After six years of debate within the halls of power, lawmakers have now chosen to move forward with a plan to charge prospective patients a fee if they choose to admit themselves to hospital without a referral. The plan is meant to reduce the number of people using the emergency services unnecessarily, but critics have already labelled it impractical and unnecessary.

50-franc fee for A&E in Switzerland

Under the plans, anyone who chooses to visit the emergency department at a hospital in Switzerland without being sent there by ambulance or a referral from a doctor, pharmacist or telemedical centre would be subject to a 50 franc charge. The fee would apply to all holders of basic health insurance, although children and anyone who is pregnant would be exempt from the charge.

The plan was originally tabled by the government in 2017 but was only voted on by the Committee on Social Security on November 17, 2023. At the vote, the committee confirmed that the proposal would now be drawn up as a law in the coming months, and will be submitted to parliament by next spring.

Cutting unnecessary treatments a way to reduce premiums, say supporters

In a statement given to 20 Minuten, the committee said the “planned measure aims to dissuade insured people from going to hospital emergency rooms for mild cases.” With the cost of health insurance set to rise dramatically in 2024, largely as a consequence of the heightened cost of healthcare, the idea is seen by many as a way of reducing premiums by eliminating “unnecessary and expensive” visits to the doctor. 

Indeed, when announcing the premium rise for 2024, the President of Switzerland and Health Minister Alain Berset said that in order to reduce premiums, people needed to be more mindful of whether their ailment really needed to be seen in the emergency room. “There are too many cases of emergencies that are not real emergencies,” committee member and National Councillor Thomas Aeschi argued back in February.

Opponents call Swiss A&E tax impractical

The proposal has not gone down well with elements of parliament. Speaking back at the start of the year, National Councillor Barbara Gysi said the tax would achieve nothing and be a burden on healthcare providers. In a press release, the Swiss Society for Emergency and Rescue Medicine said that it amounts to treating every patient as a “hypochondriac”. “Emergency services are not toll stations,” they concluded.

The Federation of Swiss Doctors also disapproved of the plan, telling 20 Minuten in a statement that it could prevent people who are genuinely ill from seeking medical treatment. Finally, the newspaper reported that a number of Swiss cantons have submitted a letter to the committee, arguing that “the tax would not only have no cost-control effect, but would hardly contribute to easing congestion in services.”

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