For members


EXPLAINED: How Switzerland wants to cut soaring healthcare costs

Swiss health costs have been rising in recent years, with further spikes, including in insurance premiums, seen as inevitable. The government is proposing measures to counter this upward trend.

EXPLAINED: How Switzerland wants to cut soaring healthcare costs
Switzerland wants o implement coordinated medical networks to save costs. Photo: Rodnae Productions on Pexels

Based on the information released by Santésuisse, an umbrella group for health insurance companies, an overall increase of around 4 percent for 2023 will be the norm.

Unfortunately for the consumers, who are already hard-hit by rising energy costs, premiums for compulsory health insurance will likely rise by an average of 5 percent in the fall, according to online price comparison site, Comparis.

And many people could even see their premiums soar by more than 10 percent in 2023 — the sharpest hike in premiums in 20 years.

The exact amounts of premiums for all policyholders will be released by the end of October.

The price hikes are not a new phenomenon per se: over the past 20 years, costs have risen at twice the rate of economic growth, resulting in health insurance premiums that are 90 percent higher than in 2002.

READ MORE: How spiralling costs are jeopardising Switzerland’s healthcare system

Why have these costs been increasing so much?

Part of the reason is the fact that people in Switzerland have a high life expectancy, but as they get older, they tend to suffer from chronic, cost-intensive diseases.

The more recent hikes can be attributed to higher medical costs incurred during the two years of coronavirus pandemic, estimated to cost insurers over one billion francs so far, not even taking into account about 265 million spent for Covid vaccinations in 2021.

Add to that the cost (paid for by the government) of Covid tests, as well as booster shots administered in 2022, and those still to be given once Switzerland rolls out second doses in 2023.

How will the government cut these costs?

Santésuisse has been urging the Federal Council to implement a range of reforms to reduce costs and ensure that not so many are passed on to consumers. 

On Wednesday, authorities announced a package of measures aimed at controlling costs. “These measures will improve medical care and contain rising costs in the healthcare system”, the Federal Council said.

Coordinated networks

These care networks are seen as a way to reduce unnecessary medical services. 

“They bring together health professionals from several disciplines to provide ‘all-in-one’ medical care. They improve coordination throughout the treatment chain, for example when various specialists are caring for an elderly person with several chronic diseases”, Federal Council said in a statement.

Hospitals, pharmacies, and various therapists would be attached to the network, and all treatments “will be invoiced at once, as if it were a single supplier”.

Right now, all service providers invoice insurance carriers separately, which adds to administrative costs; the new system is also believed to provide a better oversight and control, and eliminate unnecessary or redundant medical treatments, Health Minister Alain Berset said during a press conference in Bern on Wednesday.

Faster and cheaper access to medicines

The government also wants to guarantee “fast and as inexpensive as possible access to expensive innovative medicines”.

To achieve this, it wants to “anchor in the law” an already widely-used practice: to conclude pricing agreements with pharmaceutical companies. It would mean that drug manufacturers would have to reimburse a portion of the price to insurers.

“This measure makes it possible to guarantee rapid access to these drugs, while limiting their price”, authorities said.

Electronic invoicing

Another measure will require all providers of inpatient and outpatient services to send their invoices to insurance companies in electronic form — seen as a quicker, more effective and cheaper way to transmit billing information.

These measures “will make it possible to curb the rise in costs,” the Federal Council said, adding that “it is not yet possible to estimate the concrete extent of these savings, which would depend on how the health system will implement the measures”.

It is now up to the MPs to debate these proposals.

READ MORE: Why Swiss health premiums are set to rise — and what you can do about it

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For members


Ambulance, ER or doctor? What are Switzerland’s guidelines for health emergencies?

How unwell do you need to be to visit to a hospital emergency room in Switzerland, or what about calling an ambulance?

Ambulance, ER or doctor? What are Switzerland's guidelines for health emergencies?

In some countries it is common for people who don’t have their own doctors to go to an emergency room (ER) with all kinds of health complaints.

In some cases, they even routinely call an ambulance to take them there.

But in Switzerland the rules are different.

This is all the more relevant now, when emergency departments in a number of Swiss hospitals are understaffed and therefore already stretched to the limit. 

“We didn’t think that Switzerland would be affected [by scarcity of health workers] so badly,” said Vincent Ribordy, co-president of the Swiss Society for Emergency Medicine. “We thought that the capacity of the system would be limitless, but this is not the case.”

Given this growing lack of capacity to handle patients, “people need to understand that they don’t have to come to us for every little thing, but that in many cases pharmacies, family doctors, and duty practices can help them,” he added

So how can you know whether your symptoms are serious enough to warrant a visit to the ER?

Emergency rooms are for just that: true medical emergencies, which, if not treated quickly and immediately, can be life-threatening.

This includes (but is not limited to) heart attacks and strokes, head trauma, severe respiratory distress, heavy bleeding, serious injuries, and other conditions where any delay in treatment can put your life or health at risk.

In June 2021 the Swiss government introduced a charge of 50 francs for those people who visit the emergency room for non-urgent treatment.

It was introduced as a co-pay, meaning that the patients would have to pay out of their own pockets (i.e. it will not be covered by insurance).

However at the time no concrete indications were given as to what amounts to ’non-urgent’ treatment in the eyes of the law.

If you don’t feel well (even in the absence of the above-mentioned symptoms), you may overestimate your ailment and think it requires an urgent visit to the ER.  

But before you go there, get your condition evaluated by other medical professionals. Your first point of contact should be your primary physician (GP), who can decide whether you need to go to the hospital or can be treated another way.

In the event you don’t have a GP (or are a tourist), there are other options available in Switzerland, such as medical centres and walk-in clinics in virtually all cities.

If you are not sure how serious your condition is, you can call a “duty doctor” service (Notarzt in German, médecin de garde in French). Their numbers vary by cantons; it is 0800 33 66 55 in Zurich, 022 748 49 50in Geneva, 061 261 15 15 in Basel, and 0848 133 133 in Vaud.
People who answer the phone will ask questions about your symptoms and can decide whether you need to go to the ER, require a visit from the duty doctor, or can just wait and see how your condition evolves.
A duty doctor is also an alternative to the emergency room if you start feeling ill at night, as this service responds 24/7.
Can you be turned away from the ER if your symptoms are not serious enough?
If emergency services are overcrowded, then yes, you can be turned away.
On average, ERs refuse the admission to the 30-40 percent of patients deemed non-urgent, according to Swiss Medical Review.

READ MORE: Reader question: Can my Swiss health insurance refuse to pay my medical bills?

What about calling an ambulance?
Before you dial 144 — the national number for urgent medical help — know that conditions are even stricter for ambulances than for ER visits.

A dispatcher will ask you what the nature of your emergency is, as well as other follow-up questions to determine if you need an ambulance in the first place.
Even if you are going to the ER, an ambulance will only be dispatched if you have serious, life-threatening symptoms listed above.
Otherwise, you are expected to get to the hospital by other means.
Keep in mind that the ambulance ride is not exactly cheap, ranging — depending on where you live — from about 900 to 2,100 francs.
The compulsory health insurance (KVG / LaMal) covers half of this amount, but only up to 500 francs a year if the ambulance is called when there is no immediate danger to life.

However, if ambulance is required for life-threatening conditions, KVG / LaMal will cover up to 5,000 francs of the cost of emergency transportation.

Some supplemental insurance policies guarantee a higher, or even unlimited, cover of all transportation and rescue costs.

READ MORE: Am I liable for ambulance costs in Switzerland?