Unpaid health contributions: CDS breaks off negotiations; the case will be sent to Parliament
The Swiss Conference of Cantonal Ministers of Public Health (CDS) would like to see legislation as soon as possible following the solution found in the autumn with santésuisse to the problem of unpaid health contributions. The insurers would have liked to settle some aspects before sending the case to Parliament.
The negotiations were dragging and their outcome uncertain, and given the urgency of a change in legisation, the CDS steering committee declared the negotiations closed in their current state. The CDS will propose a bill for the Federal Assembly "on the basis of areas of agreement already found with santésuisse."
It is planned that Cantons will step in for 85% of unpaid health contributions and that in return, insurers will no longer suspend their health benefits. To ensure the payment of an insured's health contributions, Cantons must hold a certificate of low income proving that the insured in question is unable to pay.
However, if the prosecuting authorities consider that the insured is solvent, social security funds can continue to suspend their benefits until out-standing contributions have been paid. "This solution allows to differentiate between those who don't want to pay and those who cannot pay," santésuisse satisfactorily concluded in October.
The negotiations that have been held since were meant to finalise the agreement. Nevertheless three sticking points remain, according to the top insurer in a statement that followed soon after the one given by CDS. Santésuisse, who maintains that these differences could have been ironed out before the end of March, deplores the fact that the Cantonal Ministers decided to end negotiations.
Since article 64a of the LAMal [Federal law on health insurance] came into force in 2006, some 150,000 people, according to CDS figures, have had the refund of their healthcare expenses suspended because they have not paid their contributions.
One of the three points put on hold concerns the subsidies granted by Cantons to the insured on low income. Both parties agree that these subsidies should be paid directly to social security funds to prevent this money from being used for other purposes. But the CDS refuses to force Cantons, who presently pay this money to the insured, to change this practice, much to the disliking of santésuisse.
The second controversy relates to outstanding doctor and hospital invoices that are piling up, waiting for a change in legislation to come through. The CDS believes that it should be up to the insurers to pay these invoices, whereas santésuisse wants the Cantons to pay retroactively. The hospitals' unpaid bills already amount to over 80 million francs.
The third point of disagreement concerns the insured who don't pay who have no known address. The insurers would like to specify in the law that for these people also, for whom it is impossible to obtain a certificate of low income, Cantons are required to pay 85% of the contributions.
The negotiations between santésuisse and CDS to find a national solution to this issue started a year ago. Initially Cantons were suggesting they would cover only 80% of the bad debt where there is proof of low income, whereas santésuisse wanted that figure to be 100%.
Sources : AWP/ats