Paul Seewer
Claude Chatelain, publicist and business journalist.
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One of the most frequent questions that I am asked repeatedly and that obviously worries many people: Do I need additional hospital insurance? Should i cancel it?
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Assuming I say what I personally think – that these insurances are not worth the price – the person cancels the insurance and suddenly goes under the knife. The person would say to himself: If only I hadn’t quit. I would be the scapegoat then. With Federal Councilor Ueli Maurer I can only say: “Kä Luscht.”
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But I really want to take a look behind the scenes. There is a lot going on. I am only talking about the hospital tariffs of the supplementary hospital insurance, semi-private and private.
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It works like this: If a person undergoes an operation, the compulsory health insurance (OKP) pays a flat rate per case. If the person is semi-privately or privately insured, the hospital and participating doctors receive additional money from the additional insurance. I’m only talking about this extra money here.
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If you want extra money, you have to do extra work. In the case of supplementary hospital insurance, semi-private would be the two-bed room and free choice of hospital and doctor. I say “would be” because it sounds better than it is. More and more hospitals only have twin rooms, which means that this advantage is no longer available. In addition, surgical interventions are increasingly carried out on an outpatient basis, which makes hospital insurance more and more obsolete.
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So although the added value of hospital insurance is on the decline, hospitals are sticking to their inflated tariffs. Who wants to forego their benefices without necessity, after all, hospitals and doctors have made good money with private patients for decades.
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The health insurers cannot let that sit on themselves. Some therefore keep special lists of hospitals with which they have no contract. In doing so, however, they restrict the free choice of hospital with which they advertise full-bodied. That’s why it’s not so easy with these lists. The hospitals know that.
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The price supervisor calls this a factual obligation to contract. He now wants to intervene and lower the abusive tariffs. In a specific case, at the regional STS hospital group in Thun, he succeeded in doing this. But the financial market supervisory authority Finma also noticed the mischief. It acts in the interests of the insured and requires the health insurers to negotiate transparent contracts with hospitals, which clearly show how the additional services are quantified and justified. A difficult undertaking when these additional services hardly exist any more.
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Conclusion: Supplementary hospital insurance is far too expensive. Should they be terminated?
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Everyone has to decide for themselves. As you make your bed, so you ultimately lie.
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