National_report_Switzerland

National report Switzerland – Paris 30.11. – 01.12.2012

A new law supposing on Managed Care was devised by the Government and Parliament with in view mainly savings. This was brought to referendum and rejected by the Swiss people by 1’482’536 votes against 466’993 in favour. Basically the Swiss Medical Association is in favour of Managed Care groups. However the foreseen law was a strange mix up forbidding the creation of such groups by the insurances but at the same time making them directly dependent from them financially. For us the law should foresee some guarantee the investment necessary to build up such a group – the banks would refuse to grant such mortgages of a few millions of CHF to medical people unable to offer a guarantee – and further set up such groups as partners of the insurers duly represented by the Swiss Medical Association.

The Federal Administration has in mind a complete statistical knowledge of medical activity. A new project concerning outpatient medical activity including hospitals and private surgeries has been devised, the so-called MARS project, with a pure technical spirit unaware of individual data protection. Furthermore these data are supposed to be available by different administration offices other than Health. This intrusion into privacy is being fought vigorously by the Swiss Medical Association. It understands the necessity of such statistics, but only in an aggregated anonymous manner and without the heavy bureaucratic burden of all the other demanded data.

Insurers are pretty unpopular because of expensive premiums and suspicious on their private insurance activity. They try to put on pressure the social insurance in order to increase the private offer with benefits. In other words the purpose of the Federal Administration on one side and the insurers on the other side is not only to manage properly morbidity, but also to control the medical professional activity in particular therapeutic freedom. We have always fought with determination such inacceptable attempts.

Finally a popular initiative has to be submitted to the people requiring to suppress independent social insurers and replace them by a single state institutions because of the recurrent problems caused by insurers as mentioned above. Such attempts have already been made, but failed because of the strong attachment of people to free choice of doctors and hospital. This argument has been steadily used to oppose any change. The present initiative is facing a counter project of the Government introducing strict legal and operational separation between social private insurance, which has to be approved, but combined with some sort of common fund for costly cases and a more complete compensation fund to avoid insurers competition for young patient with no or only limited risk. This strange and unexpected combination seems to be just a Government strategy to fail the whole lot, initiative and counter project.