On 27 September 2022, the Swiss government published health insurance premiums for 2023. On average premiums will rise by 6.6% with large variations depending on age and where you live.
The 6.6% average increase in 2023 is the fifth largest rise since Switzerland’s current system of health insurance began in 1996. The last time it rose more was in 2010 when it leapt 8.7%.
The average monthly premium will rise to CHF 334.70 per month (CHF 4,016.40 per year) in 2023, 6.6% higher than in 2022.
Cantons with the sharpest rises in 2023 are Neuchâtel (+9.5%), Ticino (+9.2%) and Appenzell-Innerrhoden (+8.9%). Cantons with the lowest hikes include Basel-City (+3.9%), Geneva (+4.7%) and Glarus (+4.8%). Zurich (7.1%), Bern (6.4%) and Vaud (6.1%) are in between. A map put together by RTS showing average price rises can be viewed here.
Simply put Switzerland’s healthcare has a serious cost problem. In a 2017 comparison the OECD identified Swiss healthcare as the worst value for money. Prices for the same set of goods and services were 39% higher in Switzerland than in the US and nearly double (+93%) the OECD average – see page 34 of study.
Health minister Alain Berset, told the media that the only way to deal with rising premiums was to act to bring down costs. The Federal Council has presented a range of measures to tackle the problem of rising costs to parliament. Parliament must now act, said the minister.
Switzerland’s health system has key structural flaws. It largely fails to create healthcare price competition. There is little incentive for patients to shop around for lower healthcare prices, because once premiums have been paid the incentives to seek out the best value are minimal – patients pay only 10% of the cost up to a maximum. This largely allows healthcare and medicine providers to choose their pricing.
One way this weakness is being mitigated is by insurance companies selecting more affordable providers and offering premium discounts to those who use a doctor on the resulting list.
Another way might be to set annual guide prices. Patients using providers charging in excess of the guide price would be required to pay the difference. Those using providers under the guide price could be financially rewarded. A system like this could potentially get a sizeable portion of the population engaged in competing down the costs of healthcare. If such a system also allowed patients to travel abroad for care and buy medicines outside the country, costs and prices might fall significantly.
Another weakness in the current system is the incentive it creates to avoid cost-saving preventative care. One way to reduce premiums is to take out a policy with a high deductible. This then incentivises people to avoid the doctor because the cost of any check ups or preventative care come 100% out of the insured’s pocket. This means a significant percentage of the population is largely incentivised to sit tight and only use their insurance when a significant health crisis strikes, something obviously bad for these patients and costly for everyone over the long run.
Switzerland’s healthcare sector has also had to cope with the pandemic, which added a load on the system, the cost of vaccinations and a treatment backlog that is now being processed. In addition, health insurance reserves have been run down, partly by the pandemic. The government also accused insurers of holding excessive reserves and pressured them to make refunds, a move that now appears shortsighted.
To see next year’s premium and compare insurers click here. This is the FOPH’s official calculator, which is independent and free of advertising. Residents have until 31 October 2022 to cancel their current policy if they decide to change insurer.