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CSS Insurance

Position of CSS Insurance

CSS Insurance makes its viewpoint on the latest issues and problems in healthcare known by publishing short position statements on various aspects of public health policy. The main focal points are explained in a clear and comprehensible manner along with CSS Insurance's stance on the matter.

Supervision by FINMA The Swiss Financial Market Supervisory Authority (FINMA) is responsible for supervising the providers of supplementary insurance in accordance with the Insurance Contract Act (VVG). CSS calls for sensible and appropriate levels of supervision.
Single (cantonal) health insurance scheme
CSS opposes single health insurance schemes at both the national and cantonal levels.
Self-responsibility Self-responsibility is an important component of mandatory health insurance that helps stem the rising tide of healthcare costs. CSS actively supports developments that encourage people to take responsibility for their health.
Inter-generational solidarity The inter-generational solidarity between young and old is a key element of our healthcare system, which is based on solidarity. CSS is committed to ensuring that solidarity takes a form acceptable to everyone and is implemented in a way that makes actuarial sense.
Integrated care CSS views integrated care as a key instrument in promoting quality and cost efficiency in the Swiss healthcare system.
Medication In a highly regulated market for medication, CSS champions the introduction of market mechanisms in pricing and in the insurers' right to appeal against the prices set by the Federal Office of Public Health.
Financing of care CSS supports a sustainable care financing arrangement, which spreads the costs between the mandatory healthcare insurance (OKP), the insured persons and the cantons.
Mandatory services/benefits (HTA) By law, mandatory healthcare insurance only pays for those services that are effective, appropriate and economical. Health technology assessments (HTAs) guarantee a systematic review of such services. That is why CSS supports the establishment of HTAs.
Prevention CSS recognises the considerable importance of prevention in healthcare provision. Like all other benefits under basic insurance, preventive measures covered by basic insurance should meet the criteria of effectiveness, appropriateness and cost-effectiveness.
Quality Quality and transparency are imperative conditions for establishing sustainable competition that makes economic sense. CSS call for medical services and benefits to be disclosed transparently and subject to quality reviews.
Reduction of premium regions CSS generally stands by the current system of premium regions. Any adjustments to the way the premium regions are classified must be based on objective and easy-to-understand criteria.
Reserves To ensure their long-term solvency, insurers establish adequate reserves. CSS considers the current risk-based reserve model to be a sensible model for calculating minimum reserves.
Risk compensation A functioning system of risk compensation is the fundamental requirement for competition that makes economic sense. CSS therefore advocates refining the risk compensation system.
Hospital financing / Uniform outpatient financing The present "dual-fixed" system of hospital financing creates false incentives within the system; CSS therefore supports political endeavours to introduce uniform outpatient / inpatient financing (EFAS).
Tariff structures The vast majority of medical services are provided via a variety of tariff structures (incl. TARMED, SwissDRG, LOA, Physiotherapy). CSS champions the further development of tariff structures in a manner that is fit for purpose.
TARMED revision The revision of the tariff structure for outpatient medical services is under way. CSS champions the further development of this tariff structure in a manner that is fit for purpose.
Separation of KVG & VVG
CSS opposes the separation of basic insurance and supplementary insurance, as this would result in additional costs and an additional administration burden being borne by the premium payers.
Partial VVG revision After the total revision of the Federal Insurance Contract Act (VVG) was referred back to the Federal Council by the Swiss Parliament in 2013, consultation proceedings on the partial revision are likely to be launched in 2016. CSS is campaigning for the disputed points in the referral decision to be implemented accordingly.
Territoriality principle CSS position statement on mandatory benefits under the KVG which could be provided across borders. The issue of quality is at the heart of this proposal.
Digitalisation Position statement on technological development and the associated impact on the healthcare system.