Swiss healthcare accused of overcharging insurers by billions of francs

According to one of the largest associations for health insurance providers in Switzerland, Santésuisse, doctors and hospitals overcharge patients and insurers in the alpine nation by three billion francs every year. Insurance providers say that premiums for basic and supplemental health insurance could fall by 10 percent, if patients were charged correctly.

Insurers accuse Swiss healthcare of overcharging for treatments

According to media spokesperson Matthias Müller, Santésuisse estimates that three billion Swiss francs a year is spent unnecessarily in Swiss healthcare. He explained that insurers are being charged for services that have either not been used by the patient or charged more for a procedure than is necessary.

His thoughts were echoed by other health insurance associations, with Curafutura saying that Santésuisse’s findings were accurate and that insurance costs could be reduced by up to 10 percent if charges were reported accurately. Atupri health insurance said that they are over-invoiced by 60 million Swiss francs every year, and Swica also reported losses in the millions.

"We see the problem in particular in the outpatient area, where doctors can choose from numerous tariff positions," Müller explained. Health expert Felix Schneuwly noted that insurers struggle to prove these allegations as, "In comparison to the customers of craftsmen, patients do not sign a work report of the medical services rendered," and insurance companies cannot check what services have been used and which haven’t.

Hospitals and doctors in Switzerland strongly condemn the accusations

The accusations were strongly condemned by hospital groups across the country, with association H + saying it was a mystery as to how Santésuisse came up with the three billion figure. Director Anne Bütikofer said that hospitals bill insurers according to publicly available tariffs and that, "Wrong invoices could only be issued with incorrect coding, which has been proven not to happen."

Yvonne Gilli, president of the Professional Association of Swiss Doctors, noted that “a large number of different factors are summarised in the three billion figure. This includes, for example, billing errors.”

To solve the issue, hospital groups and insurers have been working together to standardise health costs across the country. Health expert Felix Schneuwly has also proposed a system of “treatment reports,” where insurance companies can see which treatments have been used and compare them to the bill sent by the hospital.