Ageing and expanding care drive Swiss premiums up 5%

Swiss health insurance premiums will rise by 5% in 2027, as ageing, home care and a broader range of services push up costs, SRF health-policy correspondent Noëmi Ackermann reports.

People are living longer and need healthcare for more years. Costs are also rising as more people receive care at home. In recent years, people have been able to receive compensation for caring for family members, including children and partners. The list of covered services is also expanding, including new offerings for people with mental health conditions.

Efforts to curb costs face political hurdles, and the healthcare system is complex. While politicians can set rules, doctors, hospitals and insurers negotiate treatment fees directly as tariff partners.

A reform approved in 2024 will change how outpatient and inpatient care is funded from 2028. Outpatient treatment, where patients return home the same day, is currently paid for entirely through health insurance premiums. Cantons cover half the cost of inpatient treatment, with the rest paid through premiums. Under the new system, insurers and cantons will contribute equally to both types of care.

The reform is intended to encourage more outpatient treatment, which is generally cheaper than an overnight hospital stay. Eastern Swiss cantons have announced that more procedures involving the feet, elbows and shoulders will have to be carried out on an outpatient basis. Patients who currently stay in hospital overnight will instead go home the same day, as more procedures can now be performed using minimally invasive techniques.

The change is unlikely to bring premiums down, Ackermann reports, but could help slow their growth.

One alternative approach is integrated care. In the canton of Jura, a network involving a hospital group, a health insurer and the canton of Bern works with a set overall budget for each insured person. The model gives the network a financial incentive to prevent illness and avoid unnecessary hospital stays. Coordinators guide patients from preventive check-ups through to discharge, helping to prevent duplicated care.

The project is being studied, but results are not yet available. The network says it is among the region’s cheapest basic insurance options, and more people are choosing the model.

Political parties have proposed other measures. The Greens want premiums based on income, while the Social Democrats want wealthier people to pay more. The Centre party has presented a five-point plan that includes strengthening primary care and family doctors. The Free Democratic Party says doctors should be paid according to treatment outcomes rather than the number of treatments.