As was already apparent early this year due to the cost increases, when the OKP premiums will be in 2023, after the premiums had been very stable in previous years.

Increase due to volume expansion

“The premiums must cover the costs,” writes the LKV. After the difficult COVID years of 2020 and 2021, costs would rise again more sharply in 2022, currently by 3.4 percent in a 12-month comparison. “Since the tariffs have hardly increased in recent years or have even fallen in some areas, the increase in costs can be explained by the increasing volume of services,” writes the LKV. In concrete terms, this means that people go to the doctor more often.

The health insurers are aware that people are already facing major challenges due to rising energy prices and inflation.” Due to the cost growth, however, it was essential to increase the premiums in 2023 with a view to financial security taken into account in the premium increase,” writes the LKV

Politicians must take action

Due to technical and medical developments (new services, new medicines, etc.) as well as demographic developments, healthcare costs tend to increase every year. “However, the increase in costs in the health care system is not a law of nature. There is previously untapped potential for cost-cutting measures,” writes the LKV and provides a catalog of measures:

• are generally only to be remunerated at the price of corresponding generics, if such is available.
• The goal of bringing drug prices to a European level must be pursued. In this regard, developments in Switzerland should be closely monitored and corresponding talks should be held with the competent Federal Council.
• The reference tariffs for hospital stays are to be based on the replaced tariff instead of the average.
• Outpatient flat rates in the doctor’s area have a cost-cutting effect. This is a medium-term goal and should be tackled in lockstep with Switzerland.
• The catalog of services is to be streamlined in various areas according to Health Technology Assessments (HTAs). Services that no longer meet the WZW criteria are to be deleted.
• Outpatient before inpatient in hospitals should be further promoted.
• Framework conditions for alternative insurance models must be optimised.
• Digitization can make processes more efficient and cheaper. Digitization must therefore be increasingly demanded in the healthcare sector.
• The introduction of requirements planning for other groups of service providers in terms of volume control must be implemented.
• In addition, our tiers payant system (health insurance company pays the service provider’s bill) could be based on a tier garant system (insured person pays the service provider’s bill and can claim back the insurance benefit from the health insurance company) to promote cost awareness.

The LKV demands that these and other measures be checked and implemented by politicians. “In this way, cost containment can work for the insured without loss of quality.”