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Are apps undermining solidarity?

Should people who live healthily pay lower health insurance premiums? The principle of solidarity is inevitably coming under increasing pressure as a result of digital change.

Text: Roland Brühwiler

No matter whether you’re fit and sporty, chronically sick, young and healthy, or old and frail, everyone basically pays the same basic health insurance premium in Switzerland regardless of age, sex or state of health. Car insurance is the perfect counter-example: here, those who cause more damage pay higher premiums.

Today, however, apps and smartwatches make it easy to measure and track how we’re helping to keep ourselves fit and healthy: Are we getting enough exercise? How is our blood pressure? Are we eating healthily? Are we getting enough sleep?

This makes comparisons possible, and could ultimately undermine the principle of solidarity if, for example, people who keep themselves fit and live healthily are rewarded through lower health insurance premiums.

“Almost half of those surveyed believe that people who keep themselves fit and eat healthily should pay lower health insurance premiums.”

What do Swiss people think about this idea? The Sanitas health insurance foundation posed this question in the second “Data society and solidarity” study conducted by the sotomo research institute in 2019. This representative survey showed that almost half of those surveyed believe that fit and healthy people should pay lower premiums.

It was a different story in 2018, when just 40% of participants were in favour of behaviour-dependent insurance premiums. Today, almost two-thirds of people who consider their own lifestyle to be healthier than that of other people find such behavioural premium discounts justified. In contrast, of those who stated that they live a less healthy lifestyle, almost two-thirds are against the idea.

Increased life-tracking and knowledge about individual health is therefore increasing the pressure on solidarity when it comes to health. In fact, some 56% of participants said they generally believe it is important for healthy people to show solidarity with the sick – provided that they don’t have to foot the bill.