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3 années ago · by · 0 comments

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How can health insurance in Switzerland be made cheaper?

Over the last two decades, the cost of health insurance has gone up an average of 3.7 percent per year in Switzerland and people are well and truly fed up.

Health insurance costs are a hot topic in Switzerland right now. Speak to anyone in the country about what concerns them most and they are likely to mention rising premiums.

“It’s two to midnight,” said Swiss price watchdog Stefan Meierhans recently, describing the current situation. Meanwhile the CEO of health insurance Santésuisse said the system was “gradually approaching collapse”.

Because while almost everyone agrees Switzerland has fantastic healthcare, it comes at a high price. Healthcare costs in 2015 were equal to 12.1 percent of GDP, or second only to the United States, OECD figures show.

It’s same story for per capita spending: Switzerland is set to spend 10,500 francs per person for healthcare in 2018 this year, according to the KOF Swiss Economic Institute at Zurich’s ETH University. Only the US spends more.

These costs are rocketing skywards too – around four percent a year, says the KOF institute.

“The Swiss health system is like an unguided missile. It behaves like a junkie that needs more and more money all the time,” health economist Heinz Locher told Swiss newspaper Blick recently, before calling for the current system to be completely overhauled.

While Switzerland is not alone in this – many developed countries are seeing ballooning healthcare costs as they deal with ageing populations and increased expectations of what healthcare can provide – the Swiss situation is exacerbated by the fact only 64 percent of health funding is publicly financed.

Compulsory insurance

Swiss people fund around a third of all the country’s healthcare costs though a compulsory insurance system. When you get a bill in the mail every month, health care costs are very real.

To make matters worse, the cost of premiums for this obligatory insurance have shot up twice as fast as GDP and wages since 1996. Out-of-pocket expenses, or the amount people have to pay before health insurance kicks in, have climbed steadily too.

And with 22 percent of Swiss people saying in 2016 they went without necessary medical care because of costs, there is no question something needs to be done.

Fewer hospitals, more generic medicines

Many of the ideas being proposed to cut costs – an increased use of generic medicines, for example – have been floating around for a while.

But a heated recent debate has thrown up a few surprises.

“What’s new in the current debate is that previously ‘managed competition’ has been the order of the day when it comes to Swiss healthcare,” Simon Wieser a health economist who heads up the Institute of Health Economics at the Zurich University of Applied Sciences (ZHAW) told The Local recently.

“Now we are even seeing centrist political parties talking about caps, like the Christian Democratic Party (CVP) with its Kostenbremse (cost brake) initiative,” he added, referring to a proposal that would see increases in health insurance premiums more closely tied to economic and wage growth.

The CVP’s proposal – which is light on details – also called on doctors and hospitals to avoid “overtreatment” of patients either through medications or surgery.

“It’s probably correct that we are seeing some overtreatment. There is an incentive to provide ambulatory care,” said Weiser on this point.

“What’s new in the current debate is that previously ‘managed competition’ has been the order of the day when it comes to Swiss healthcare,” Simon Wieser a health economist who heads up the Institute of Health Economics at the Zurich University of Applied Sciences (ZHAW) told The Local recently.

“Now we are even seeing centrist political parties talking about caps, like the Christian Democratic Party (CVP) with its Kostenbremse (cost brake) initiative,” he added, referring to a proposal that would see increases in health insurance premiums more closely tied to economic and wage growth.

The CVP’s proposal – which is light on details – also called on doctors and hospitals to avoid “overtreatment” of patients either through medications or surgery.

“It’s probably correct that we are seeing some overtreatment. There is an incentive to provide ambulatory care,” said Weiser on this point.

“At the same time, if you have a hospital and you want a good hospital director and good doctors, you have to offer them the chance to carry out a variety of procedures,” he added, explaining why the same treatments are often offered at hospitals close to each other.

Wieser noted however, that the canton of Zurich had introduced “minimum caseload requirements” as a way to address this oversupply. Theses requirements ensure hospitals are suitably prepared to carry out certain procedures.

“This is a step in the right direction,” he said.

But it is another suggestion from the economist that move prove a bridge too far: “This is a difficult one too, because it is hard to ask doctors to earn less money – but some doctor’s incomes are very high.”

Assurance maladie: avec Assura

Nous nous efforçons de vous proposer la meilleure couverture possible. Choisissez ci-dessous le modèle d’assurance de base et les assurances complémentaires qui vous conviennent parmi notre large gamme de produits.

L’assurance obligatoire des soins ou assurance maladie de base, qui est régie par la LAMal, permet de bénéficier de soins de qualité. Les assurances complémentaires, sous le régime de la LCA, permettent de bénéficier de plus de confort et d’une couverture plus large. Le tableau ci-contre permet de mieux comprendre le fonctionnement du système santé suisse.

Assurance de base

Assura propose trois modèles pour l’assurance obligatoire des soins. Pour toutes ces variantes, les assurés ont le choix entre différentes franchises.

Adultes: Fr. 300.- / 500.- / 1000.- / 1500.- / 2000.- / 2500.-

Enfants: Fr. 0.- / 100.- / 200.- / 300.- / 400.- / 500.- / 600.-

http://health-insurance-switzerland.ch

http://assurance-maladie-economique.ch

http://cassa-malati-economica.ch

Modelli di assicurazioni obbligatorie

Dei modelli adattati alle sue necessità e al suo budget.

L’assicurazione obbligatoria delle cure medico-sanitarie, chiamata anche assicurazione di base, è obbligatoria per tutte le persone residenti in Svizzera. Copre le prestazioni legali di base in caso di malattia, d’infortunio e di gravidanza.

Dato che ognuno ha delle esigenze diverse, Assura le permette di optare per un modello d’assicurazione di base che può scegliere tra una vasta gamma.

http://health-insurance-switzerland.ch

http://assurance-maladie-economique.ch

http://cassa-malati-economica.ch

Cassa malati come funziona

Generalità sulla cassa malati

Negli Stati Uniti prende il nome di “health care”, che, seppur in forme diverse, comprende tutta una serie di assicurazioni specifiche per la persona.

In Svizzera è detta “cassa malati”.

Di cosa si tratta? Semplice. È la cosiddetta “assicurazione sanitaria”, che in Svizzera è obbligatoria per legge per tutte le persone con domicilio nel paese.

La cassa malati ha praticamente le medesime funzioni di una qualsiasi assicurazione: l’istituto che la fornisce, infatti, tutela la salute e l’interesse medico del soggetto a fronte del pagamento di una polizza.

Ma come funziona la cassa malati in Svizzera? Quali sono le sue caratteristiche? Vediamolo qui di seguito.

Caratteristiche della cassa malati in Svizzera

Come anticipato, la cassa malati è obbligatoria per tutti i cittadini con domicilio in Svizzera.

Una volta che un soggetto è entrato nel paese dispone di tre mesi di tempo per sottoscrivere l’assicurazione, scegliendo la cassa malati che preferisce a seconda dei prezzi e della qualità dei servizi offerti.

Le casse malati variano da marchio a marchio: più alto è il blasone dello stesso, maggiori saranno i costi di sottoscrizione.

Una volta scelta liberamente la cassa malati più opportuna, sarà possibile cambiare la propria scelta al termine di un anno civile (ovvero i canonici 365 giorni esatti), optando per altre alternative purché si sottoscriva un nuovo contratto (che, come detto, è obbligatorio per legge).

Dal punto di vista degli importi, le casse malati si contraddistinguono a seconda dell’età del soggetto sottoscrivente e dal suo luogo di domicilio, nonché dalla tipologia assicurativa del contratto e dalla franchigia.

Quest’ultima, solitamente, ammonta a circa il 10% della prestazione sanitaria, ma sono gli stessi premi a variare enormemente da una cassa malata all’altra.

Altro concetto importante nella sottoscrizione del contratto riguarda la copertura sanitaria in materia di infortuni: nel caso in cui si sia già assicurati con il proprio datore di lavoro a proposito dell’assicurazione da infortuni, non sarà necessario sottoscrivere un’ulteriore polizza. In caso contrario, si dovrà integrare l’assicurazione sanitaria della cassa malati con tale ulteriore garanzia.

Il funzionamento della cassa malati

La cassa malati funziona ed è attiva nel momento in cui il soggetto sottoscrivente contrae una malattia.

Una particolarità della cassa malati riguarda l’età degli assicurati, i quali hanno diritto a premi differenti a seconda delle fasce anagrafiche in cui sono inseriti: minorenni (fino ai 18 anni), giovani adulti (dai 19 ai 25 anni) e adulti (dai 26 anni).

A livello burocratico è la “Legge federale sull’assicurazione malattie” (LAMal) a garantire il pagamento e le prestazioni economiche in materia di infortuni, malattia e maternità.

A livello sanitario, la Svizzera si differenzia dall’Italia proprio per la necessità di dover sottoscrivere un’assicurazione sanitaria obbligatori.

Il belpaese, da questo punto di vista, è privilegiato, poiché sul territorio italiano non c’è bisogno di una vera e propria assicurazione sulla propria salute: si può ottenere assistenza sanitaria in qualsiasi caso, e l’unico pagamento da effettuare consiste nel ticket sanitario.

In ogni caso, la Svizzera risulta pur sempre un paese all’avanguardia in materia di assicurazioni.

E questo è dimostrato dalla funzionalità e dalla qualità dei suoi servizi.

« La sanità non è solo costi »

Costi della sanità, ospedali contro il governo

Il dibattito deve vertere anche sulla qualità e mettere al centro dell’attenzione il paziente, afferma l’associazione degli ospedali

Versicherungsmodelle der obligatorischen Grundversicherung

Auf Ihre Bedürfnisse und Ihr Budget zugeschnittene Modelle.

Die obligatorische Krankenpflegeversicherung, auch Grundversicherung genannt, ist für alle in der Schweiz wohnhaften Personen obligatorisch. Sie deckt die gesetzlichen Grundleistungen bei Krankheit, Unfall und Mutterschaft.

Da wir alle unterschiedliche Bedürfnisse haben, bietet Ihnen die Assura eine breite Palette an Grundversicherungsmodellen.

http://health-insurance-switzerland.ch

http://assurance-maladie-economique.ch

http://cassa-malati-economica.ch

You have to be insured

From birth or arrival in Switzerland, you have three months within which to obtain compulsory health insurance. During this period you are already insured. You are free to choose a health insurance company on the list of authorised companies. In exceptional cases, you are not required to take out insurance.

You have to pay the premiums, a deductible and a retention fee

Every insured person pays a monthly premium to the insurance company. The amount of the premium varies from insurer to insurer and from canton to canton. Children up to the age of 18 pay lower premiums. People on low incomes may be entitled to a premium reduction.

You have to pay a share of the costs

If you require treatment, you will have to pay part of the costs. Your share is made up of a deductible, the retention fee and a contribution to the cost of a hospital stay.

Deductible

The deductible (often referred to in Switzerland as the « franchise ») is the amount (CHF 300 for adults; children up to the age of 18 do not pay a deductible) that you have to pay towards your treatment costs every year. Only after this amount has been reached does the insurance company start to pay out. If you want to reduce your premium, you are free to increase your deductible.

Retention fee

Even after the deductible has been exceeded, you still have to pay 10 per cent of any treatment costs. However, this charge, often referred to as a « retention fee », amounts to a maximum each year of CHF 700 for adults and CHF 350 for children.

Hospital contribution

The hospital contribution amounts to CHF 15 per day spent at the hospital. Children, young adults in education or training and women whose maternity benefits are fully covered do not pay any hospital contribution.

Avoid unpleasant surprises

When a doctor prescribes treatment that is not covered by the basic insurance, he or she must inform you about it. However, if you have any doubts, it is worth checking with your health insurance company.

Services in detail

In principle, compulsory health insurance covers the costs of the examination and treatment of a medical condition and its consequences. The Federal Office of Public Health provides detailed information on the services under compulsory health insurance.

http://health-insurance-switzerland.ch

http://assurance-maladie-economique.ch

http://cassa-malati-economica.ch

Health insurance premiums will rise by 4.5 percent on average in 2017, the highest rise for six years, with children facing a heavy 6.6 percent increase.

People in some cantons will face increases of up to 7.3 percent next year, according to figures released on Monday by the Swiss federal health office (BAG).

Next year’s figures – based on a standard adult health insurance with a 300 franc deductible – show that in seven cantons, all in German-speaking areas, premiums will rise below four percent on average. The canton of Bern will face the lowest rise, of 3.5 percent.

At the other end of the scale eleven cantons including Geneva will see their insurance payments go up by more than five percent, with those in the Jura facing the highest increase, of 7.3 percent.

Premiums in the eight remaining cantons will rise between four and five percent on average.

Families will be the hardest hit, with premiums for children under 18 rising by 6.6 percent on average.

Young adults aged 19-25 will see their health insurance bill increase by 5.4 percent.

Health insurers are obliged to set lower premiums for children, but the amount is not fixed by law. The heavy increase this year is due to the fact that premiums paid in previous years did not cover costs, said BAG.

Swiss basic health insurance, called LaMal, is obligatory for every resident. The country’s 60 or so private insurance companies set their premiums each year after discussion with the federal government.

Since LaMal was first introduced in 1996, premiums have risen by on average 4.6 percent a year and by 3.6 percent in the last decade, according to BAG.

In actual figures, that means average monthly premiums have increased from 173 francs in 1996 to 447 francs next year, based on a 300 franc deductible.

Some have slammed 2017’s rises, with Socialist Party MP Rebecca Ruiz telling news agencies that the news was “another hard blow” to the insured, particularly families.

Ruiz, who is also president of a patients’ service, said the news shows that parliament is not on the side of patients.

In recent months the Swiss federal government has considered a number of ideas to tackle the problem of growing medical costs, such as raising the lowest deductible.

Source: thelocal.ch

http://health-insurance-switzerland.ch/

http://assurance-maladie-economique.ch

http://cassa-malati-economica.ch/

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