Healthcare costs are soaring, premiums are strangling households and yet the public debate is going round in circles. Fees are adjusted, marginal savings are promised, and new «reforms» are brandished - without ever getting to the heart of the problem. This is neither an accident nor a demographic inevitability: it's a locked system, captured by powerful interests, where price has replaced results and where real medical effectiveness has become secondary. As long as this taboo remains intact, no cosmetic measure will put the brakes on the runaway trend.
There's a lot of talk about healthcare costs in Switzerland. Measures« are being announced, tariffs adjusted and savings promised. And yet, premiums continue to rise, year after year. Why do they keep rising? Because we refuse to get to the root of the problem.
The heart of the dysfunction is not the public hospital, nor the family doctor, nor even the insured. It lies in the gradual capture of the system by industrial and financial interests - first and foremost the pharmaceutical industry - and in a chain of incentives that is totally disconnected from actual medical results.
The crux of the problem: conflicts of interest and overpriced drugs
Today, the validation of treatments and their reimbursement take place in an environment saturated with conflicts of interest. Experts, commissions, clinical studies, opinion leaders: all too often, the same players gravitate between research, industry, consultancy and regulation.
As a result, extremely expensive therapies are being pushed into reimbursement even though their clinical benefit is marginal. It's a familiar story in oncology, with treatments costing several thousand francs a month for a median survival gain of just a few months. A researcher from a major laboratory has admitted it outright: a drug that prolonged the lives of colon cancer patients by 6 to 12 months, sold at a premium, was a huge commercial success - regardless of its cost/benefit ratio for the community.
This is not an isolated scandal, it's a business model.
In Switzerland, drugs account for almost a quarter of compulsory insurance costs. The prices of patented drugs remain systematically higher than in the reference countries, and generics sometimes cost twice as much. As long as this rent is protected by regulation and political pressure, no peripheral «reform» will change the trajectory.
The wrong solutions: centralisation and a single fund
Faced with spiralling costs, some people are advocating total centralisation and a single health insurance fund. This is a dangerous illusion.
The French example is a textbook case: bureaucratic monopoly, exploding expenditure, implicit rationing, delays, shortages of carers, and no sustainable cost control. Centralisation does not reduce spending; it eliminates checks and balances, stifles innovation and removes responsibility from all those involved.
Competition between insurers - when it is genuine and transparent - remains a fundamental lever for containing costs, improving services and experimenting with new models. Transforming health insurance into a monopolistic administration would be a major step backwards.
How can we really reduce costs? Five necessary changes
1. Decartelising allopathic medicine
Conventional medicine has become a therapeutic oligopoly dominated by a few industrial players. We need to break this structural dependence, re-evaluate protocols on the basis of real benefit rather than lobbying, and restore a medicine guided by results, not by the market.
2. Open reimbursement to all effective therapies
What matters is not the ideological label of a therapy, but its measurable effectiveness. Traditional, complementary and alternative therapies should be reimbursed as soon as they demonstrate clinical results, a reduction in relapses or a lasting improvement in quality of life - often at much lower cost.
3. Publicly evaluate practitioners' results
Transparency is the system's big taboo. We need public indicators of results: remission rates, complications, relapses, patient satisfaction. Not to punish, but to clarify, compare and improve. Without results measurement, there can be no cost control.
4. Eliminate unnecessary financial intermediaries
The system is full of intermediaries who capture value without providing care: opaque structures, platforms, administrative arrangements. We need to encourage a direct link between patient and therapist, reduce the parasitic financial layers and reallocate these resources to real care.
5. Enable à la carte health insurance based on ethics
Fundamental principle: policyholders should not be forced to use their premiums to finance actions that run counter to their ethical convictions. Those who do not support certain practices should be able to choose an insurance policy that does not reimburse them. Freedom, responsibility and moral consistency are also levers for controlling costs.
Conclusion: looking after the system before looking after the figures
Rising healthcare costs are not a demographic inevitability. It is the product of a captive, opaque and poorly incentivised system. As long as we protect pensions in the name of progress, as long as we confuse price with value, as long as we refuse to measure real results, no reform will work.
Switzerland does not need more bureaucracy. It needs political courage, radical transparency and freedom of choice.
Reducing costs does not mean rationing care.
It means putting the patient - and the result - back at the centre.
Relevant analysis? Like, share and republish now.