Swiss voters are set to decide on a significant revision of the healthcare financing model, aimed at standardizing costs between inpatient and outpatient care and improving the affordability and quality of healthcare services. Supported by various political parties and healthcare organizations, the reform is expected to take effect in 2028, potentially saving up to 509 million dollars annually by reducing unnecessary treatments and enhancing coordination among healthcare providers.
Swiss voters are currently faced with a complex decision regarding a proposal for revising healthcare financing, an issue that has seen previous initiatives aimed at reducing costs and lowering premiums rejected this year. The proposed modification to healthcare law, accepted by parliament in December, is the result of a lengthy process that began in 2009 and represents a significant revision of the Federal Law on Compulsory Healthcare, originally introduced in 1996.
Currently, healthcare financing in Switzerland differentiates between inpatient and outpatient care. Inpatient care, defined as any hospital treatment requiring an overnight stay, sees taxpayers covering at least 55% of costs via their canton’s contributions, with the remaining costs supported by compulsory health insurance. Conversely, outpatient care, where patients are treated and discharged on the same day, is entirely funded by healthcare premiums. Long-term care costs, applicable to nursing homes or home care, are shared between compulsory insurance, the patients’ contributions set at a federal level, and the canton.
The EFAS (Einheitliches Finanzierungsmodell der Gesundheitsversorgung) revision aims to standardize the distribution of costs across all areas covered by basic health insurance. Under this new scheme, cantons would cover a minimum of 26.9% of net costs (after the patient’s contribution), while health insurance premiums would account for a maximum of 73.1%. The proposed changes are set to begin implementation in 2028, with adjustments for long-term care commencing in 2032, focusing on tariff-based payments that fully encompass costs.
This revision of the Compulsory Healthcare Law seeks to realign the financial responsibilities between cantons and insurance companies when it comes to hospital treatments. Supporters believe that improved coordination among healthcare providers will enhance both the quality of care and affordability for patients. The revision also addresses inefficiencies within the current system, such as the necessity for hospital stays post-surgery—often viewed as unnecessary—and the disproportionate costs borne by patients choosing outpatient care, as insurance companies typically cover the full outpatient expense.
Additionally, the reform intends to reduce the financial burden on insured individuals. The rise in outpatient care in recent years has transferred costs from inpatient procedures entirely onto compulsory health insurance premiums, rather than being shared more evenly across the system. An estimate from the Federal Office of Public Health suggests that these changes could lead to savings of up to 509 million dollars annually through better coordination and reduced unnecessary treatments.
The proposed law enjoys broad support from various sectors, including the government, multiple political parties, and a vast majority of healthcare organizations. Proponents argue that enhanced coordination among healthcare actors will significantly benefit patient care. They contend that a more systematic approach will ensure that patients receive appropriate treatments, allowing for recovery at home, and ultimately leading to cost savings for both the insured and the healthcare system.
Key organizations backing the amendment include the national support and home care group Spitex, the federation of hospitals H+, and the Swiss doctors’ federation FMH, among others. They collectively advocate that promoting outpatient care will not only enhance recovery and reduce costs for patients but also improve working conditions for healthcare professionals. Regularizing shifts within the outpatient sector is expected to make healthcare jobs more attractive, thereby alleviating some of the burdens faced by the workforce.
Opponents of the reform raise concerns about how these changes might impact healthcare delivery, particularly in rural areas where access to outpatient services may be limited. Critics argue that while the intent is to improve efficiency and reduce costs, there could be potential unintended consequences that might not directly benefit patients or healthcare providers in underserved regions.
The proposed revision to the healthcare financing structure marks a pivotal moment in Swiss healthcare policy, aimed at addressing existing inefficiencies while balancing the contributions of cantons, insurance companies, and individual patients. As the Swiss electorate prepares to vote on this proposal, the discussion reflects broader concerns about the sustainability and quality of healthcare services. If passed, the EFAS revision could set a precedent for future healthcare reforms, navigating the complexities of financial responsibility, quality of care, and access to necessary treatments in Switzerland’s healthcare landscape.
The outcome of this vote will likely influence the direction of healthcare policy in Switzerland for years to come, highlighting the need for continuous dialogue and adaptation in a system that is both complex and essential to the well-being of the population. As discussions around healthcare evolve, the responses from voters and stakeholders alike will shape the future of how healthcare is financed and delivered, ultimately impacting the lives of millions who depend on these services.
