"For many customers, premiums remain unchanged."

Sanitas CEO Andreas Schönenberger is certain that we’ve all got to pull together to be able to finance our healthcare system in the long term.

Text: Helwi Braunmiller, photos: Kostas Maros

The most pressing question first: what can we expect with regards to premiums for next year?

As things stand today, I’m happy to say that premiums will remain stable for most of our customers in 2020. For a large majority, premiums for basic insurance and supplementary insurance will remain the same. There’s also good news for young adults aged 19 to 25: they will continue to benefit from excellent discounts for basic insurance. In the longer-term, however, there’s no getting away from the fact that premiums will rise again sharply due to an ageing population, unsuitable incentive systems, expensive treatments, and so on.

Do you have any tips on how your customers can save money?

Discounts are widely available for insurance plans that efficiently manage patient treatment, such as our alternative insurance models CallMed, NetMed, CareMed and – from October – our new model Medbase MultiAccess. With CallMed, for example, customers benefit from 24/7 availability, with lower costs than in the event of emergency hospital treatment. In addition, they are referred directly to the specialist best suited to their needs. This improves efficiency, because it prevents multiple analyses and unnecessary visits to the doctor, which in turn cuts costs.

However, this often gives the impression that health insurers are trying to reduce costs but primarily for their own gain.

This is actually not possible as far as basic insurance is concerned. By law, health insurers are obliged to set their premiums so that they cover costs without making a profit. If health insurers generate profits due to lower than expected health costs, they build up reserves. These reserves can then be used in the future to cushion the increase in premiums for their policyholders.

In Switzerland it’s hard to cut health costs. We have one of the most expensive healthcare systems in the world. What’s your opinion?

I think that our healthcare system needs to move with the times. It could be much more efficient, streamlined and liberal. Despite the existing overcapacities (20 to 30% of hospital beds are lying empty), huge investments in hospitals are planned over the next few years – over CHF 15 billion. ​ Why don’t we reduce these overcapacities in hospitals? Swiss citizens regularly vote against hospital closures no doubt due to a fear, among other things, of shortfalls in medical care. Another problem is the lack of transparency regarding treatment costs. For example, people aren’t given the hard facts when it comes to hospital costs. 55% of the costs are paid directly by the cantons and are not visible for patients. This ultimately leads to insured persons claiming benefits without a second thought. What’s more, the fixed tariffs don’t sufficiently reward excellent performance, which could lead to a decline in quality in the long term. In Switzerland there’s definitely a lack of transparency with regard to quality and costs. Compulsory basic insurance was introduced in 1996 to prevent costs from spiralling and to make the health system affordable for all. Unfortunately, this has only worked to a limited extent, because healthcare costs have grown faster than the gross domestic product.

Could unified basic insurance be the way out of the cost dilemma?

From our point of view this is the wrong approach. Without competition, costs will rise faster and quality will decline. State-controlled unified basic insurance would offer no incentive to improve quality, efficiency and the cost-benefit ratio.

Does Sanitas have a way of cushioning the rising costs?

There’s certainly no easy way to resolve this issue. The healthcare system is very closely regulated. Within this framework, we aim to curb rising costs through innovation and good cost management. In particular, we promote alternative insurance models in this context. Here we have the freedom to reward efficiency and quality instead of quantity. This is why we’re developing new alternative insurance models and services, focusing even more strongly on prevention and thus promoting personal responsibility for health. At the same time, more scope should be provided for innovation and genuine competition. For example, health insurers should be free to terminate contracts with service providers who don’t provide good quality services. For this to happen, however, transparency must be created regarding the quality and costs of treatment. And insurers should be given the opportunity to reward quality.

Supplementary hospital insurance plans have also come under fire in the media. Are they on their way out?

No. In fact, quite the opposite. There are always customers who want additional services. And supplementary hospital insurance plans offer services that extend far beyond the choice of a single or two-bed room or treatment by the chief consultant. For example, our Preference services help customers get a second medical opinion or an appointment with a specialist. And we’re always striving to adapt our range of products and services to the needs of our customers – both in the inpatient and outpatient sectors.

What trends will impact on health insurers in the future?

An ongoing trend that I’m concerned about is increasing regulation. In my opinion, it inhibits innovation in our already complex healthcare system and ultimately harms customers.

What role does Sanitas play for its customers?

We focus on customers as individuals and see ourselves as their health partner – not just when they fall ill, but also when it comes to staying healthy. We actively support our customers and make their lives easier, for example with digital services such as our Sanitas Portal app for all their insurance affairs and our health promotion offers.

What are you most looking forward to in the months ahead?

I look forward to offering our customers attractive premiums and new, innovative products and services that will enable us to better meet their needs and help them stay fit and healthy in the future. We are also simplifying processes, for example the online purchasing process and cost settlement. And I’m delighted with our new brand identity, which puts the spotlight on our partner-based concept “Together for your health” and focuses on the well-being of our customers.