June 9 votes in Switzerland: how can healthcare costs be reined in?
Health insurance premiums are a growing burden for Swiss households. This year alone, they increased by 8.7% on average. As a result, a large part of the population is unable or difficult to pay the compulsory monthly premiums.
On June 9, the Swiss voted on two initiatives aimed at capping health costs. While the Social Democrats wanted to limit health insurance premiums to 10% of a household’s income, the Centre Party sought to introduce a mechanism to force the state to curb the rising costs.
Do these two initiatives convince you? What measures do you think would be most effective to put an end to the ongoing rise in healthcare costs? Should financial help for households be boosted, or should the procedures covered by health insurance be reduced? Let us know in the conversation below.
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Swiss federal votes on June 9
The data:
Medical progress is being made, offering increasingly effective but very expensive screening and treatment.
The population is ageing
So what are the solutions?
In Switzerland, as elsewhere, we want to have our cake and eat it too, i.e. we cherish the new medical resources but are unwilling to pay the price.
We curse the doctors who are taking the money.
Ditto for the pharmas.
Ditto for insurance companies.
Ditto for a bloated bureaucracy that results in high costs.
Responses
The vast majority of doctors are not exaggerating. They are under pressure from patients who want more and more means of treatment and screening. However, there is no denying that some specialists do over-consume.
Pharmaceutical companies are in the business of making money for their shareholders' dividends and dumping their products, meaning that medicines manufactured in Switzerland are cheaper abroad. Who are they kidding?
How come the insurers are making a profit?
There aren't enough carers, but too many civil servants.
So let's nationalise the pharmas and the insurance companies, which should be conglomerated in the same way as the ECA insurance company in Vaud.
Then let's decide whether we want to support a medical system that is continually improving its resources, or fighter jets that are forced to go and train in Sweden or Italy because of the small size of the country.
Les données:
La médecine avance et propose des dépistages et des traitements de plus en plus performants mais très chers
La population vieillit
Alors quelles solutions ?
En Suisse, comme souvent ailleurs du reste, on veut le beurre et l'argent du beurre c'est à dire qu'on chérit les nouveaux moyens de la médecine mais sans vouloir en assumer le prix.
On maudit les médecins qui se "sucrent"..
Idem pour les pharmas.
Idem pour les assurances
Idem pur une bureaucratie pléthorique entraînant des gros coûts.
Réponses
La vaste majorité des médecins n'exagère pas. Elle subit la pression des patients qui veulent de plus en plus de moyens de traitement et de dépistage. Il ne faut pas nier cependant que certains spécialistes effectivement sur consomment
Les pharmas sont des boites à faire du fric pour les dividendes de ses actionnaires et font du dumping, c'est à dire que les médicaments fabriqués en Suisse sont moins chers à l'étranger. De qui se fiche-t-on ?
Comment se fait il que les assureurs font des bénéfices ?
Il n'ya pas assez de soignants mais trop de fonctionnaires
Donc, nationalisons les pharmas et les assurances qui doivent se conglomérer à l'image de l'assurance ECA vaudoise
Ensuite décidons nous si nous voulons assumer une médecine progressant dans ses moyens continuellement ou alors des avions de chasse obligés d'aller s'entraîner en Suède ou en Italie vu l'exiguité du territoire national
Health costs are reduced by being healthier, simpler than that.
That is, eat better, move more and keep your brain exercised with cultural or other diversions.
Eat less, and especially less sugar. Look that pasta, rice and bread are carbohydrates i.e. sugars. Replace sugars with more vegetables and fruit that is not too sweet.
Less meat. Drink but not during meals or at least very little during meals because water dilutes the gastric juices so you digest worse and longer.
Eating is also very important. Don't eat snacks and skip breakfast, just drink an unsweetened drink. if you can do 16/8 is a good place to start. 16 hours without eating and 8 hours in which you eat 2 meals, without snacks.
During the 16 hours of fasting, the body and mind repair themselves well.
Health insurance is really the last thing to think about but instead discussions are always at this level.
I costi della salute si diminuiscono essendo più sani, più semplice di così.
Cioè mangiare meglio, muoversi di più e tenere allenato il cervello con svaghi culturali o altro.
Mangiare di meno, e soprattutto meno zuccheri. Guardate che la pasta, il riso e il pane sono carboidrati cioè zuccheri. Rimpiazzare gli zuccheri con più verdure e frutta non troppo dolce.
Meno carne. Bere ma non durante i pasti o comunque pochissimo durante i pasti perché l'acqua diluisce i succhi gastrici quindi si digerisce peggio e più a lungo.
Anche quando si mangia è molto importante. Non fare snacks e saltare la colazione, bevendo solamente una bevanda non zuccherata. se riuscite a fare il 16/8 è ottimo per cominciare. 16 ore senza mangiare e 8 ore in cui si mangiano 2 pasti, senza snacks.
Durante le 16 ore di digiuno il corpo e la mente si riparano bene.
La cassa malati è proprio l'ultima cosa a cui pensare ma invece le discussioni sono sempre a questo livello.
My proposal would be to merge the two insurances, the accident insurance paid by companies and the private health insurance.
Fewer hospitals and more outpatient centres.
Medicines that are not vital should be paid for at 100%, only the vital ones should be transferred to the health insurance.
not 100% private
Mi propuesta sería fusionar los dos seguros el de accidente que pagan las empresas y el de enfermedad privado.
Menos hospitales y más centros tipo ambulatorios
Medicinas que no sean vitales deberian pagarse al 100% solo las vitales se pasarian al seguro médico
no sea privada al 100%
I know this may be difficult, but please 'just switch off the machines'. I have observed recently among our circle of friends how the doctors 'prolonged life' at a huge cost for someone after a severe stroke. Three months in hospital unconscious being artificially kept alive. Also with less severe cases a lot of unnecessary treatment just for treatment's sake. Please just switch off the machine and save us from extended sufferings (and costs).
The problems with health and accident insurance are inherent in their structure.
They should not be public limited companies or similar, with the obligation to make a profit and pay very high salaries to directors and all the bureaucracy that goes with it.
Just look at the local buildings and the insurance companies.
Then the State (canton or rather federal) should agree to take charge of the health of its citizens while deducting a premium proportional to the salaries or incomes and just like the AVS manage the sector.
Le problèmes des assurances maladie/accident sont inhérents à leur structure.
Ce ne devraient pas être des SA ou autres, avec l'obligation de tirer des profits et payer très cher des membres de direction et toute la bureaucratie attenante.
A voir les immeubles locaux et el des assurances.
Ensuite l'Etat (canton ou plutôt fédéral) devrait accepter de prendre en charge la santé de ses citoyens tout en prélevant une prime proportionnelle avec mesure aux salaires ou revenus et tout comme l'AVS gérer le secteur.
How the public perceives medical futility is one of the most important things.
医学的無益 medical futility を国民がどう認識するかも大切なことの一つだと思います。
The subject is too complex to deal with in a forum, because the interrelationships that play an important role between patients, doctors, insurance companies, and the state are intricate and non-transparent. Nobody apart from the patient has an interest in creating transparency. Nobody is willing to give anything up. Cutting unnecessary benefits is almost impossible (too many people would have to change jobs). Moving to a single fund would produce a lot of unemployed (about 10% of administrative costs are basically redundancies, wages, jobs). The single fund would only be manageable with a huge, uncontrollable, inefficient apparatus like the current private insurances. Decreasing private insurance would lead to de-lobbying and displeasing many politicians who have their hands in the pie. Touching the medical caste (dog doesn't bite dog) would be very difficult. Healthcare is business. Touching the pharmaceutical industry is a business. Too many politicians with their hands in the cookie jar (lobbying). The issue is political, not soci-scientific!
Il tema è troppo complesso da trattare in un forum, perché le interrelazioni che giocano un ruolo importante tra pazienti, medici, assicurazioni, stato sono intricate e non trasparenti. Nessuno, a parte il paziente ha interesse a creare trasparenza. Nessuno è disposto a rinunciare a qualcosa. Togliere le prestazioni inutili è quasi impossibile (troppe persone dovrebbero cambiare lavoro). Passare a una cassa unica produrrebbe moltissimi disoccupati (circa il 10% dei costi amministrativi sono fondamentalmente ridondanze, salari, posti di lavoro). La cassa unica sarebbe gestibile solo con un apparato enorme, incontrollabile, inefficiente come le attuali assicurazioni private. Diminuire le assicurazioni private porterebbe a de-lobbizzare e a scontentare moltissimi politici che hanno le mani in pasta. Toccare la casta dei medici (cane non morde cane) sarebbe difficilissimo. Sanità è business. Toccare l'industria farmaceutica è un'impresa. Troppi politici con le mani in pasta (lobbyng). Il tema è politico, non soci-scientifico!
Single or multiple health insurance does not make people healthier, it changes very little.ciao
Le casse malati, uniche o molteplici non rendono la gente più sana, cambia pochissimo.ciao
Value-Based Healthcare
A market-based delivery system can refocus an inefficient healthcare model and improve patient satisfaction by facilitating providers’ ability to deliver value, which is the intersection of quality and costs. Physicians’ ordering preferences initiate virtually every medical service and resource deployed. A practical solution must be clinically reliable and physician-specific when documenting their effective and efficient ordering patterns.
Fortunately, this solution is not just a theory. It has been successfully implemented and proven effective. As the Wall Street Journal reported, physicians adjusted their practice patterns by adopting statistically reliable clinical processes, leading to substantial cost savings of $200,000,000 in 14 hospitals within a single city over two years. These are not just numbers, but a testament to the potential of this solution. Similar outcomes can be achieved to benefit every hospital and community in Switzerland. If these documented results interest you in your present situation, I would be eager to discuss an initiative with you at your convenience.
W.C. (Bill) Mohlenbrock MD, FACS
(858) 354-0415 (m)
bmohlenbrock@alliancecaretech.com
It is impossible to fulfil all the objectives of health policy, namely
1. no 2-class medicine
2. optimal health protection for all, including medical progress
3. no excessive increase in healthcare costs
under one roof. Consumers (citizens) are prepared to spend a high proportion of their income on healthcare, which is rational because they only have a limited lifespan. This is why they accept the disproportionately high rise in healthcare costs.
Even if efficiency gains of perhaps 30% are still possible, the costs will continue to grow disproportionately due to medical advances and the lack of elasticity of demand and may one day reach a level that is no longer acceptable. However, this will then lead to rationing and thus to two-tier medicine.
Es ist unmöglich, alle Ziele der Gesunheitspolitik, nämlich
1. Keine 2-Klassenmedizin
2. Optimalen Gesundheitsschutz für alle unter Einbezug des medizinischen Fortsschrittes
3. Kein überdimensionierter Anstieg der Gesundheitskosten
unter einen Hut zu bringen. Der Konsument (Bürger) ist, was rational ist, weil er ja nur ein zeitlich beschränktes Leben hat, bereit, einen hohen Antel seines Einkommens für die Gesundheitsvorsorge und -pflege auszugeben. Deshalb nimmt er die überproportional zur Teuerung wachsenden Gesundheitskosten in Kauf.
Selbst wenn noch Effizienzgewinne von vielleicht 30 % möglich sind, werden die Kosten wegen der medizinischen Fortschritte und der fehlenden Elastizität der Nachfrage weiter überproportional wachsen und vielleicht irgendeinmal ein Niveau erreichen, das nicht mehr akzeptiert wird. Dann aber wird es zu Rationierungen und damit zu einer 2-Klassenmedizin kommen.
So I voted, but I was unhappy with the substance of the vote. How can healthcare be a fundamental right, when it is managed by profit driven entities?
What we should really be doing is (1) encouraging people to lead healthier lifestyles. Treatment costs should be separated into buckets e.g. disease due to unhealthy habits and other. One target would be to reduce costs gradually in the 1st bucket and use it to encourage healthier lifestyles.
(2) In parallel, make the food chain produce and deliver healthier choices (supermarkets, the push for organic, less meat in diets etc should have a greater emphasis)
(3) we should look at how healthcare is delivered but with a fresh set of eyes. On recent trips to hospitals, I was astounded at how much one time use items are used. Just washing bed linen daily involves 2 sheets and 3 pillow cases, for a 2000 bed hospital that's 10,000 items daily and for the most part it is not necessary. Common sense has been replaced by to-do lists, check lists. Even the curtains that separated beds are made of disposable sheets. This all adds up to a high cash out.
You are right except one thing, less meat for you may be healthy but this does not apply for everyone. Also should you exclude broken leg surgeries from skiiing? I mean thats self inflicted. So be careful with generalising about the concept of “healthy” diet or habits. For some people it is healthier to smoke rather than to consume meth. Smoking habit has a cause and it is not just for fun. Drugs and sugar binging which causes diabetes is caused by anxiety, stress which can only be reduced by changing entirely our work culture, structure and economy. So in ideal world, what you say it make sense, but it is not as simple as denying health care to those who broke simply need it.
The Swiss system is still a better alternative than what the US struggles with. Health care is considered a privilege in the US, and not a right. I reside in Australia at the moment, and healthcare options like Medicare is readily available and allows patients to pick their own physicians. Yes, you do need private coverage like Switzerland and the US. At the end of the day it's the business of medicine.
The Dutch system looks promising but doctors will never go for it because they would earn much less.
Il sistema olandese sembra promettente ma i medici non ci staranno mai perché guadagnerebbero molto di meno.
You are historically one of the best countries with policies that work, your excellent geography helps you, you look like a world power, or you are, famous for the policy of banks and management of funds, I call on you: you are going to get involved with HEALTH, which is essential for the human being, for the citizen with rights, in my opinion you should increase more taxes in other branches, such as in the business sector (commercial sectors, bankers, etc. or tourism). It is a question of the people to allow new laws and new policies, why have revolutions existed, why the thousands of battles that the Saxons and the Europeans lived through, if as a continent they are already a first world continent. Please, come to your senses and give priority to health, not by increasing premiums, but to look for a solution to the crises (which always occur at any stage or decade) by another way, either by moving or removing bureaucratic institutions that are sometimes only for decoration, because their function has become monotonous. Call on citizens to come together and establish a plan that will help everyone as a country. Venezuela Caracas Central University.
Ustedes historicamente son unos de los mejores paises con politicas que funcionan, la geografia tan excelente de ustedes los ayuda, parecen una potencia mundial, o lo son, famosos por la politica de bancos y manejo de fondos, les hago un llamado: van a involucrarse con la SALUD, que es lo primordial para el humano, para el ciudadano con derechos, al mi parecer deberias incremetar mas impuestos en otras ramas, como en el sector empresarial (rubros comerciales banqueros etc o turisticos). Es cuestion del pueblo permitir nuevas leyes y nuevas politicas, para que han existido las revoluciones, para que la miles de batallas que vivieron los sajones, los europeos si ya como continente son un continente de primer mundo. Porfavor, recapaciten y denle prioridad a la salud no incrementando las primas, sino buscar la solucion a las crisis (que siempre se presentan en culquier etapa o decada ) por otra via, sea moviendo o removiendo instituciones burocraticas que a veces son solo de aornos, porque su funcion ya se hizo monotona. Llamen al ciudadano a reunirse y establecer un plan que ayude a todos como pais. Venezuela Caracas Universidad Central.
But there is an alternative to the horrendous healthcare costs!!!
The abolition of the 4500 TARMED tariff items, which are shamelessly abused by doctors
Doch es gäbe eine Alternative bei den horrenden Gesundheitskosten!!!
Die Abschaffung der 4500 TARMED Tarifpositionen, die von den Ärzten schamlos missbraucht werden
Why has it never been discussed until today that the citizen with a deductible of 2500 could contribute the most. Are the lobby doctors to blame or????
LGTrudi
Warum wurde bis heute nie darüber geredet, dass der Bürger mit einem Selbstbehalt von 2500 am meisten beitragen könnte. Sind die Lobby Arzte daran schuld oder????
LGTrudi
Even with the deductible of 2500, the first 300 are the same for everyone.
Anche con la franchigia di 2500, i primi 300 sono uguali per tutti.
Perhaps you should consider what other countries do for their healthcare systems. The Swiss are athletic and very active. This is the biggest thing the Swiss—or anyone—could do to keep healthy, so focus more on fitness.
Can the Swiss set up standard procedures for specific ailments that the individual or companion can treat? Suppose a person acts responsibly, follows a healthy lifestyle, maintains a good weight, does not smoke, gets good sleep, exercises, etc. In that case, they get a discount on the insurance premium on top of being healthy.
Healthcare should be set up like a Quality Control program at a major manufacturing company. Incentives for living a healthy lifestyle are the first order. A system that supports this focus is necessary.
The Swiss are more intelligent than I am. I'm sure they will do the right thing—they always do. It's too bad the US is not run by the Swiss. We suffer so many inefficiencies to support wealth transfer to the upper class. It is a case of "When the head is no good, the whole body suffers," and America is suffering.
A healthy lifestyle is the only possible solution, prevention. hello
Uno stile di vita sano è l'unica soluzione possibile, la prevenzione. ciao
It is incomprehensible to me why the basic premiums are so different. They should be the same throughout Switzerland. = And so should the premium reductions, otherwise you will be penalised if you live in the "wrong" canton!
Besides, I have been in favour of a single health insurance fund for x years. It would save a lot of administrative costs.
Es ist für mich unverständlich, warum die Grundprämien so unterschiedlich sind. Diese sollte schweizweit gleich sein. = Und die Prämienverbilligungen ebenfalls, sonst wird man bestraft, wenn man im "falschen" Kanton wohnt!
Ausserdem bin ich schon seit x Jahren für eine Einheitskasse. Das spart eine Menge Verwaltungskosten.
To address rising healthcare costs in Switzerland, a multi-faceted approach is essential, focusing on payment reform through value-based care and bundled payments, price transparency with standardized pricing and public databases, and increasing administrative efficiency by streamlining processes and enhancing health IT integration. Emphasizing preventive care and wellness programs, such as chronic disease management and community health initiatives, can reduce long-term costs. Additionally, pharmaceutical reforms, including negotiating drug prices and promoting generic drugs, are crucial. Innovations in healthcare delivery, like expanding telemedicine and shifting services to outpatient settings, along with strong regulatory and policy changes, such as antitrust enforcement, are also necessary to curb escalating healthcare expenses in the Swiss context.
Yes.
Yes.
Yes.
Yes.
Well, the voting papers reached me today the 7th of June. If we could vote electronically it would still be time to vote, not so by mail...
Nationalize the entire industry! Yes, I know...the capitalists will scream murder. But then...look at all the skyscrapers pharma outlets have built themselves...WITH OUR MONEY.
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