Adhesion contracts with franchises will cause more costs

In September, the national Council decided that the Insured with a higher deductible to paint than the mini 300 Swiss francs in the future three years bound to stay. The aim of these gag contracts is to prevent the "franchise hopping" to make it impossible so it is up to the Insured to reduce in terms of a planned intervention, the Franchise, to raise it again next year.

According to the Federal office for health (BAG) are, however, only 0.17 percent of the Insured, the change targeted the Franchise. The three-year contracts would then only lead to a cost saving of 5 million Swiss francs, wrote the BAG last year in a report. In the national Council, the view of the civil side dominated in September, the need to introduce the adhesion contracts despite low potential savings.

The under-appreciated effect

now, However, calculations show that the opposite is likely to happen: The three-year contracts could cost the health and therefore the premiums for all. Today, the Insured can change the insurance and the amount of the Franchise every year. With a higher deductible premiums, you can save.

The reason that the bill of the national councils are not absorbed well, is the cost-dampening effect of high deductibles. It is much higher than the damage of the franchise hopper. First, these Insured to take a larger part of the costs themselves, and, secondly, think twice about whether you want to take a doctor.

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If you need to undertake now, in the case of a higher deductible for three years, the risk is significantly greater in this period because of a disease, the high costs themselves. The presumption is that many of the Insured are not willing to take that risk, and instead for the higher Franchise for the minimum of 300 francs to decide. Particularly older and sicker Insured could consider this.

the Exact impact on total health care costs. If only one half of one percent of the Insured, a total of around 16000 adults, due to the adhesion contracts against its increased electoral franchise decides to increase the cost, overall, even if one takes into account the higher premiums. First, because this Insured is less out of pocket pay. Secondly, because you have to go more often to the doctor.

"A fictional Problem"

The costs are higher than the savings due to the adhesion contracts. This is evident from the calculation which made the health insurance company CSS 2015. Insured with the minimal franchise of 300 francs to pay a higher premium, but the bottom line is per capita per year 250 francs cost more than those with a deductible of CHF 500 and 322 Swiss francs more than those with a deductible of 1000 to 2500 francs. The total savings due to higher deductibles is according to authors ' calculations 1.1 billion Swiss francs.

The Federal is calculated on a saving of 5 million Swiss francs will be achieved only if all Insured persons who have a higher deductible, commit for three years. This is very likely the result of a study conducted by the Federal office of public health in 2017. Only 23 percent of the more than 2,000 respondents were in favour of a multi-year commitment. Decide now, however, 77 percent of today's higher Franchise Insured against three-year-old gag contracts, and in the deepest Franchise change, could result in additional costs of up to CHF 800 million. These additional costs would have to be borne by all the Insured together. The national Council desired effect to save with multi-year contracts of 5 million Swiss francs, would then have the opposite result.

"With the gag contracts will solve the majority of the national Council of a fictional Problem, and drives for all Insured premiums in the amount," warns Felix Schneuwly, health insurance expert at Online comparison service, Comparis.

Hope on the Council of States

One who supported the three-year contracts, the Grisons Heinz Brand, SVP national councillor and President of the health insurance Association Santésuisse. He remains, the decision would be useful. "The three-year scheme, the deductibles will improve the self-responsibility," he says. The number of "franchise-hopper" is much higher than the Federal estimates because it had observed the exchange too long. Brands Association believes that the calculation of the costs of the illusory.

Brand refers also to a study commissioned by the Federal government, and 8.3 percent of the proceeds. "Even if this template is not the most important, in order to curb the excessive cost increases, it forms one of the many steps to the goal," says Brand. The Bernese BDP-health politicians Lorenz Hess, Chairman of the Board of the health insurer Visana, it looks similar to this: "We must fight the targeted Franchise." The Basel SP-national councillor Silvia Schenker, which rejected the proposal in the autumn, in your Reserved confirmed. They feared that the adhesion contracts have a negative impact on health. "The new calculations, the potential savings are an additional Argument against the template," says Schenker. She hopes the Council of States.

This shares the reservations: The preparatory Committee of the Council of States made the same Considerations and proposes to the Council in the next Session in March, not on the template.

(editing Tamedia)

Created: 07.02.2019, 22:13 PM