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Old 11.03.2013, 12:11
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More coverage from basic health insurance for mothers soon?

The federal council supports the parliamentary initiative that not just the pregnancy itself should be freed from franchise + deductible, but also the complications arising out pregnancies.

Hopefully the legislation will go through quickly!

For more info (in German, French or Italian) click here.

Last edited by international; 11.03.2013 at 12:12. Reason: forgot to post the link :-S
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Old 11.03.2013, 12:51
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Re: More coverage from basic health insurance for mothers soon?

hmmm, wonder who is going to end up paying for this one? Not sure I quite understand the problem - it states in the article that women who have no problems during pregnancy have no extra costs, where those who have problems do have extra costs and this isn't fair. This is the part that stumps me. And I am not sure what complications they mean - if extra tests are needed? In case a pregnancy needs to be terminated? Anyways, I guess premiums for women of childbearing age shall increase...
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Old 11.03.2013, 13:15
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Re: More coverage from basic health insurance for mothers soon?

Well essentially the problem was that mothers with a healthy child paid no franchise or deductible for any treatment, mothers with complications (further exams, medication, etc.) had to pay on top.

The cost impact probably won't be too bad, as the percentage of those costs is low in the general scheme of things. I am not sure how this will impact the premiums, probably a lot less than other issues.
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Old 11.03.2013, 13:33
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Re: More coverage from basic health insurance for mothers soon?

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Well essentially the problem was that mothers with a healthy child paid no franchise or deductible for any treatment, mothers with complications (further exams, medication, etc.) had to pay on top.

The cost impact probably won't be too bad, as the percentage of those costs is low in the general scheme of things. I am not sure how this will impact the premiums, probably a lot less than other issues.

do you mean for the same tests, the woman with complications had to pay more, or are you talking about additional tests that are required? If it is the latter then doesn't it make sense that if you require more tests than "normal" that it should cost more? If 2 people injure their knee and one requires surgery and the other doesn't, shouldn't the one needing surgery pay more?
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Old 11.03.2013, 14:25
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Re: More coverage from basic health insurance for mothers soon?

It make sense that the one with surgery should pay more. However the political idea is to decrease the financial strain on pregnant women. That is why "regular" pregnancies are not subjected to a deductible etc. So essentially with that aspect taken into account, why should women be punished financially for having a difficult pregnancy with complications. A knee with surgery or without surgery will be subjected to the same deductible and franchise rules, regardless if the injury is "simple" or complicated.
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Old 12.03.2013, 06:02
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Re: More coverage from basic health insurance for mothers soon?

am I missing something here?? in most cases a woman chooses to get pregnant so they should be prepared to bear the the cost of getting pregnant, I accept that the cost of pregnancy is covered but why shouldn't they pay for complications??

I didn't choose to have cancer but I still have to pay deductibles and in some cases have to pay full cost for things that are outside the "normal" treatment such as MRSA de-colonisation, which if I didn't do and spread MRSA would cause a lot of extra costs for hospitals and insurance companies...
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Old 12.03.2013, 06:25
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Re: More coverage from basic health insurance for mothers soon?

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am I missing something here?? in most cases a woman chooses to get pregnant so they should be prepared to bear the the cost of getting pregnant, I accept that the cost of pregnancy is covered but why shouldn't they pay for complications??

I didn't choose to have cancer but I still have to pay deductibles and in some cases have to pay full cost for things that are outside the "normal" treatment such as MRSA de-colonisation, which if I didn't do and spread MRSA would cause a lot of extra costs for hospitals and insurance companies...
I agree. In the story they don't want to link pregnancy, with or without complications, as an illness which is subjected to franchise and selbstbehalt - as it wouldn't be "fair". As currently a pregnancy w/o complications does not have costs, they want to extend that policy to all pregnancies. But I thought this is exactly the reason to have health insurance - if you are healthy you have no costs, otherwise, you share in the costs. I would think that this would indeed result in higher costs along the line somewhere, and I will be interested to see if everyone pays for it or only women.
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Old 12.03.2013, 10:03
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Re: More coverage from basic health insurance for mothers soon?

Essentially yes you are both right, usually pregnancy is a choice, and it is not logical that it is treated differently than anything else covered in accordance to LaMal.

However as the political decision has been made to treat pregnancy differently, then all aspects should be treated differently and there should not be a difference between a "regular" and a "complicated" pregnancy.

If the political decision to treat pregnancy differently is a good one or not is a different discussion, and I hope there will not be a significant rise in premiums for women due to new legislation.

On the other hand the impact will probably not be very large in my experience, the calculation of health insurance premiums is influenced by a number of factors and pregnancy does not generate the highest costs by far.
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Old 12.03.2013, 21:08
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Re: More coverage from basic health insurance for mothers soon?

In Germany we were privately insured and my costs were significantly higher than those of my husband who is 2 years older. I believe the chances of pregnancy and related costs were a big reason of why that is.

I understand what you are saying, and looking back, it was probably that way for all my pregnancies in the US (just had to pay 1 co-pay for the entire pregnancy and a copay of $500 for the hospital part). I think that everything was covered otherwise, although as I didn't have any complications, per se, I don't know for sure. But the US is a whole other can of worms and insurance varies so much that it is hard to compare!
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Old 12.03.2013, 21:12
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Re: More coverage from basic health insurance for mothers soon?

OK, the problem is this:

Franchise is chosen by the insured, some people choose higher franchise to reduce their payments, all well and good.

Therefore, to be fair, only the lower franchise (plus the 10% up to 700) should be paid (i.e. CHF 300/ annum + (max) 700), higher franchise, YOUR problem.

I'm cool with that.

Tom
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Old 12.03.2013, 21:26
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Re: More coverage from basic health insurance for mothers soon?

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In Germany we were privately insured and my costs were significantly higher than those of my husband who is 2 years older. I believe the chances of pregnancy and related costs were a big reason of why that is.

I understand what you are saying, and looking back, it was probably that way for all my pregnancies in the US (just had to pay 1 co-pay for the entire pregnancy and a copay of $500 for the hospital part). I think that everything was covered otherwise, although as I didn't have any complications, per se, I don't know for sure. But the US is a whole other can of worms and insurance varies so much that it is hard to compare!
Yeah private insurances calculate their premiums according to the "risk", however the social insurance "shouldn't". However I am not always sure if that is the case... The US is really a different can of worms (one I prefer not to open ), but perhaps some insurances also had that viewpoint. In any case, the whole thing is due to an initiative, which are usually not very legislation friendly... unfortunately.
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