Why is it necessary to control healthcare costs?
26 July 2024 | Comment(s) |
Geneviève Aguirre-Jan
Foreword: This blog is part of a three-part series on the necessity of controlling health costs. This first part explains the need to curb costs and the role of health insurers, the second looks at current efforts in this area, and the last outlines the measures Groupe Mutuel would like to see taken.
For several years now, Switzerland has been faced with a steady rise in health costs. This trend, which shows no sign of slowing down, is fuelled in particular by the growing demand for care due to the increase and ageing of the population, advances in medical technology and the expectations of the population. Health insurers defend premium payers by systematically checking invoices and striving to control costs.
Key figures
In 2022, healthcare expenditure reached CHF 91,482 million, or a monthly average of CHF 869 per capita. This represents a significant increase on the CHF 694 per capita in 2012 and CHF 544 in 2002.
The following year, in 2023, costs within the compulsory health insurance (AOS/OKP) rose by 6% on the previous year, marking the strongest growth in costs for a decade and exceeding the CHF 40 billion mark for the first time.
The reasons for this upward trend
Health expenditure is divided into different cost groups, each representing a variable proportion of total expenditure. In 2022, these groups were already well defined, but in 2023, an upward trend was observed in some of them as early as the first quarter.
Medicines
The cost of medicines, which account for around a quarter of total costs under the compulsory insurance (AOS/OKP), rose by 5.4% to almost CHF 9.6 billion. This increase is mainly due to anti-cancer drugs and immunosuppressants, which weigh heavily on the bill. The introduction of expensive new therapies and the complexity of setting prices for these new drugs indicate that this upward trend will continue.
Outpatient medical treatment
For both inpatient and outpatient treatment, costs rose by 4.4% and 5.4% respectively per insured person. The costs of psychotherapy carried out by psychologists also rose sharply in 2023, following the authorisation to bill their services directly to the AOS/OKP.
The role of health insurers
The constant rise in healthcare costs has an impact on basic health insurance premiums, which are a burden on household budgets, but also on the State (cantons and Confederation), since 28% of insured persons currently benefit from an individual premium reduction (subsidy) financed by the cantons and the Confederation.
Health insurers are also committed to keeping compulsory health insurance premiums as low as possible. The rigorous control of invoices that they guarantee limits reimbursement to what is strictly authorised by compulsory health insurance. Their commitment to quality care helps to combat unnecessary treatment.
Finally, health insurers are active in defending premium payers in parliamentary proceedings, thanks to their “position papers”, which they regularly deliver to members of parliament and which are published on the Groupe Mutuel website.
In a nutshell
Controlling healthcare costs is a major challenge for Switzerland. Health insurers are active players in this field and play an important role in defending premium payers. In this way, they help to ensure that healthcare is accessible and sustainable for all.
