The healthcare system in Switzerland has the advantage of services that are highly available nationwide, with up-to-date technical facilities and extremely well-educated staff, making it one of the best healthcare systems in the world. This is primarily financed by means of insurance premiums. Lawmakers, supervisory authorities and health insurers regularly ensure that this is the case by making carefully balanced adjustments.
|Why are insurance costs rising?|
Demographics – population growth and the growing share of older people – and medical advances play a role as regards the growth in costs. The main reason for the growth in costs, though, is volume growth and the expansion of the benefits catalogue together with the policyholders' entitlement attitudes.
Medical and technological advances continually result in new services. New medications often cost several times more than their predecessors. The often rash consumer behaviour in the supply-induced healthcare market (expansion of services by doctors) is continually driving the growth in services.
Furthermore, heavy restrictions have been placed on competition among health insurers, which means that they have little room for manoeuvre in determining the amount of premiums. In the case of basic insurance, they are obliged to reimburse the costs of the insured benefits in full. As a result, there is not much incentive to seek less costly treatments.
Health insurers have very little influence on the development of premiums. However, this does not prevent us from striving to achieve lower healthcare costs within the scope of our capabilities.
|Where do health insurance premiums go?|
In 2014, basic insurance customers in Switzerland paid a total of CHF 25.8 billion in health insurance premiums. By far the largest part of this sum served to finance medical services worth CHF 28.6 billion.
Most of the money was used for inpatient hospital treatment, outpatient treatment in doctors' practices, and medications. This was followed by outpatient hospital treatment and nursing home costs. The cost sharing of insured persons in the form of deductibles, excesses and cost contributions to hospital stays amounted to a total of CHF 4 billion.
The difference between the premium income and costs was financed through additional sources, such as investments of CHF 734 million.
Please bear in mind that health insurers do not make any profit from basic insurance. Surpluses are put in reserves.
Overview of the healthcare cost breakdown
Source: FOPH – compulsory health insurance statistics for 2014
|How are the prices of medications developing?|
Around 17% of the benefits paid under basic insurance are used for medications. This high proportion is due to the above-average price of medications in Switzerland, among other factors. This will not change unless a fundamental system shift is considered.
Who is responsible for determining the prices of medications in Switzerland? To what extent does the pharmaceutical industry influence the development of prices? Why are generic medications also more expensive in Switzerland than elsewhere?
You can read the answers to these and other key questions related to the pricing of medications in our article.
|How do you have to participate in the costs?|
In the health insurance system in Switzerland, insured persons participate in the costs of medical services, thus helping to moderate health insurance premiums.
This cost participation consists of three components:
This is the maximum amount you are willing to pay out-of-pocket for medical services. You can select from among six different levels. The higher the selected deductible, the lower your insurance premium.
The excess is a cost participation component prescribed by law. It becomes applicable after the selected deductible has been reached and may amount to no more than CHF 700 per calendar year.
The hospital cost contribution
The hospital cost contribution is also prescribed by law. Starting from age 26, adults pay CHF 15 per day for each hospital stay.