Swiss Abroad suggest solutions for reducing healthcare costs

The ageing of the population is one of the factors driving up healthcare costs. Keystone/Gaetan Bally

Combating the overuse of medical care, improving diet, creating a single health insurance scheme – Swiss citizens living abroad have come up with a wide range of ways to limit healthcare costs. But there’s one thing on which everyone agrees: the system needs to be reformed.

Most Swiss people abroad don’t pay health insurance premiums in Switzerland. However, expats are aware of the problem caused by rising healthcare costs. Our readers have expressed their fears and raised potential solutions in the debate we launched on SWI swissinfo.ch.

>> Join our debate on healthcare costs:

A number of people support the creation of a single health insurance fund, an idea that was widely rejected in federal referendums in 2007 and 2014. “This fund would cover the costs of basic medical care. The Confederation and the cantons would be the majority shareholders and would define measurable success criteria,201D argues Nando, a Swiss in Italy.

Nando says he is satisfied with the health system in his host country. “Basic care and emergency services are free for everyone. We pay for basic insurance with our taxes.”

Another reader is convinced that a single system for everyone would work in Switzerland, not least because of the country’s small size. “It would put an end to the waste of resources,” he says.

In Aram’s view, the state should itself offer basic insurance. “This would force private players to innovate and cut costs,” he writes. He acknowledges that this model has its shortcomings, but he insists that it would be a step in the right direction.

Prevention better than cure

Other contributors recommend stepping up prevention. “To reduce healthcare costs, we need to launch a federal campaign to tackle major failings: poor diet, gluttony, drug and alcohol consumption. Let’s go back to basics: let your diet be your medicine,” suggests Elena Lacroix Jaeggy.

Achille agrees: “Overeating is certainly an important factor, but no more so than alcohol, where we know that the first sip already increases the likelihood of developing cancer.”

This reader also points out that physical exercise is essential for good health. He therefore recommends launching campaigns combining these different factors to improve public health.

Another participant in the discussion criticises the attitude of the big pharmaceutical groups, “which want to make profits and have shareholders who expect high returns”. He feels that for these people, prevention is unfortunately not profitable.

>> For full details of the issues being put to the vote on June 9:

Overuse in the firing line

For his part, Marco believes that poor diet is not the root of the problem. For him, it’s the overuse of healthcare services that’s responsible for the rising costs. A view shared by one user, who points the finger at “people who consult a doctor for a cold or call an ambulance for non-urgent cases”.

Yerly blames “the inefficiency of the administration, which is incapable of spotting imaginary patients who manage to obtain medication or sick leave”. Anderma has a similar view: the Swiss administration is too passive and is therefore holding back innovation that would help limit healthcare costs.

Vera Gottlieb, on the other hand, believes that the main thing to do is to get drug prices under control. “The pharmaceutical industry should contribute to this effort,” she writes.

>> Join the discussion on our debate platform “dialogue”:

Burden on households

“In Switzerland, everyone has to pay very high health insurance premiums,” says Giacomo Notrevo. He believes that this system suits the rich, but not people on low incomes, who are then dependent on state subsidies. “The Swiss parliament should set up a national commission to examine other ways of organising healthcare and reform the system,” he suggests.

One reader also points out that healthcare costs are one of the largest items in household budgets. She seems attracted by the solution proposed by the Social Democratic Party’s initiative to cap premiums, on which the Swiss people will vote on June 9. “We need to limit the impact of rising premiums by setting a sensible percentage of household income for health insurance,” she says.

Finally, Michel Parnia, a Swiss living in Canada, asks: “I lived with food ration cards. Have we reached a situation where we will have to ration healthcare?”

Edited by Samuel Jaberg. Translated from French by DeepL/ts