Single health insurance scheme

Competition between health insurers is a key factor in cost efficiency. Introducing a single health insurance scheme would put our high-performing healthcare system at risk.

Competition as an effective means

CSS rejects the idea of a single health insurance scheme for all of Switzerland – as well as at the regional and cantonal level. Competition between health insurers currently leads to high quality and efficient invoice checking, which works in favour of the premium payers by preventing benefits from being paid unnecessarily.

Freedom of choice for insured persons

Insured persons have a wide range of innovative products and services to choose from and enjoy premium discounts when opting for an alternative insurance model. Under a system monopolised by a single general health insurer, insured persons would lose this freedom of choice and thus the possibility afforded them by law of changing health insurers.

Single health insurance scheme would not reduce costs

A single health insurer is therefore the wrong approach. Healthcare costs are not rising because admin costs are too high. The main cost drivers are the benefit costs, which make up an average of 95% of the premiums for mandatory healthcare insurance. A single health insurance scheme would have no impact whatsoever on this. Having a single health insurer would not solve the cost problems in the healthcare system. Any business that has a monopoly inevitably ends up with efficiency problems due to the lack of competition.

Combating false incentives and encouraging prevention

The current healthcare system does indeed have a number of weaknesses: on the one hand, there are various false incentives that contribute to the increase in the volume of services being used and therefore also to rising costs. On the other, the system is not really geared towards prevention. However, a single health insurance scheme would not automatically solve these cost and system-related issues as service providers and policymakers would continue to have differing interests. CSS is campaigning at the policy level for the elimination of false incentives. In addition, CSS is working to ensure that prevention and efficient treatment pay off for those involved.

Previous initiatives rejected

The Swiss electorate has rejected the idea of a single public health insurer on several occasions. Most recently, the voters clearly rejected the initiative to introduce a single health insurance scheme nationwide in the referendum of 28 September 2014. The 61.8% 'No' votes thus reflect the population's continuing clear endorsement of the competition-based healthcare system whose funding is based on social solidarity.

A popular initiative was launched in western Switzerland in autumn 2017 to create a single health insurance scheme for each canton. The initiative ultimately failed to secure enough signatures. In 2020, the Canton of Neuchâtel launched an identical proposal in the form of a cantonal initiative. However, Parliament again rejected the idea of revisiting a single cantonal health insurance scheme. Both the population and Parliament believe in the current system, which has become firmly established since the Swiss Federal Health Insurance Act was introduced in 1996.

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