The new health article raises to existing principles of health policy in the Constitution. Whether he also brings changes, argue about supporters and opponents. He is committed to a competitive principle embodied system.
The constitutional articles on health policy, most of the people and the Council first June has to decide is the classic case in which an initiative was launched successfully in their place but finally reached a different proposal to the vote. Largely responsible for the minority of ständerätlichen Commission on Social Security and Health (SGK) was. The initial impetus for constitutional revision was the people's initiative, the SVP for lower health insurance premiums, which was filed in summer 2004. The Federal Council rejected the SVP advance. He was convinced that the measures envisaged by the founders were not likely to reduce in the compulsory basic insurance premiums. Above all, the government turned against the fact that some of the benefits of the compulsory basic insurance in the voluntary private insurance should be moved. The Federal Council saw the social character of health insurance at risk.He recommended to reject the initiative. The already completed and still on-going reforms of the Health Insurance Act should be promoted as an indirect counter-proposal to the initiative.
Counter-proposal of the Parliament
Even in Parliament, there was a majority in rejecting the SVP initiative agreed with the Federal Council. Only the SVP representatives fought on for their first referendum. But the question of whether the initiative was held against a counter-proposal at the constitutional level, the parliamentarians assessed differently. A majority of ständerätlichen Commission accepted the view of the Federal Council to waive a direct counter proposal. A minority, led by professional Ausserrhoden Hans Altherr (fdp.), pleaded for it. They could prevail in the end with their concerns within the Council by casting vote of the president. Also in the National Minority Commission finally succeeded in convincing a majority of the large chamber expects to submit the People and the indirect counter-proposal. And in the end happened, what we hoped for: The People's Party drew on 10 Their initiative back in January 2008.
Therefore, the Sovereign in June are now so alone on the counter-proposal. So far, so good. But what is at stake. What will it set a new course for health policy?What's new? Explicitly mentioned Articles of the Constitution the principles of efficiency, convenience and economy. He takes on the principles of the current health insurance law. He further says that the health insurance is governed by the principles of competition and transparency, and refers to the responsibility.What this actually means, it has emerged between supporters and opponents of the template, a violent dispute.
Regulated competition
Parliament is sticking to his website to the new constitutional article that with him the "current state" of health policy is committed. The emphasis lies on a regulated competition, the quality and efficiency. As the new principles, the freedom of contract and monism would be included. What is not said: Even in its implementation is already working. In a one-tier system of funding public money be paid to those carriers who paid the medical and nursing services. For the advocates, health insurers are in the foreground. This is the article lays but not explicitly. Under freedom of contract means that the fund no longer have to settle with all doctors, but were competent to take only those under contract that meet certain criteria.
Proponents of constitutional revision now emphasize, however, that the introduction of freedom of contract standing in the new provision. In contrast, the new patient choice and the quality and security of supply would be enshrined in the Constitution. The question of the introduction of freedom of contract is the big issue. The opponents of the proposal, led by the Swiss Medical Association, FMH toss just before the presentation to seek freedom of contract and thus to restrict the free choice of doctor for the patient. A report commissioned by them coming to the conclusion that freedom of contract that the purpose of the template. In fact, she was a central issue in Parliament and was described by the speaker of the ständerätlichen Commission in the final discussions as the cornerstone of the new constitutional article. On the other hand, the commitment to freedom of contract was formulated in an earlier version of the article more clearly what was later withdrawn. Also, this process must be allowed to interpret the standard does not entirely ignore. Couchepin said again at the opening of the voting campaign, that the constitutional amendment had no effect on the freedom of contract.
Who pays, orders
Another issue is the change to one-tier funding system. Proponents stress that this creates more transparency and competition distortions be eliminated. To ensure that the unequal compensation for outpatient treatment and the treatment is abolished in the hospital, because unilateral subsidy is eliminated hospitalization. Against the monism used primarily by the Conference of Cantonal Health Directors. They criticized, among other things, that this would flow cantonal public money amounting to 8 to 10 billion francs in the health insurance, with no one stood that this control. The cantons are afraid their health care contract to meet ultimately can not remember if they lose the power to decide on the use of their funds. Others warn that with the formulation "can-term care benefits" the mandatory health care insurance company, the professionals providing care services could be deleted. But this is to be noted that the current constitutional article makes absolutely no statement or warranty on the details of the compulsory health insurance. Here, everything is left to the legislature.
In the final vote of the National Council's counter-proposal by 133 against 63 votes was called good. The Senate agreed with him by 29 votes to 13. The Bundesrat, which had opposed in Parliament or a direct counter proposal supported it today. very explicitly for the presentation has been the Association of Swiss hospitals, H +. Fight them is by the Swiss Medical Association and various professional associations of care. To the patient and consumer organizations oppose the template. Even in the cantons of their blows against a stiff wind. Ye the boards of the Conference of Cantonal Directors of Health and the cantonal welfare directors have declared the fight.
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