Switzerland: union warns against impact of new health financing system

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(19 March 2024) The vpod/ssp public services has launched a campaign and petition – “Nein zu EFAs” – to try to block changes to the healthcare financing system in Switzerland that will have seriously negative consequences for staff and patients.

“EFAS” refers to the unitary financing of in- and out-patient care and will involve the transfer of responsibility from the cantons (regions) to health insurers. The union is concerned about the insurers having even more power over the health system and warns of increased pressures to cut costs with a negative impact on health workers and patients. Vpod/ssp also argues that EFAS will lead to health spending being re-directed to profit-oriented areas to the benefit of private corporations and to the detriment of those needing care, particularly the elderly.

In the EFAS system, the rapidly rising costs in long-term care due to demographic factors will be borne by the premium payers and no longer covered by taxes. This will increase inequality as premiums are paid per capita, regardless of income and wealth

The union estimates that  health insurance companies will manage CHF 11 billion of taxpayers' money and they will determine who receives financing for care services and operations. Vpod/ssp argues that the increasing focus on profit will mean money for basic medical care will be scarcer and patients' needs no longer be the first priority.

The union says that patients’ health and safety is already at risk as a result of long-term pressure on healthcare workers to deliver care while dealing with cuts to funding. With EFAS, this pressure will increase even further, as staffing ratios and salaries will be squeezed to generate more savings.

Vpod/ssp warns of a vicious cycle as more patients will need to be treated in an even shorter time while staffing pressures increase as many health workers are already leaving the profession because of stress and excessive workloads.

EPSU General Secretary Jan Willem Goudriaan expressed his strong support for the campaign and said: “This just another example of private companies seeking profit out of our health services – services that should be publicly provided and publicly funded. This will undermine any attempt to tackle the staffing shortages and excessive workloads that are faced by Swiss health workers as well as millions of their colleagues across Europe.”