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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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EXPLAINED: Should I take out Swiss health insurance before or after the birth of my baby?

In Switzerland, you can choose between taking out health insurance for your baby either before or after the birth – but there’s a catch.

EXPLAINED: Should I take out Swiss health insurance before or after the birth of my baby?

In Switzerland, basic health insurance is mandatory even for the youngest among us.

Though it is generally recommended to register your baby with a health insurance prior to giving birth to save yourself the admin headache during recovery and bonding time, you can also take out health insurance after birth – though this could have financial consequences.

In any case, you should do this no later than three months after welcoming your baby.

When taking out basic health insurance after birth, your baby will be insured retrospectively from their birth. This also means that the premiums must be paid retrospectively up to the entire month of birth.

You must also inform your own health insurance of your new arrival. Note that your baby does not have to be registered with the same health insurance as you or your partner.

Are there any consequences to taking out basic health insurance for my baby after birth?

No, there are no financial consequences to taking out basic health insurance for your newborn following the birth, provided you do so within the necessary time frame.

What about supplementary health insurance?

While taking out basic health insurance will – hassle aside – play out the same way before and after the birth, this is not the case for (voluntary) supplementary health insurance.

In Switzerland, you are strongly recommended to register with a basic health insurance company during your pregnancy as this will enable you to take out supplementary health insurance for your baby at the same time. Some insurance companies, such as Concordia (100 francs), will even give you a so-called baby bonus.

Further to this, when registering your baby with a health insurance company for basic health coverage you will not be asked to provide any health check for your (unborn) baby.

However, when taking out supplementary health insurance after your child’s birth, the insurer will collect information about your baby’s health in the form of an extensive survey – similar to those adults in Switzerland have to fill out when registering with an insurance company.

This means that should your baby be born ill or with a disability, the insurance company can impose restrictions on the benefits they are to receive, or worse, refuse to sign a contract for your baby altogether.

According to a 2019 article by Swiss broadcasting company SRF, most Swiss supplementary health insurance companies will almost always reject a baby that is born with a disability as they consider them a ‘bad risk’.

You will also have to inform the insurance company of any illness or disability that has been detected during antenatal screening tests, in which case the insurer may again refuse to take your baby on.

However, note that the health insurance company is not allowed to request antenatal screening tests. Parents must only declare the results with the insurance if they have it.

In general, it is advisable to have your baby insured between the 4th and 8th month of your pregnancy.