Experts assess five proposals to curb rising health premiums

Health insurance premiums in Switzerland will rise again next year, SRF reports. After asking its community for ideas to address the increases, SRF put five proposals to three independent experts.

Make health insurers state-run

Some users argued that a state-run insurer could charge lower premiums because it would not need to make profits or pay dividends. One cited figures claiming public social insurance in France spends 3 percent on administration, compared with 21 percent for private insurers.

Christina Vetsch-Tzogiou of the Zurich University of Applied Sciences said insurers cannot make profits from compulsory health insurance, and administrative costs account for only about 4 percent of premiums. The main driver of rising costs, she said, is higher spending per treated person, linked to medical advances, increased use of services and possible overtreatment. A single insurer would therefore be unlikely to solve the cost problem.

Invest in prevention

A community member proposed stronger prevention measures, including sugar taxes, the Nutri-Score food label, restrictions on highly processed products, limits on margins for healthy products, more support for sport and earlier, systematic screening for certain illnesses.

Cécile Grobet of the Zurich University of Applied Sciences said Switzerland spends about 1.5 percent of its health expenditure on health promotion and prevention. She called for a national strategy with clear goals and assessments of the costs and benefits of measures. Prevention would not quickly reduce premiums, she said, but could help fewer people become ill in the long term.

Reduce the number of specialists

Another proposal called for strengthening family medicine, limiting the number of specialists and capping their salaries.

Igor Francetic of the University of Applied Sciences in Italian-speaking Switzerland said family medicine is becoming less attractive to younger doctors, and political measures to raise its status would not necessarily change that. He said stronger controls on medical specialities and specialist fees could regulate both the volume and price of services, calling that an excellent proposal.

Link premiums to income

Users also suggested setting premiums nationally according to income, with payments capped at a share of a person’s salary.

Vetsch-Tzogiou said this would mainly redistribute costs rather than reduce them, and would not encourage people to reconsider their use of services. It could weaken awareness of costs when choosing an insurance model or accessing care.

Francetic said premium subsidies currently address affordability. But he noted that in Ticino, estimates suggest half of residents could receive subsidies from 2029, raising the question of whether premiums collected directly according to tax principles have become unavoidable.

Review covered services

A final proposal called for reassessing the relevance of services included in the statutory health insurance benefits catalogue. Grobet said regular reviews of whether treatments are effective, appropriate and cost-effective make sense. Previous reviews have saved about 150 million francs a year, according to the Federal Office of Public Health, she said, adding that more reviews are needed despite budget cuts in this area.