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Switzerland set to introduce 50 franc fee for emergency room visits

A proposal to introduce a mandatory CHF50 fee for hospital emergency room visits for minor ailments has been approved in Switzerland.

Switzerland set to introduce 50 franc fee for emergency room visits
Photo: Depositphotos

On Tuesday, the Swiss National Council voted in favour – by a majority of 108 to 85 votes – to impose a mandatory charge on emergency room visits for minor medical conditions. 

The proposal will now go to the Council of States, where it is expected to be approved. 

While representatives in several cantons including Zurich and Bern have debated the measure, supporters have argued that it would be ineffective unless it was established at a federal level. 

Member content: What you need to know before taking out Swiss health insurance

Under the proposal, the rule will be adopted federally but individual cantons will decide whether or not the fee should be implemented. 

A 'personal responsibility' initiative?

Arguing that the move would improve personal responsibility and bring down overall healthcare costs, Thomas Weibel (Green Liberals) was behind the successful parliamentary initiative. 

Weibel suggested that the fee would encourage patients to consult their general practitioner before visiting the hospital, as family doctor consultations are significantly cheaper than emergency room visits. 

According to figures introduced into the National Council by Weibel, a visit to an emergency room costs the hospital CHF427, with GP visits costing less than half. 

Photo: Depositphotos

Supporters of the proposal also say that it would make hospital emergency departments more efficient, as they would be able to focus purely on actual emergencies rather than an array of non-urgent medical complaints. 

Weibel also said the move would make patients more aware of how much it costs hospitals when patients visit the emergency room. 

As The Local reported in the lead up to the October 2019 Swiss election, rising healthcare costs were one of the major concerns of voters in Switzerland. 

Have your say: What are the most important issues in the 2019 Swiss election

The devil in the detail?

While details remain relatively scarce, Swiss media is reporting that people who have been referred to the hospital by their doctors as well as people under 16 would be exempt from the new fee. 

Medical ailments considered ‘minor’ would be those which do not require a subsequent hospitalisation. 

The fee would be imposed regardless of the patient’s existing insurance coverage, meaning it would need to be paid in addition to any relevant deductible and would not impact monthly premiums. 

An uneven impact? 

Those opposed to the fee argued that it would be administratively difficult to implement and that it would lead to disputes.

They also criticised the lack of detail in the proposal, particularly the specifics surrounding which conditions would be deemed ‘minor’ and if any exceptions would apply. 

Yvonne Feri, of the Social Democrats, said that the costs of the new fee would be borne out by the poorest members of society – as well as those in rural areas. 

Speaking in parliament, Feri said “above all, the fee hurts the poorest, the elderly and the chronically ill.” 

“In the countryside, you often don't find a family doctor so quickly.”

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A commission established to consider the proposal issued a non-binding rejection of the idea in April, arguing that the costs of introducing the fee would be disproportionate to the actual effect – and that the exceptions would be difficult to properly set. 

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UPDATE: What are Switzerland’s rules for cannabis consumption?

Switzerland has a complicated set of rules for both medical and recreational cannabis consumption. Here's what you need to know.

UPDATE: What are Switzerland's rules for cannabis consumption?

Long prohibited and seen as a gateway drug with potentially dangerous impacts, countries across the globe have begun legalising cannabis in recent years. 

While the legalisation for medical use has been widespread, there have also been successful legalisation campaigns in several countries. 

The situation in Switzerland is also in flux and has been complicated by a range of recent changes.

Whether referred to as cannabis, marijuana or hemp, Switzerland’s Narcotics Act qualifies it as “a psychoactive substance”, with tetrahydrocannabinol (THC) being its most intoxicating ingredient.

The law specifies that “only THC is controlled under the Narcotics Act. Other active substances like cannabidiol (CBD) are not subject to the Narcotics Act as they do not have comparable psychoactive effects”.

Here’s what you need to know. 

Switzerland has legalised medical marijuana 

As of August 1st, the use of cannabis for medical purposes will be allowed in Switzerland

Patients who are medically prescribed the drug will no longer need to seek exceptional permission from the health ministry, as was the case prior to August 1st. 

Demand for cannabis-based treatments has risen sharply, with the health ministry issuing 3,000 exceptional authorisations in 2019.

The government “intends to facilitate access to cannabis for medical use for patients” and was therefore lifting the ban on its use for that purpose, it said in a statement.

The previous procedure involved “tedious administrative procedures”, said the ministry. “Sick people must be able to access these medicines without excessive bureaucracy.”

As of August 1st, “the decision as to whether a cannabis medicinal product is to be used therapeutically will be made by the doctor together with the patient” the government wrote

The sale and consumption of cannabis for non-medical purposes will remain prohibited.

READ MORE: Switzerland to lift ban on medical use cannabis

The new regulations could benefit thousands of people suffering from severe chronic pain, it added, including those with cancer and multiple sclerosis.

READ ALSO: Why Basel is about to become Switzerland’s marijuana capital

The law change will also mean that the cultivation, processing, manufacture and trade of cannabis for medical use will be subject to the Swissmedic regulatory authority, just as with other narcotics for medical use such as cocaine, methadone and morphine.

Legality of recreational cannabis is determined by the THC

THC of at least 1 percent is generally prohibited in Switzerland and use of products with this (or higher) content may be punishable by a 100-franc fine.

Of course, if someone is determined to smoke it, 100 francs may not be much a deterrent — but that’s a subject for another article.

“By contrast, possession of up to 10g of cannabis for personal use is not considered a criminal offence”, the law states, as long as it is not used by or sold to minors.

Italy's constitutional court has blocked the latest efforts to legalise cannabis.

Photo by Miguel MEDINA / AFP.

And, as with nearly everything else in decentralised Switzerland, “there are still considerable differences between cantons regarding implementation of the fixed penalty procedure”.

However, “cannabis flowers intended for smoking with a high proportion of cannabidiol (CBD) and less than 1 percent THC can be sold and purchased legally”, according to the legislation. 

That’s because, unlike the THC, cannabidiol “does not have a psychoactive effect”.

In other words, low-content THC and CBD will not give the “high” that recreational users seek.

When will Switzerland legalise recreational cannabis?

Currently, small amounts of recreational cannabis are tolerated in Switzerland.

“The decisive factor for classification as a banned drug is how much THC is contained in a cannabis product. If the THC content exceeds one per cent, the product is prohibited. Hashish is prohibited regardless of its THC content.”

As noted by the Swiss government, “If you are caught in possession of a small amount of cannabis (no more than 10 grams) for your own consumption, you will not be fined. In addition, if you supply (but do not sell) up to 10 grams to an adult, e.g. when sharing joints, you will not be fined.”

“If you are caught using cannabis, you may be given a fixed penalty fine of 100 francs.”

In June 2020, the National Council approved a plan to start cannabis trials for recreational use.

The experiments are to be carried out in Switzerland’s larger cities. Basel, Bern, Biel, Geneva and Zurich have all expressed interest in conducting the trials. 

The study seeks to find out how the market for cannabis works – and how to combat the black market. The social effects of legalisation will also be examined. 

At this point, no decisions have been made. However, Swiss authorities have set certain conditions in case recreational use is approved.

The National Council said if cannabis were to be legalised, it must be locally grown in Switzerland – and it must be organic. 

Health Minister Alain Berset noted that legalisation should benefit Swiss farmers even though “very few producers have experience in this area”.

READ MORE: Switzerland backs recreational cannabis trials – with one condition

Can you grow your own cannabis?

In truth, a number of people cultivate marijuana plants on their balconies or in their (secluded) gardens for their own personal use.

As it turns out, the law allows it, as long as it is a variety of the plant that does not have a narcotic effect — that is, the THC content must be less than 1 percent. 

By the same token, cannabis-based products with THC content of below 1 percent can be brought into Switzerland from abroad.

However, the import rules differ depending on the type of product  it is — flowers, seeds, extracts, oils, or other goods.

How much cannabis is consumed in Switzerland each year?

Precise numbers are hard to come by, but according to an article in Le Temps, which based its information on a medical study, about 100 tonnes are consumed in the country annually.

Cannabis remains the largest market in terms of volume: it represents 85 percent of drugs consumed in Switzerland, netting between 340, 000 and 500,000 francs per year.

READ MORE: Drugs and alcohol: Just how much do the Swiss consume?