In Switzerland, how much you pay for compulsory health insurance depends on where you live. Premiums vary hugely by canton. For 2016, average monthly adult premiums in Basel City are CHF 545.60, Switzerland’s most expensive, compared to CHF 326.70, in lowest-cost Appenzell-Innerhoden. The difference between the two cantons is 40%.
In addition to big differences between cantons, prices vary within some cantons, which are sliced up into zones. For example, Zurich has three zones. Average monthly adult premiums are highest in zone 1 (CHF 468.80) and lowest in zone 3 (CHF 394.20).
The Federal Department of Home Affairs has decided to streamline the zones within cantons that have them by redrawing the lines along district boundaries rather than commune ones, and by reducing the number of zones, starting in 2018. The Federal Department of Home Affairs argues that the current system is too complex and somewhat arbitrary.
Only ten cantons will be affected by the plan. They are BE, BL, FR, GR, LU, SG, TI, VD, VS and ZH. BE, GR, LU and SG will see their zones reduced from three to two. Vaud, Valais, Fribourg and Ticino will keep their two zones, and Zurich will keep its three.
Many are critical of the move. Insurers are concerned that there will be steep rises in premiums for some. Santésuisse reckons premium hikes could affect around 3 million people living in rural areas. It expects rises of between 10.4% and 14.7% in the worst affected communes. On the other hand, those living in urban areas will see reductions. Some argue the changes will lead to cross-subsidisation. Santésuisse says the leveling of premiums proposed by the Department of Home Affairs does not reflect cost realities. The Department of Home Affairs thinks the opposite is true.
Rural cantons like Basel-Landschaft and Bern are firmly against the plan. Others like St. Gallen approve of the project. And Vaud would like to see the consolidation go even further. It plans to eventually merge its two zones into one, arguing that the cost differences between the two zones are negligible. Between now and 1 January 2019, Vaud will reduce the allowable maximum zone premium difference, and move to a single zone on 1 January 2020. So if you live in Lausanne your premiums might go down, but if you live in Leysin they will probably rise.
Links below show the new zones. A zones are the most expensive.