Overview

Tarmed intervention – sensible, important and right

Adjusting the tariff for outpatient medical services (Tarmed) rectifies shortcomings of the outdated Tarmed and should result in annual savings of about 470 million francs. However, a full revision is now urgently required.

The costs associated with the Swiss healthcare system have risen steadily ever since it was first introduced. Due to the fact that premiums are inevitably always adjusted in line with costs, the annual increase in premiums is becoming intolerable for more and more households. The continual increase in costs is due to several reasons, such as advances in medicine and technology, higher life expectancy or supply-induced demand. Another important factor in the increasing costs is the outdated tariff for outpatient medical services called Tarmed. After all, approximately a quarter of total healthcare costs are generated in the outpatient sector.

Tarmed is outdated and urgently needs to be revised

The currently valid Tarmed has never been extensively revised since its introduction in 2004 and has not properly reflected advances in medicine for a long time. But it gets worse: strictly speaking, the tariff was never appropriate right from the start, because the database was already outdated when it was launched and at the time various tariff items were dressed up after the event for political reasons. An example: the tariff still assumes that a cataract operation takes 45 minutes (that was the standard in the 1990s), even though the procedure now barely lasts a quarter of an hour. Casually speaking: doctors make a mint because although they actually work for 15 minutes, they are paid as though they had worked for three quarters of an hour. This and many other incorrect tariffs were no longer acceptable, so action needed to be taken.

The Federal Council sent out an important signal

The Federal Council has now intervened. This is because although the tariff partners were in agreement that the Tarmed had to be revised, no agreement was reached during many years of negotiations. The Federal Council’s draft ordinance, which was sent out for consultation in the spring of 2017, envisaged a tariff structure which was supposed to lead to savings of about 700 million francs. After giving due consideration to the criticism on the part of doctors and hospitals, some of which was understandable and justified, the final ordinance nevertheless assumes a figure of 470 million francs. Although this does not completely meet the expectations of the members of curafutura, who had called for annual savings of 600 million via their association based on an objective assessment, even the just under half a billion francs is a substantial figure which after all corresponds to about 1.5 percent of the total costs which make up individual premiums. Even though it must be assumed that doctors and hospitals will try to compensate elsewhere for these financial losses, the signal is clear: if the tariff partners do not agree a revision, the Federal Council will act. The intervention is intended to ruffle some feathers.

The Federal Council’s intervention will of course not change anything where medical care for the general public is concerned. Neither will the quality of healthcare suffer as a result, as has been pessimistically claimed by quite a few specialists, nor will access to medical benefits be restricted in any way whatsoever.

A full revision is now urgently required

The approved tariff intervention will rectify several incorrect tariffs and double reimbursements and takes technological advances into account to a certain extent. It is hoped that it will make the tariff partners see reason and that the revision work on the outdated Tarmed will soon be resumed. This is because further measures are required to curb price rises in the healthcare system and to ensure that the system can be financed in the long term.

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