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Old 07.08.2022, 01:49
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Ideas for measures to prevent a projected doubling of health care premiums by 2040

According to a study by the Boston Consulting Group, health care spending could double by 2040, and with it health insurance premiums, which have also nearly doubled between 2000 and 2020, with the average per capita premium burden rising from CHF 2,003 in 2000 to CHF 3,784 in 2020.


Well, what to do?


I am very disappointed by the very fierce approach of the medical association (the "Samstagsrundschau" by their boss was very unsympathetic) and the weak success of the measures under Berset and his predecessors.


I am also disappointed by the pending initiatives.
The initiative of the center party (Mitte) dupped "cost brake initiative (Kostenbremse-Initiative)" stipulates that if the increase in average costs per insured person and year in the mandatory health insurance two years after the adoption of the initiative is more than one fifth above the development of nominal wages, that then in the following year countermeasures are taken.

I am of the opinion that the text is too lax, nevertheless it was rejected by the Federal Council as too rigid with reference to rationing problems. It is the task of the health authorities to counter rationing problems and with the second highest health expenditure in the world, there is (in my eye) no such problem. I would be in favor if it were explicitly stated that if the growth of "real wage growth"+x% is exceeded in the following year, measures to reduce the excess growth have to be implemented and that the corresponding additional costs will be payed back to the insured proportionately from the federal and cantonal budgets to provide an incentive to contain costs.

The premium relief initiative of the social democratic party does not address the cost growth side, I am in favor of relieving those who spend more than 10% of their disposable income on health insurance premiums, but this does not slow down cost growth and I am not sure if I would favor the spending and therefore probably tax growth without a corresponding decline in premiums.


What are your ideas on how to counter the growth? What would an initiative have to look like for you to agree with it?

a)What do you think about cashback programs in cooperation with health insurances, which reward certain behaviors e.g. visiting a cantonal hospital vs. a local hospital, buying generics instead of alternatives, daily sports etc. with significantly lower premiums?

b)A liberalization of online pharmaceuticals to increase pressure on drug prices?

c)Mandatory disclosure of treatment costs before appointments are made or treatment is started, coupled with financial incentives to choose lower-cost options?

d)Establishment of an online portal that, in addition to the current Tramed value and Tramed points, also discloses hospital costs and health insurance costs of all kinds, e.g. administrative expenses, procurements?


e)A limit on the number of doctors/specialists/hospitals in x km distance to y number of people?

f)The introduction of mandatory higher franchises and correspondingly higher deductions for the choice of these franchises?

g)The abolition of compulsory insurance?


h)The introduction of general or for non-essential visits, hospital visit costs or similar costs for specialists or certain operations in order to prevent overcharging?

i) The introduction of license revocation measures for physicians, e.g. if x% of certain average values are exceeded with regard to treatments, operations of all or certain types?



What would be your ideas?

Sources:

https://www.bcg.com/publications/202...ndheitssystems


https://www.srf.ch/audio/samstagsrun...ik?id=12201692


https://www.bk.admin.ch/ch/d/pore/vi/vis489t.html

https://www.admin.ch/gov/de/start/do...-id-85812.html

https://www.sp-ps.ch/de/kampagnen/we...ngs-initiative
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  #2  
Old 07.08.2022, 01:59
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

Increase population to spread costs.
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Old 08.08.2022, 02:35
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

Maybe I asked the wrong question.
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Old 08.08.2022, 06:24
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

Can you please provide more info about why you are making this very long, specific and detailed post with questions to ask; are you merely interested in the topic or actually looking to organise an initiative or are you doing a university study on it?
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Old 08.08.2022, 07:59
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

Make health insurance non-mandatory, as was the case until 25 years ago.

Tom
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Old 08.08.2022, 12:07
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Make health insurance non-mandatory, as was the case until 25 years ago.

Tom

This you can do and as it is expensive, everybody will stop insurance knowing full well they will get treated with or without insurance


How they pay is another problem later on, which, with no health insurance will mean either insured people will need to subsidise or the confederation will need to pay, so essentially us again.


It is not the done thing to turn people away or refuse medical treatment, leaves very bad impressions
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Old 08.08.2022, 12:24
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Can you please provide more info about why you are making this very long, specific and detailed post with questions to ask; are you merely interested in the topic or actually looking to organise an initiative or are you doing a university study on it?

I am concerned about the rising costs and would like to find solutions and do something about it. If there is a possibility to organize an initiative, I would be open to it, but I have no political or legal experience and have never organized an initiative before.
It is not a university project.
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Old 08.08.2022, 12:35
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Make health insurance non-mandatory, as was the case until 25 years ago.

Tom
How would that help?

It would disadvantage those who couldn't afford (or to prioritise) payment of premiums.
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Old 08.08.2022, 13:03
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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How would that help?

It would disadvantage those who couldn't afford (or to prioritise) payment of premiums.
My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom
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Old 08.08.2022, 13:06
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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I am concerned about the rising costs and would like to find solutions and do something about it. If there is a possibility to organize an initiative, I would be open to it, but I have no political or legal experience and have never organized an initiative before.
It is not a university project.
One way to keep medical costs lower would be to provide better information and more affordable infrastructure, equipment, services, etc. to help prevent illness in the first place.

In general, the medical system focuses on treatment of existing conditions, be they acute or chronic, but hardly on prevention and also not much on a well-rounded process of healing/recovery.
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Old 08.08.2022, 13:09
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom



Falling ill or requiring medical attention has sod all to do with the size of your bank account......
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Old 08.08.2022, 13:30
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom
Bully for you.! Not everyone is that lucky.
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Old 08.08.2022, 13:36
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Make health insurance non-mandatory, as was the case until 25 years ago.

Tom
In principle I agree with this. I also oppose laws mandating helmets for motorcycle riders, etc...

The problem is that when someone without insurance gets sick, or when someone riding a motorcycle without a helmet gets in an accident and has a major head injury, we treat them anyway and usually at the expense of others.

So if we were going to take the "you don't have to buy insurance" approach, I also think we should have to take the "but if you get sick everything you have can and will be taken and sold to cover the costs of your treatment" approach.

Since we won't take the hard line (even though I don't like coercive laws and massive regulatory schemes) it seems to me that everyone having some minimum insurance for large and unexpected medical situations (fell off a mountain, hit by an unmarked bus, cancer, heart attack, etc...) makes sense.
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Old 08.08.2022, 13:52
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom
What's that got to do with reducing overall healthcare costs? Zero.
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Old 08.08.2022, 13:57
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Since we won't take the hard line (even though I don't like coercive laws and massive regulatory schemes) it seems to me that everyone having some minimum insurance for large and unexpected medical situations (fell off a mountain, hit by an unmarked bus, cancer, heart attack, etc...) makes sense.
That's what we have anyway. You don't pay for the smaller expenses unless they reach your franchise minimum.

Personally, I think insurance premiums should be tiered to encourage people to be healthier.

Giving people reductions for not smoking, not being obese and so on could produce a healthier society with less of a drain on the health system.

Not sure how measuring being actively fit could be done - gym membership is not a way to do it as there are many ways to keep fit without attending a gym.

This would be better than increasing premiums on those that claim as everyone can get ill through no fault of their own.
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Old 08.08.2022, 14:04
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom
Me too. And yet if you were unfortunate to suffer from cancer your treatment could end up costing you more than a lifetime of premiums.

Look at it as a hypothecated tax - at least you know exactly what you are paying for and can demand the service. If insurance weren’t compulsory, general taxation levels would increase for the reasons mentioned by others.
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Old 08.08.2022, 14:20
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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My premiums have always exceeded my medical expenses, it was cheaper to pay out of pocket.

Tom
Yes but you have to factor in the cost of therapy for the people who know you.
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Old 08.08.2022, 14:44
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Me too. And yet if you were unfortunate to suffer from cancer your treatment could end up costing you more than a lifetime of premiums.

Look at it as a hypothecated tax - at least you know exactly what you are paying for and can demand the service. If insurance weren’t compulsory, general taxation levels would increase for the reasons mentioned by others.
Solution would seem to be to charge mandatory insurance against major health events, but make it voluntary for the slight discomforts that the specialist wants to do the full Dr House treatment for.
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Old 08.08.2022, 15:15
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

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Solution would seem to be to charge mandatory insurance against major health events, but make it voluntary for the slight discomforts that the specialist wants to do the full Dr House treatment for.
Although having having not done the sums, I think this may make absolutely no difference.
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Old 08.08.2022, 15:22
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Re: Ideas for measures to prevent a projected doubling of health care premiums by 204

I suppose that one way to reduce health care costs here is to model the Swiss healthcare system on the UK's famous National Health Service.
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