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 The part of cantons in the financing of hospitals should be modulated according to the level of insurance allowances disease, decided on Wednesday the Council of States.
The Upper Chamber adopted by 25 votes against 1 a new model, having given up upsetting all the system. This solution, which should be introduced before 2009, foresees a joint financing of the hospital services by the insurers and the cantons. These last ones will pay a part of at least 60 %, a rate chosen to avoid an increase of premiums, explained Christiane Brunner ( PS / GE) in the name of the commission. Flexible rate An exception is however foreseen: the minimal rate could fall to 45 % for cantons (18 at present) the average premiums of which for adults are lower than the national average. Christoffel Brändli ( UDC / GR) and Anita Fetz ( PS / BS) pleaded, with the support of the federal councillor Pascal Couchepin, for a fixed rate of 60 %.
Any exception will be made at the cost of the insurers and thus the insurants who will see their premium increasing, they exploited in vain. The proposition was thrown back(rejected) by 24 votes against 13. By 29 votes against 11, the Council also refused to follow Philipp Stähelin ( PDC / TG), who suggested lowering the rate reduced to 40 %.
Hospital list Cantons will participate only in the financing of hospitals, public or private, appearing on a list. They will fix themselves this catalog aiming at to insure the cover of needs in care of the population. The possibilities of appeal against these lists will be limited. Cantons will have to coordinate their plannings and will be anxious to establish a common planning for the state-of-the-art medicine.
Services will be indemnified in the form of fixed prices by case. An organization loaded with the maintenance of uniform structures at the Swiss level will be established. Cantons will finance separately the services of general interest as the obligation of coverage, the preservation of capacities for reasons of regional policy, the research and the university training. Government-regulated hospitals Concerning hospitals not appearing on the list, the insurers can conclude with them agreements. The canton would pay nothing except in case of medical necessity. Alain Berset ( PS / FR) rose in vain against this possibility offered, according to him, to the insurers to influence the hospital landscape.
The services of establishments not appearing on the list should not be covered by the basic insurance, he estimated. This competition can be of use as barometer to cantons, notably concerning expenses practised for the new medical techniques, answered Pascal Couchepin. Rejected model
The Council of States so abandoned a solution elaborated last year and which had aroused the condemnation of cantons. This model, thrown rejected by 21 votes against 14, aimed at revising completely the financing of the health insurance by including, besides hospitals, the ambulatory services as well as the home cares and in medical social center for old persons.
The insurers would have taken care of all the services covered by the basic insurance, the cantons paying off to them a part of 30 %. By 22 votes against 15, the senators however adopted one motion asking to the federal council to return in front of the Parliament with a similar project by the end of 2008.
The Council besides agreed to give a legal base widened in the collection of data by the Federal Office of the Statistics. Henceforth all the suppliers of services, and not only hospitals and MSC, can be obliged to supply information allowing to watch the quality and the financial performances of services.
By 32 votes against 9, the Council refused to follow the left wing which, with Pascal Couchepin's support, asked that the insurers pay a contribution (50 centimes a year and by insurant) to finance the collection of data.
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médecin-conseil