Healthcare costs Introduction of uniform healthcare financing can begin
In future, all healthcare services will be financed equally, regardless of who provides them and where: voters in Switzerland are in favor of this fundamental system change. The implementation of the new rules will take years.
24.11.2024, 12:04
24.11.2024, 17:04
SDA
Around 1,302,500 voters cast a Yes vote and 1,140,800 a No vote, giving a Yes share of 53.3 percent. This clear approval is surprising. In the last polls, an unusually high number of respondents had not announced their position on the complex proposal. Voter turnout was just under 45%.
French-speaking Switzerland outvoted
However, the Yes vote is not uniform: the German-speaking parts of the country simply outvoted the French-speaking parts. The clearest approval came from St. Gallen with 64 percent in favor, while the loudest "no" votes came from Neuchâtel and Geneva with 65 percent.
In the bilingual cantons of Bern, Fribourg and Valais, the language divide was clearly visible. Their No and Yes percentages were lower than those of the monolingual cantons.
Furna GR and Mauraz VD provide a picture of this: Furna in Prättigau said yes to 80 percent, Mauraz with over 83 percent no. The picture was mixed among the municipalities in Ticino; the canton as a whole said yes to the bill by a very narrow margin of 50.5 percent.
Implemented from 2028
The Efas proposal (uniform funding for outpatient and inpatient care) has a long history. In 2009, now 15 years ago, Aargau healthcare politician Ruth Humbel (center) initiated the proposal in the National Council. All healthcare services should be financed uniformly by health insurance companies, cantons and patients.
Following the approval of the electorate, implementation of the bill can now begin. With the amendment to the Health Insurance Act, the cantons will in future cover at least 26.9% of the costs (after deduction of the deductible and patient co-payment) and the health insurance funds will cover a maximum of 73.1% via the premiums.
This new system is to be applied from 2028, but the change in the long-term care system will not take place until 2032, as the changeover in this sector requires uniform and cost-covering tariffs. These have yet to be negotiated.
Removing false incentives
Today, healthcare services covered by basic insurance are financed differently. The cantons pay 55% of the costs of treatment involving overnight stays in hospital. The health insurance fund pays 45 percent. Outpatient treatment is paid for by the health insurance fund alone.
In long-term care, patients and health insurance companies each pay a fixed contribution towards the costs of care. The remainder is borne by the cantons and/or the municipality of residence, depending on the canton. On average, the health insurance funds covered around 54% of care costs in 2022 and the cantons 46%. The cantons wanted long-term care to be included in the bill.
Supporters expect the bill to eliminate false incentives, in particular because there would be fewer hospital stays and later admissions to nursing homes. And the coordination of care would be improved, which would be of particular benefit to the chronically ill. Supporters also saw standardized financing as a means of combating the rise in premiums.
Fears of higher premiums
The VPOD trade union fought the bill with a referendum; the Federation of Trade Unions and the SP campaigned for a no vote. They consider the reform to be harmful. The change to the system would mean worse conditions for nursing staff and patients because power would shift to the health insurance funds.
The opponents also feared higher premiums, particularly due to the inclusion of long-term care. Expenditure in this area would rise particularly sharply because the number of elderly people in need of care is growing.
