Volt says YES to the Amendment of the Federal Insurance Act (KVG)

The fact that health insurance companies and health insurance premiums are a major problem in Switzerland is nothing new. For example, shortly before the 2023 National Council elections, the healthcare system was ranked third behind ‘Immigration & asylum’ and ‘Environment & energy’ among the most important issues for voters. It should therefore be clear that there is an urgent need for action on this issue, which will be addressed by the amendment to the Federal Health Insurance Act (KVG). However, a small reform alone will not be enough to solve all the problems in the healthcare system and prevent a further rise in health insurance premiums.

The proposal in brief

One solution is to adjust the distribution of treatment costs between insurers and the cantons, as proposed by the amendment to the Federal Health Insurance Act (KVG). This would mean that benefits would no longer be divided differently between insurers and the cantons depending on the type of treatment (outpatient, inpatient, nursing care) and financing would be standardised. In future, the cantons would bear a quarter of the costs, while the insured parties would bear the rest, i.e. three quarters.

Reasoning

The parliamentary majority hopes that the bill will eliminate disincentives in the healthcare system. At present, it is not very attractive for health insurance companies to promote outpatient treatment, as they have to bear the full costs themselves, even though this would often be cheaper and more medically appropriate. The reform aims to eliminate this disincentive. Now, the most sensible and overall most favourable treatment method is to be chosen instead of the most favourable method for the health insurance companies. In addition, the bill is intended to achieve massive cost savings. For example, this is to be realised by promoting outpatient treatment, which is cheaper than inpatient treatment due to the short hospital stay. Annual savings of up to CHF 400 million are expected, but the exact extent of the savings potential is difficult to estimate, as the specific future behaviour of the financing players, i.e. the cantons and health insurance companies, is key here. In addition, premium payers are to be relieved. By standardising the financing of services, the cantons undertake to keep their share of financing constant. This is intended to counter the trend of declining cantonal funding shares in recent years. It is hoped that premiums will not continue to rise.

However, the bill has the effect of increasing the power of health insurance companies in the healthcare system even further. By increasing the share of the health insurance funds in the financing of care services, they are effectively gaining influence. At the same time, the health insurance companies will gain greater influence in areas in which they were previously less powerful, such as retirement and nursing homes and long-term care. There is therefore a risk that the healthcare system will become more profit-orientated due to the influence of the health insurance companies. However, it should be noted here that health insurance companies already have a great deal of influence in the healthcare system, and this will not be significantly increased with the proposal or reduced if the proposal is rejected. However, the health insurance companies' position of power should certainly be addressed.

Volt's position

Volt agrees with the arguments put forward by those in favour of the reform: the elimination of disincentives in the healthcare system is key. The advantages of eliminating disincentives, planning security, savings potential and relief for premium payers outweigh the downsides of the proposal. However, Volt is aware that the bill is not perfect and that there is a great need for further action in the healthcare sector. For example, Volt is calling for the introduction of a uniform health insurance provider to force the remaining private health insurance companies to become more efficient. The single health insurance fund should also make it possible to negotiate fair drug prices. These reforms could greatly reduce the burden on premium payers and the health insurance system in general.

Sources

Eidgenössische Wahlen 2023
Volksabstimmung zur Änderung des Bundesgesetzes über die Krankenversicherung (KVG) (Einheitliche Finanzierung der Leistungen)
KVG-Revision mit schweren Nebenwirkungen: EFAS : vpod/ssp
Gesundheitswesen – Volt Schweiz