Per capita healthcare costs continue to rise at rates that by far outstrip the cost of living and wage growth. As a result, an increasing number of insured persons find themselves struggling to pay their monthly premiums. At the same time, many cantons are increasingly withdrawing from the premium reduction system in an attempt to make savings. That is why CSS welcomes the now intense discussion, first launched back in 2017, on suitable measures for reining in costs within the mandatory healthcare insurance (OKP) system. To this end, it mainly actively supports the introduction of a uniform system of financing for outpatient and inpatient services (EFAS), the rapid revision of central tariff structures such as TARDOC and LOA, and the wider spread of digitally supported, integrated care.
These three key reforms could be accompanied by further measures from the Federal Council's cost-containment packages, such as the introduction of an outpatient tariff agency, the right of health insurers to appeal against hospital planning, and new approaches to medicine prices.
If these measures don't have the desired effect, it would make sense to set multi-year targets for OKP growth and to set up a cost-monitoring task force in order to keep future cost growth in check and make it measurable in qualitative terms. CSS therefore in principle supports the measures adopted by the National Council as part of the counterproposal for the cost-containment initiative. When formulating such cost targets, attention must be paid as far as possible to their feasibility and political acceptance (e.g. transitional periods, phased introduction, etc.). The periodicity of the cost targets is another question that arises regarding feasibility. Cost targets that are valid for more than one year are easier to achieve.
Targets of this kind for the growth of healthcare costs could serve as benchmarks for all future cost containment measures, thus making the latter both measurable and manageable. Parliament's decision to manage the costs on a tariff-partnership basis and, where necessary, to prevent volume growth also makes sense in this context. Broadly accepted goals would put pressure on the stakeholders (federal government, tariff partners) to increase efficiency and quality and to reduce volumes and/or prices – e.g. to limit non-necessary services or to carry out services more efficiently while providing the same or better quality. In addition, they would strengthen the tariff partnership by increasing the pressure on tariff partners to enter into agreements that place greater emphasis on cost-effectiveness, thus reining in cost growth.