Joachim Eder on changes in the Swiss healthcare system

The economic umbrella organization has five core demands aimed at contributing to a more sustainable Swiss healthcare system when it comes to quality, innovation and financial viability.

To begin with, the roles in the healthcare sector must be more clearly separated. While the public sector should define the framework conditions, it should generally leave the provision of services to private organizations.

We also want to see more courage in the face of competition. This will require significantly greater transparency about the quality of the services provided. Because only once consumers are in a position to make a well-informed choice will quality and efficiency prevail.

The third core concern of the economy is giving everyone access to innovative treatment options. In this regard, policymakers are responsible for creating innovation-friendly framework conditions, not just for the development of new therapies, but also for modern processes such as the electronic patient dossier.

A fourth priority is individual responsibility: Well-informed patients who are given relevant options to choose from will strengthen the system. There can be no real competition for services without them.

However, it only works if financial considerations also play a role in people's decision-making. For this reason, the fifth priority is for the general trend toward more individualism to be reflected in the financing of health care services.

But the opposite is the case today: The share of health care costs financed on a solidarity basis is increasing every year, which results in higher basic insurance premiums.

The centerpieces are the cost-braking initiative by the Alliance of the Centre and the premium relief initiative by the SP. Both popular initiatives did not stand a chance in the National Council, and the same is likely to be true in the Council of States.

Nonetheless, consensus exists in parliament for further measures to curb cost growth and for more financial resources to be allocated to individual premium reductions. With its indirect counterproposals, the National Council is leading the way.

I personally believe it to be very important to move away from the reforms of the last few years. These were mostly directed toward a centralized healthcare system and represented a kind of short-term "patches" policy. Going forward, all stakeholders should find common ground with clearly agreed goals, instead of constantly blaming one another or blocking innovative approaches.

The Swiss hospital landscape is undergoing radical change: there will be far-reaching medical, technological and organizational changes in the near future.

Apart from the price and cost pressures that are driving consolidation, those at the helm will be especially preoccupied with the drastic shortage of specialists, digital networking and increased outpatient care. Here, the main dilemma is the balancing act between social responsibility and profit orientation.

Fundamentally, steps taken to optimize hospital financing and free choice of hospital are having an effect. Also, the collaboration between the cantons has improved, but an even stronger supraregional approach could well be imagined.

Finally, under an ideal tariff solution, all service areas concerned should be tariffed using the same calculation logic, irrespective of whether the services are provided on an outpatient or inpatient basis. The project Uniform Financing of Outpatient and Inpatient Services (EFAS) is proposing a solution here.