, etc. In that case, they get a discount on the insurance premium on top of being healthy.
Healthcare should be set up like a Quality Control program at a major manufacturing company. Incentives for living a healthy lifestyle are the first order. A system that supports this focus is necessary.
The Swiss are more intelligent than I am. I'm sure they will do the right thing—they always do. It's too bad the US is not run by the Swiss. We suffer so many inefficiencies to support wealth transfer to the upper class. It is a case of "When the head is no good, the whole body suffers," and America is suffering.

Reszum
Reszum
The following contribution has been automatically translated from DE.

It is incomprehensible to me why the basic premiums are so different. They should be the same throughout Switzerland. = And so should the premium reductions, otherwise you will be penalised if you live in the "wrong" canton!
Besides, I have been in favour of a single health insurance fund for x years. It would save a lot of administrative costs.

Es ist für mich unverständlich, warum die Grundprämien so unterschiedlich sind. Diese sollte schweizweit gleich sein. = Und die Prämienverbilligungen ebenfalls, sonst wird man bestraft, wenn man im "falschen" Kanton wohnt!
Ausserdem bin ich schon seit x Jahren für eine Einheitskasse. Das spart eine Menge Verwaltungskosten.

Sarujan
Sarujan

To address rising healthcare costs in Switzerland, a multi-faceted approach is essential, focusing on payment reform through value-based care and bundled payments, price transparency with standardized pricing and public databases, and increasing administrative efficiency by streamlining processes and enhancing health IT integration. Emphasizing preventive care and wellness programs, such as chronic disease management and community health initiatives, can reduce long-term costs. Additionally, pharmaceutical reforms, including negotiating drug prices and promoting generic drugs, are crucial. Innovations in healthcare delivery, like expanding telemedicine and shifting services to outpatient settings, along with strong regulatory and policy changes, such as antitrust enforcement, are also necessary to curb escalating healthcare expenses in the Swiss context.

HAT
HAT

Yes.
Yes.
Yes.
Yes.

Rafiq Tschannen
Rafiq Tschannen

Well, the voting papers reached me today the 7th of June. If we could vote electronically it would still be time to vote, not so by mail...

VeraGottlieb
VeraGottlieb

Nationalize the entire industry! Yes, I know...the capitalists will scream murder. But then...look at all the skyscrapers pharma outlets have built themselves...WITH OUR MONEY.

mejrc
mejrc

My health insurance is like this:
chf 1100 per month for 2 people, chf 300 every January as a penalty clause, In other words I pay the first chf 300 .MINIMUM 10% & some at 20% & 30% cost of all medicines to be paid by me & it keeps increasing. Not " all " medicines covered, most are horrendously expensive & can be dramatically reduced using government intervention, if they had the guts to do something about it, & stop lining their own pockets. Action this day please --- Mr. Government.

mejrc
mejrc

You must accept that medical insurance is a business like any other business. During my life I have worked with the big companies & as a private business. I have had many discussions with senior directors & nearly all have this disgusting idea that to solve problems, profit or other parameters is so simple, ---- increase the price, put the price up, will solve the problem. Would you believe this achieves completely the opposite.
We are now at saturation point with all forms of medical insurance. People can`t afford it or soon will be in the dirt. I pay over chf. 1000 per month for 2 people in a basic hospital room. Over the years a 6% or 10% increase PA is not unusual, but as we are on pension I can assure you our pension does not increase at anywhere near this rate. But we have to pay because its law, we must have medical insurance, that I accept. The basic problem is where is the money coming from to support health insurance. I think capping certain areas is a way forward but it`s not the only way. The pharma industry should be compelled to contribute some of their " vast profits " to help retain Switzerland`s buckling & damaged medical services. Monumental, multi million Franc bonuses paid to certain directors is not acceptable in any circumstances & should be topped. How do these people sleep at night, how do they pay their bills, what a hard & dismal life they have. Some of these pharma companies say they need these vast profits to invest in medical research, to a certain extent true, ---- but a sizable chunk of money plowed into the Swiss medical system would be more than appreciated by a population having a progressive problem of paying the bill, & by the way, -- all or a majority of people particularly the aged & infirm. Where I live in southern Switzerland a room in an old peoples home will set you back around " chf 7000 to 10000 per month " That`s not a cost, that`s daylight robbery. Some old people are encouraged to sell their home to pay for their last few years on this earth, --- pretty disgusting really.
I rest my case. -- Uncle John.

Pani
Pani
The following contribution has been automatically translated from DE.

A single health insurance fund would certainly reduce costs, as the many lobbyists of the various health insurance companies would no longer be able to make decisions for their own interests and high advertising costs would also be eliminated. A single health insurance fund would also take a closer look at specialist doctors, GPs, hospitals, care costs and the pharmaceutical industry in order to avoid unfair billing. There would also be fewer unnecessary operations and examinations. A single health insurance fund would lead to more transparency, not like the current system!
I say YES to a 10% reduction in premiums, so the Federal Council and Parliament must finally act and come up with concrete solutions so that everyone can still pay for our health.

Eine Einheitskasse würde die Kosten sicher senken, da die vielen Lobbyisten der verschiedenen Krankenkassen nicht mehr für ihre eigenen Interessen Entscheidungen treffen könnten und hohe Werbekosten würden auch wegfallen. Eine Einheitskasse würde auch bei den Spezialärzten, Hausärzten, Spitäler, Pflegekosten, Pharmaindustrie genauer hinschauen um ungerechte Abrechnungen zu vermeiden. Es würden auch weniger unnötige Operationen und Untersuchungen durchgeführt. Eine Einheitskasse würde zu mehr Transparenz führen, nicht wie im aktuellem System!
Ich sage JA zu 10% Prämienreduzierung, so muss der Bundesrat und das Parlament endlich handeln und konkrete Lösungen bringen, so dass Jedermann unsere Gesundheit noch bezahlen kann.

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