Health insurance premiums: Salvo of initiatives to link health premiums to health costs – Vaud & Régions

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The cantons of Lake Geneva are launching the big maneuvers on health insurance premiums. Vaud and Geneva are preparing to file, each in turn, the same three cantonal initiatives with the Federal Assembly. The three texts aim to ensure “a better match between premiums and costs of services,” said the joint press release, released late Wednesday afternoon. These initiatives are translated from Italian, since Ticino initiated the process. All Latin cantons should follow. But Vaud and Geneva are the first to follow behind the Ticino. Wednesday morning, the two cantonal executives decided to transmit the project to their respective parliament. In the end, the Federal Assembly should end up with more than fifteen similar initiatives on its hands.

“Joint action”

“The approach of my colleague from Ticino Raffaele De Rosa (PDC) is extremely relevant,” notes Rebecca Ruiz (PS), Vaud Minister of Health. Because, as a former national councilor, I know that joint action by several Cantons has more weight in the Federal Chambers and can allow a broad debate on the subject. “

The three cantonal initiative projects call for changes to the federal law on the supervision of health insurance. This new standard, which came into force in 2016, reduces the role of the Cantons in the premium approval procedure. The Federal Office of Public Health (FOPH) no longer transmits premium data to them. “The Cantons must be fully and transparently informed by the OFSP,” said Rebecca Ruiz. I would remind you that the impact of bonuses is massive on their finances through LAMal subsidies. ”The first initiative, entitled“ More strength for the cantons ”, therefore aims to return to the practice before the entry into force of the new law on the supervision of health insurance.

“According to the goodwill of the health insurance companies”

This first initiative is a prerequisite for the second, called “For cost-effective premiums”. The Cantons must in fact have all the information necessary to be able to apply the second text which links the evolution of premiums to that of costs. In other words, an automatic compensation mechanism would be put in place when the premiums exceed the actual costs. “In 2020, the level of premiums for Vaudois was lower because they had paid too expensive premiums in 2019 and 2018, recalls Rebecca Ruiz. But this corrective measure was done according to the goodwill of the health insurance funds and after the Canton’s protests, while the corrections of excessive premiums should be automatic. ”This second initiative also asks to guarantee a fair participation of the Cantons in the constitution national reserves of each health insurance.

Excessive reserves

Precisely, the third and last initiative tackles these famous reservations. Entitled “For fair and adequate reserves”, it aims to cap them. In total, the reserves of the funds, which are constituted by the accumulation of profits, amount to 9 billion. They are necessary for health insurers to guarantee the solvency of the compulsory insurance system. But the Cantons consider that their accumulation has become excessive and cost the insured. According to data from the OFSP, as of January 1, 2019, the overall level of reserves in Switzerland is more than double the legal limit and many funds have a high solvency rate. For the first twelve cases, five have coverage of 200%, six of more than 150% and one of more than 125%. The initiative wants to introduce a concrete threshold at 150% of the legal limit. Beyond that, reimbursement to the insured would be compulsory.

Rebecca Ruiz insists: “The debate on the level of the funds’ reserves and on the reimbursement of overpaid premiums must be done. It is about the credibility of the system that the population understands less and less. ”

Created: 15.01.2020, 5:42 p.m.

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