Cost explosion in the Swiss healthcare system: Myth or reality?

Is the Swiss healthcare system really in danger of collapsing under the cost pressure? HSG Professor Martin Eling and HSG student Hagr Arobei, the organiser of the panel, provide information.

Professor Eling, the healthcare system in Switzerland has so far been considered expensive but good. As an insurance management expert, what challenges do you currently see the system facing?

Martin Eling: The Swiss healthcare system is indeed at a turning point. Rising health insurance premiums are a symptom of underlying challenges. These include demographic changes, such as the ageing of the population, which not only leads to a higher demand for healthcare services, but also to more expensive, often more specialised treatments. As well, technological progress is driving up costs; although new medicines and treatment methods improve quality of life and the chances of recovery, they are often associated with high prices. 

What does this mean in concrete terms for patients in Switzerland?

Martin Eling: The healthcare system is currently too opaque and inefficient. Many fees that have to be paid for services do not directly serve the patient's well-being. This leads to a significant increase in costs, which is not sustainable. In addition, many costs are not transparent for patients. This is unsettling and leads to mistrust. For example, it is often unclear which costs are borne by the cantons or the federal government and when which service provider is responsible.

What adjustments can we make? In your opinion, what approaches can be taken to tackle these problems?

Martin Eling: Innovative solutions are needed. This includes promoting preventative measures to improve the health of the population and save costs in the long term. It is also important to adapt the remuneration system so that quality and efficiency are rewarded instead of simply increasing the volume of services.  Finally, we need to make greater use of innovative technologies and digital solutions to increase the efficiency of the healthcare system and improve patient care. This is where our panel discussion at HSG comes in: It offers an excellent opportunity to discuss possible solutions together. Only through an open dialogue between all those involved can we set the course for a sustainable healthcare system in Switzerland.

What specific options do you see to counter rising premium costs - also in view of the upcoming vote on 9 June 2024 in Switzerland? 

Martin Eling: There are several approaches that could provide both short-term and long-term relief: Firstly, the introduction or strengthening of integrated care models, such as managed care, could increase efficiency in the healthcare system and reduce costs. Such models promote coordination between different healthcare providers and ensure that patient care is targeted and without unnecessary duplication. 
Secondly, a greater emphasis on and financial support for preventive measures, such as health-conscious behaviour and early detection programmes, could reduce the demand for expensive medical treatments in the long term. 
Thirdly, the upcoming vote could also be used to discuss structural reforms that limit premium growth without compromising the quality of care. This could include, for example, a redistribution of costs between the federal government, cantons and insured persons in order to alleviate the financial burden on the population. 

In your view, is there a kind of "best practice" and a country that has organised its healthcare system in an exemplary manner? What can Switzerland learn from this? 

Martin Eling: An often-cited example of an exemplary organised healthcare system is that of the Netherlands. The key point is that a balanced relationship between state regulation and market competition can lead to efficiency gains in the healthcare system without compromising the quality of care or universal access to services. Important steps could be, in particular The introduction of more transparency with regard to costs and services, greater promotion of competition among insurers and healthcare providers and a more intensive focus on prevention and integrated care. In addition, the Dutch model offers suggestions on how to ensure high-quality, accessible and affordable healthcare for all citizens through targeted state control and incentives. 

What can the audience expect during the panel discussion on Tuesday, 21 May 2024, at 6.30 pm in SQUARE on the campus of the University of St.Gallen?

Hagr Arobei: At the HSG, we learn that complex topics require an interdisciplinary approach. This is what we want to achieve with the polyphonic line-up of the panel: The speakers represent expertise from all relevant sectors: pharmaceuticals, insurance, business, politics and healthcare. They identify 
problems and discuss how they can be tackled, live and accessible to the public.

What prompted you personally to organise the panel?

Hagr Arobei: I came from Iraq as a refugee and grew up in Switzerland. I am therefore aware of how privileged we are here in terms of healthcare compared to the conditions in Iraq. Even as a child, this made a big impression on me. Through my student job as a financial analyst at a consulting firm that supports biotech companies and my role as event and partnership director at the HSG Healthcare Club, my interest has grown further. It is important to me to really understand the challenges and to develop solutions from many different perspectives. 

How were you able to attract the guests for the panel?

Hagr Arobei: I got in touch with Pfizer Switzerland in the summer of 2023. I asked whether they would be interested in taking part in a panel discussion. When I received a positive response, I got in touch with the other speakers in order to provide as many different perspectives as possible. I knew that this was a unique opportunity to organise an event on this topic that would have great added value for the public. 

Hagr Arobei studies Business Law at the University of St.Gallen (HSG). Prof Dr Martin Eling will moderate the panel. He is Professor of Insurance Economics at the HSG and heads the Institute of Insurance Economics. His research focusses on cyber risk, microinsurance and social security such as retirement and healthcare provision. 

Further information in flyer and online agenda (both in German).

Image: Adobe Stock / Stockfotos-MG