Overview

“Always the same with these health insurers!”

Health insurance companies are a popular topic and are time and again the subject of lively debate. Here, we present the five most common claims – and provide our explanations.

“They make tonnes of money with our premiums!”

It is not permitted to make a profit with the premiums that we take for basic insurance coverage. This is stipulated under the Health Insurance Supervision Act. Instead, these premiums serve to ensure that we have enough put to one side for a rainy day. Imagine, for example, that you have a mountain hut: during the summer months, you collect wood so that you can keep your parlour warm in winter. If the winter is especially cold, you are happy to have the leftover firewood from the previous year. Should it be mild, however, you have a reserve for next year. The situation is similar with our premium income. Every summer, we propose new premiums to the Federal Office of Public Health and these are based on the precalculations of our spending for the coming year. Among other things, our premium specification is based on the benefits claimed by our insured persons. If our premium income in the following year is higher than our expenditure, we build up the excess as a reserve. If our assumptions turned out to be too low, we can draw on this reserve.

“They spend vast sums on administration!”

Let’s assume you have been in hospital. The hospital invoice is now checked rigorously with respect to efficacy, expediency and cost-effectiveness. Here, our data system recognises all sorts of irregularities. This allows us to save around CHF 300 million every year. This invoice check, for example, is part of our administrative costs and is beneficial for your premium.

“They blow hundreds of millions on advertising!”

According to the Federal Office of Public Health, we health insurers spent a total of CHF 105 million on marketing, advertising and commissions in 2017. Relative to our premium income, this corresponds to a value of 0.3%. In reality, it is therefore not true to say that we blow vast sums on this area, as it accounts for only a very small share of our spending.

“They are only interested in healthy individuals because they don’t cost anything.”

If this was actually the case, we would have to call ourselves a “healthy person insurer”. We work hard for all of our customers, irrespective of their state of health. For example, with a variety of health-related programmes. Perhaps you have heard about our Case Management, for instance? Here, we support insured persons in returning to the world of work after a lengthy illness or an accident. Those affected benefit from a personal contact person who provides them with the required security and motivation upon their return. Or are you familiar with Helsana Business Health? With occupational health management, SMEs can optimise their structures and processes in order to promote the physical and mental health of their employees. We are therefore not interested in healthy individuals, but rather in your health.

“Costs are increasing because we are getting older.”

You can blame a lot on your age, for example grey hair or wrinkles on your face. But this isn’t the case for healthcare costs. Or, at least, only in part. According to the Federal Statistical Office (FSO) , it is only just under 1% of cost increases that can be attributed to the age of the Swiss population. An FSO study reveals that the rise in costs is primarily due to population growth and technological advancements, which are repeatedly yielding new and more expensive treatment methods and medication. The forecast states that this development will mean age plays an even smaller role in future.

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