Per capita healthcare costs continue to rise at rates that by far outstrip the cost of living and wage growth. Health insurer's premiums rise at the same rate, as premiums must always cover costs. CSS agrees with the initiative in the sense that this tendency is causing many households – especially middle-income families – to experience financial difficulties. For CSS, a worrying situation.
The popular initiative aims to cap this premium burden at 10% of the household's available income and harmonise the system of individual premium reductions (IPR). At present, the cantons are generally free to decide how much of a premium reduction to grant and to whom. However, CSS believes this initiative to be merely an expensive way of tackling symptoms. The initiative does nothing to address the root causes of cost growth. First, it is to be feared that much-needed efforts to improve efficiency and quality will be slowed down if rising costs are concealed by a massive expansion of the IPR system. Second, individual premium reductions would have to double within the space of 20 years in order to achieve the same level of cushioning as they do today. In other words, the initiative is not sustainable in the long term. In addition, unlike in the indirect counter-proposal, the main financial burden would have to be borne by the federal government and not the cantons, although it is the latter who actually play a key role in avoiding inefficiency and oversupply.
The Federal Council also rejects the SP's initiative because it concentrates solely on how the subsidies are to be funded and fails to take the curbing of healthcare costs into consideration. The Federal Council has issued its own indirect counter-proposal, according to which the cantonal contribution to the premium reductions would be linked to the gross cost of healthcare in the canton in question. The counter-proposal would mean that cantons with higher healthcare costs and a higher household premium burden would have to pay more overall than cantons with lower costs. This would create an incentive for cantons to contain the rise in healthcare spending.
Even though CSS believes the indirect counter-proposal to be a step in the right direction, it is especially important to also curb healthcare costs and thus relieve the burden placed on the insured persons. This is the aim of the current reforms. CSS therefore particularly supports the introduction of binding targets for cost growth in basic insurance.