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Country profiles of health system responses to the crisis | Switzerland 497 The benefits package • Removal of eyeglasses from statutory coverage in 2011; reintroduced for children only following pressure from parliament (2012). • New decision criteria for statutory coverage of very expensive treatments, particularly new cancer drugs, introduced by the Supreme Court: health outcomes (survival time in months) and the size of patient groups needing expensive treatment will be taken into account (2011, 2012). User charges • No response reported. Changes to health service planning, purchasing and delivery Prices of medical goods • The Federal Council reduced prescription drug prices by applying an exchange rate of CHF 1.29/€ instead of CHF 1.58/€ to many drugs (2012). Salaries and motivation of health sector workers • No response reported. Payment to providers • Payments for laboratory tests in primary care medical offices were reduced by 10% (2007). This provoked a strong reaction from primary physicians in the form of an initiative call for, among others, support of training, setting up practices and purchasing equipment, and securing incomes of primary care physicians. As primary care physicians were not satisfied with the measures proposed in response to these demands by the Swiss Government in its “Master Plan for Primary Care and Family Medicine”, the initiative was maintained and a popular vote may take place in 2014 or 2015. • Introduction of a DRG-based payment system for hospital care at the national level replacing per diem payments and global budgets (2012). Overhead costs: restructuring the Ministry of Health and purchasing agencies • Growth in personnel costs of health administration (both at the national and cantonal levels) was frozen or cut (up to 10%) since 2008. Provider infrastructure and capital investment • Some investments blocked or postponed. • Investment costs included in DRG costing (2012).
498 Economic crisis, health systems and health in Europe: country experience Priority setting or protocols to change access to treatments, coordination of care and patterns of use • In mid-2012, legislation on “managed care models” introducing a greater coordination of care (coordination between providers, obligations on insurers to offer “integrated care plans” with gatekeeping and reduced co-payments compared with standard plans) was rejected in a referendum. Waiting times • No response reported. Health promotion and prevention • Draft on health promotion, disease prevention and screening programmes rejected by parliament (2012).
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Economic crisis, health systems and
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The European Observatory on Health
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Keywords: DELIVERY OF HEALTH CARE E
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vi Economic crisis, health systems
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viii Economic crisis, health system
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List of abbreviations ACS Health in
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List of tables and figures Tables P
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xvi Economic crisis, health systems
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xviii Economic crisis, health syste
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xxii Economic crisis, health system
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xxvi Economic crisis, health system
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Acknowledgements This book represen
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Preface This book maps health polic
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Part I Country case studies
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4 Economic crisis, health systems a
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10 Economic crisis, health systems
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Chapter 4 The impact of the crisis
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Chapter 4 | The impact of the crisi
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Albania Genc Burazeri and Enver Ros
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Country profiles of health system r
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Austria Thomas Czypionka and Maria
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Azerbaijan Fuad Ibrahimov Economic
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Bulgaria Antoniya Dimova and Mina P
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Cyprus Elisavet Constantinou and Ma
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Czech Republic Tomáš Roubal and J
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Estonia Triin Habicht and Mall Lein
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Finland Jan Klavus and Lauri Vuoren
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France Karine Chevreul, Karen Berg
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Germany Klaus-Dirk Henke and Wilm Q
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Iceland Sigrún Gunnarsdóttir and
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Ireland Anne Nolan and Steve Thomas
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Israel Bruce Rosen and Amir Shmueli
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Kazakhstan Ninel Kadyrova and Tata
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Latvia Uldis Mitenbergs and Maris T
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Malta Natasha Azzopardi Muscat Econ
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Montenegro Ratka Knežević Economi
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Page 486 and 487: Norway Anne Karin Lindahl and Jon M
Page 504 and 505: The Russian Federation Elena Potapc
Page 508 and 509: Serbia Vukasin Radulovic Economic t
Page 520 and 521: Spain Enrique Bernal-Delgado, Sandr
Page 528 and 529: Switzerland Alberto Holly and Phili
Page 532 and 533: Tajikistan Ghafur Khodjamurodov Eco
Page 538 and 539: Ukraine Valeria Lekhan and Mariia T
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