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CSS Insurance

Territoriality principle

The principle of territoriality is enshrined in the Swiss Federal Health Insurance Act. CSS regrets this as the quality of services in particular could benefit from open borders. The quality of results achieved by certain foreign service providers surpasses that of Swiss providers by a long way. For example, the Martini Klinik in Hamburg performs some 2,200 prostatectomies a year using minimally invasive methods and three robots. 93.5 per cent of all patients operated on in this fashion retain full continence; in Germany as a whole, the success rate is just 56.7 per cent. In Switzerland, there are 23 robots capable of performing this operation. However, the leading hospitals perform surgery on around 100 cases only a year. This oversupply leads to high costs per case and a low volume of cases, and thus casts doubts on quality. In Hamburg, on the other hand, patients can expect higher quality as more cases are handled, making this a routine operation. And the entire group of insured persons benefits too: thanks to the lower prices, a lesser burden is placed on mandatory healthcare insurance. An opening of the borders would favour competition. Swiss providers would have to face competition from abroad, and transparency regarding the quality of services would lead to the formation of centres of specialisation. A framework needs to be created for cross-border care. Patients need to know why it would be better for them to go abroad for certain treatments; transparency regarding quality is required as much in Switzerland as it is abroad. In addition, emergency and basic care must be available close by. Opening up specialised areas could boost competition in Switzerland and lead to a concentration of the services offered – and thus to improved treatment quality. There should be no compulsion to seek treatment abroad. Patients must be able to decide for themselves. Only in this way can we promote quality medicine and benefit from it.

You can find further information on the topic of territoriality in our publication on health policies "im dialog" 3/2016 (in german).