What should be the basis for compulsory and optional health insurance premiums? Opinions of Swiss doctors

Jannot, Anne‐Sophie; Perneger, Thomas

doi:10.4414/smw.2014.13918

Cited by 2 publications

(3 citation statements)

References 19 publications

(21 reference statements)

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“…A switch to an income-dependent premium system has been suggested to improve equity in health finance, but repeatedly failed to gain enough votes in popular referenda (e.g., ( Perneger and Hudelson, 2005 )). Furthermore, the support for the status quo system currently still seems to be strong ( Jannot and Perneger, 2014 , Longchamp et al, 2012 ). Interestingly, a preference for the current regional flat-fee system over an income dependent system even prevails among Swiss physicians ( Jannot and Perneger, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

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Failure to pay for social health insurance premiums: Acts of protest or desperation?

Wyl

Beck

2015

Preventive Medicine Reports

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BackgroundIn Switzerland, basic health insurance is mandatory for all inhabitants, but a rising number of insured have arrears in premium payments, potentially leading to coverage suspension. We aimed at characterizing insured with debt enforcement proceedings with respect to socio-demographic and health utilization aspects.MethodsCross-sectional analysis of 508.000 insured with basic health insurance contracts in 2013, of whom 14,000 (2.8%) with debt enforcement proceedings, from 11 Swiss cantons. Groups were characterized using logistic regression and latent class analysis.ResultsInsured with debt enforcement proceedings were more likely to be young, male and without dependents (partner, kids). Having no supplementary insurance and receiving partial premium subsidies was associated with an increased debt enforcement proceedings risk.Within the debt enforcement proceedings group, three subgroups were identified: 60% were young and seemingly healthy, with a below-average fraction of premium subsidy recipients (18%) and low out-of-pocket payments in prior year (median Swiss Francs 0).Two groups consisted of relatively ill elderly persons (22%, 99% of whom with chronic illnesses) or families (18%), many of whom (29% and 51%) were recipients of premium subsidies. Median out-of-pocket payments in the prior year were high (Swiss Francs 625 and 688, respectively).ConclusionsSixty percent of premium arrears derive from young insured without apparent financial problems; 40% are owed by elderly and families, which are potentially hurt by coverage loss.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, the support for the status quo system currently still seems to be strong ( Jannot and Perneger, 2014 , Longchamp et al, 2012 ). Interestingly, a preference for the current regional flat-fee system over an income dependent system even prevails among Swiss physicians ( Jannot and Perneger, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Failure to pay for social health insurance premiums: Acts of protest or desperation?

Wyl

Beck

2015

Preventive Medicine Reports

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“…In addition, Swiss residents can purchase supplementary health insurances for additional treatments or special inpatient conditions, e.g. single room or chief physician treatment [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with post-acute discharge location after hospital stay: a cross-sectional study from a Swiss hospital

Zimmermann

Koné

Rost

et al. 2019

BMC Health Serv Res

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Background In 2012, Switzerland introduced the diagnosis-related group hospital payment system. Fearing that vulnerable patients may be discharged early, Acute and Transitional Care (ATC) was introduced to address the nursing care of patients who no longer needed an acute hospital stay. ATC is more costly for patients when compared to other discharge options like rehabilitation while providing less rehabilitative services. This study investigates factors associated with the place of discharge for patients in need of care. Methods Data was collected from 660 medical records of inpatients 50 years and older of the municipal hospital Triemli in Zurich, Switzerland. We used stepwise logistic regression to identify factors associated with their discharge into ATC or rehabilitation. Results Older patients with higher Delirium Observation Scale (DOS), lack of supplementary health insurance, resuscitation order and a lower social network were more likely to be discharged into ATC than rehabilitation. Conclusions The association of supplementary health insurance and social network with discharge into ATC or rehabilitation is problematic because patients that are already vulnerable from a financial and social perspective are potentially discharged into a more costly and less rehabilitative post-acute care facility. Electronic supplementary material The online version of this article (10.1186/s12913-019-4101-6) contains supplementary material, which is available to authorized users.

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What should be the basis for compulsory and optional health insurance premiums? Opinions of Swiss doctors

Cited by 2 publications

References 19 publications

Failure to pay for social health insurance premiums: Acts of protest or desperation?

Failure to pay for social health insurance premiums: Acts of protest or desperation?

Factors associated with post-acute discharge location after hospital stay: a cross-sectional study from a Swiss hospital

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