Health Policy Survey Analysis of Parliamentary Responses

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Version 3 – April 28, 2026 (First version: April 22, 2026)

Executive Summary

The politically neutral information platform clarus.news conducted a survey in March/April 2026 among the 38 SGK members of Parliament on four central questions concerning the Swiss healthcare system. The response rate was modest – the majority did not respond or only referred to party programs. Five parliamentarians provided substantive answers, whose comparison with public statements and interest ties presents an insightful picture.

This analysis documents the responses, reveals contradictions to public sources, and formulates concrete recommendations for action for the responsible committees.

Update Notice (28.4.2026): After advance submission to the five responding members on April 27, 2026, two statements have been received. Both National Councillor Barbara Gysi and Council of States member Peter Hegglin have suggested corrections and clarifications. The justified points have been incorporated in this version; the statements are also reproduced verbatim.

Part I: Participating Parliamentarians

The following five SGK members provided substantive responses. The following interest ties were recorded based on publicly accessible sources (Lobbywatch, parlament.ch, personal websites).

Name Party/Council Canton Current Functions Related to Healthcare
Barbara Gysi SP/NR SG President SGK-N 2023/2024; President Pflege- und Adoptivkinder Schweiz; Board member Spitex Verband SG/AR/AI (since 2021); Board member fmc Schweizer Forum für integrierte Versorgung (since 2022); Mandates and income disclosed on personal website
Peter Hegglin Centre/SR ZG President RVK (Association of small and medium-sized health insurers); Member of the Board of Directors santésuisse (by virtue of RVK function); Member Foundation for the Promotion of Special Community Tasks of Social Health Insurance; Lobbywatch records a total of 38 connections, primarily agricultural, political or cultural
Andreas Glarner SVP/NR AG Founder Careproduct AG (sold to Galenica in 2017); SGK member since 2019
Andri Silberschmidt FDP/NR ZH No interest ties in healthcare (self-declared); FDP Vice-President; Government Council candidate ZH 2027
Baptiste Hurni SP/SR NE Vice-President Swiss Patient Organisation (disclosed); Vice-President SP Switzerland

Part II: Detailed Analysis of the Four Core Topics

1. Deductible Increase from CHF 300 to CHF 400

Context: The Federal Council opened the consultation on the implementation of Motion 24.3636 Friedli (SVP) on March 13, 2026. Next step presumably 2027/2028.

Positions of Respondents:

  • Glarner (SVP): Confirms "de facto shift to the insured – but possibly with a healing effect" (i.e., demand control).
  • Hegglin (Centre): "Strengthens personal responsibility"; refers to good healthcare system; all actors would have to contribute.
  • Silberschmidt (FDP): No direct answer; reference to fdp.ch/gesundheit.
  • Gysi (SP): "Cost shift to patients, particularly elderly and chronically ill".
  • Hurni (SP): "Transfert de charges vers les malades (…) et une baisse de la solidarité dans la LaMal". Announced referendum.

Key Findings:

The expected savings of approximately 300 million francs compare to an annual cost growth in basic insurance of 2.3 billion francs (2023/2024) – a ratio of approximately 1:8. The measure thus works primarily symbolically or as demand dampening, not as structural cost containment.

2. Emergency Fee CHF 50

Context: The National Council narrowly approved the parliamentary initiative (GLP, Patrick Hässig) with 96:91 votes on March 18, 2026. The Federal Council and majority of cantons reject it. The bill has not yet been considered in the Council of States.

Positions of Respondents:

  • Glarner: Fee goes to the hospital; "will presumably be rejected in the Council of States"; earmarking was "not a topic".
  • Hegglin: Sympathy for the proposal; "it's mainly trivial cases that should be prevented".
  • Gysi: Administrative effort "many times higher" than revenue; open questions (e.g., reimbursement for pharmacy referral); earmarking would be unconstitutional in her assessment (causal levy argument).
  • Hurni: Clear rejection ("Jamais je l'espère"); Council of States will hopefully not accept it, otherwise referendum.

Public Contradiction to the Argumentative Basis:

According to an analysis by Helsana, which Federal Councillor Baume-Schneider cited in the National Council debate on March 18, 2026, the proportion of minor cases among hospital emergencies has decreased from over 8% to around 5% in the last ten years. The justification "prevent trivial cases" thus stands on empirically weak ground.

3. Blocked Supply Reforms (Conflicts of Interest)

Context: The INFRAS/ZHAW study (2019), data basis 2016, quantifies the savings potential for OKP benefits at 16–19% (7 to 8.4 billion francs/year) without quality loss. Central reform proposals (e.g., reference price system for generics) were rejected in 2020/21.

Positions of Respondents:

  • Glarner (SVP): "These conflicts of interest play a central role – unfortunately!" Every innovation is sunk with "patient safety" and "security of supply".
  • Hegglin (Centre): "Parliamentarians are representatives of the people. They must disclose their interest ties. But parliamentarians are also consumers of healthcare facilities."
  • Silberschmidt (FDP): Personal renunciation of interest ties (exemplary); no assessment of the system question.
  • Gysi (SP): Refers to current examples of pharma lobby pressure (reimbursement of high-turnover medications, volume discount system, generics accommodation).
  • Hurni (SP): Discloses own interest ties (Vice-President Patient Organisation). "The main problem comes from the very powerful lobbies of pharma, health insurers and doctors (especially specialists)."

Remarkable Intersection: Interest Ties and Initiatives by Council of States Member Hegglin

Council of States member Hegglin, who relativizes interest ties in his response ("Parliamentarians are also consumers of healthcare facilities"), presides over the association of small and medium-sized health insurers (RVK) and sits on the board of directors of santésuisse due to this function. In September 2024, the Council of States adopted his Motion 24.3220 "Relaxation of the contracting obligation (freedom of contract)" with 30:12 votes. The motion targets the general contracting obligation between health insurers and service providers (doctors and hospitals) and would have – if implemented – given health insurers expanded possibilities to selectively conclude or reject contracts with individual service providers.

Statement Council of States Member Hegglin (email of April 27, 2026): "I certainly do not have around 39 mandates. (...) In the healthcare sector, I have the presidency of the Association of Small and Medium-sized Health Insurers and in this function I am a representative on the santésuisse Board of Directors. The motion to relax the contracting obligation came from the SGK-S. It aimed to enable more competition in the area of reimbursement for laboratory services. I have always understood competition as enriching, better services at competitive prices. I therefore do not understand the title 'Remarkable Contradiction'. I ask you to correct the misleading statements."

Editorial Response: We have reviewed three points from Hegglin's statement.

  • "39 mandates": Lobbywatch counts 38 "recorded connections" as of November 21, 2025, not "39 mandates". The majority of these are agricultural functions (BO Milch, Sbrinz, Farmers' Association), political and cultural memberships. The formulation "39 mandates" was imprecise and has been corrected. In healthcare, three connections are relevant: RVK presidency, santésuisse board of directors and Foundation for the Promotion of Special Community Tasks of Social Health Insurance.
  • "santésuisse board": Correct is "santésuisse board of directors". This clarification has been incorporated in this version.
  • Motion on contracting obligation: Motion 24.3220 was submitted personally by Council of States member Hegglin (Curia Vista, parlament.ch); he was simultaneously the majority speaker of the SGK-S. However, the content of the motion does not concern – as stated in the statement – "the reimbursement of laboratory services", but rather the general contracting obligation between health insurers and service providers (doctors and hospitals). This emerges from the wording of the motion, the official bulletin of the Council of States debate of September 26, 2024, as well as from reporting by NZZ, Tages-Anzeiger, swissinfo.ch and the press release of the hospital association H+ of January 17, 2025.

From a journalistic perspective, the intersection between Hegglin's interest ties (health insurer associations) and the motion he submitted (strengthening the negotiating power of health insurers vis-à-vis service providers) remains. The subheading has been changed from "Remarkable Contradiction" to the more neutral formulation "Remarkable Intersection". Regarding the substantive question – whether there is a conflict of interest here – the editorial refers to the public Lobbywatch profile and to the statement by Council of States member Hegglin himself, which is available to every reader for their own assessment.

4. Expansion of Service Offerings

Positions of Respondents:

  • Glarner: Abolition of contracting obligation as most effective means; competition for MIGEL list; refers to own experience with Careproduct AG.
  • Hegglin: Health Technology Assessment (HTA) as concrete instrument.
  • Silberschmidt: "FDP constantly criticizes" – no concrete instruments mentioned.
  • Gysi: Public health insurance according to SUVA model (regionally structured) in the UVG sense.
  • Hurni: More planning competencies for cantons; more WZW audit competency for BAG; more price transparency; state competency for price setting.

Part III: Recommendations for Action to the Committees

Recommendation 1: Cost Truth in Political Communication

Both the deductible increase and the emergency fee are politically labeled as "cost containment measures", but actually work as cost shifting to the insured or patients. The committees should consistently make this distinction in their reports and press releases and show the ratio between savings (300 million francs) and cost growth (2.3 billion francs/year).

Recommendation 2: Review Empirical Basis of Emergency Fee

Before the SGK-S considers the bill, the Helsana analysis (decline of minor cases from 8% to 5%) as well as other available insurance data should be systematically evaluated. The assumption by Council of States member Hegglin that "mainly trivial cases" would be prevented must be proven or falsified with numbers.

Recommendation 3: Review Earmarking

The constitutional assessment by National Councillor Gysi (earmarking = tax = unconstitutional) as well as the already existing BJ assessment on the trivial fee should be formally presented to the committee. If the earmarking option is rejected, the legal basis must be clearly documented.

Recommendation 4: Transparency in Interest Ties

The committees should establish an internal process that transparently documents the interest ties of members (and their amount, if known) for every health policy bill. Proposal: For every committee deliberation on health topics, a current Lobbywatch snapshot is included in the deliberation documents. The practice of National Councillor Gysi of transparently disclosing all income from mandates on her personal website could serve as a model for extended transparency practice.

Recommendation 5: Prioritize Structural Reforms

The INFRAS/ZHAW study (7–8.4 billion francs savings potential) should be newly evaluated and updated by both committees. Parallel review of the concrete instruments mentioned by the respondents:

  • HTA expansion (Hegglin)
  • Targeted abolition of contracting obligation with competition for MIGEL (Glarner)
  • Reference price system for generics (re-evaluation after 2020/21)
  • State price competency for medications and services (Hurni)
  • Review of a regional SUVA-like solution (Gysi, parallel to existing insurers)

Part IV: Concluding Remarks

The survey shows a political picture that can be read along party-political lines: The bourgeois parties (SVP, FDP, Centre) tend to support deductible increases and emergency fees as instruments of personal responsibility; the left-wing parties (SP) reject both and announce referendums.

What is remarkable across party lines: Even a bourgeois National Councillor (Glarner) describes conflicts of interest in Parliament as a central problem for reform blockades. This unusual cross-party diagnosis deserves serious engagement by the committees.

Without structural reforms (reference price system, targeted contractual freedom, HTA expansion, price transparency), deductible increases and fees remain patchwork. The committees have the opportunity – and given cost growth of 2.3 billion francs/year the responsibility – to shift the debate from symbolic politics to the system question.

Methodological Note

The original version of this analysis from April 22, 2026 was submitted in advance to the five responding SGK members on April 27, 2026. This gave them the opportunity to comment before publication. By April 28, 2026, National Councillor Gysi and Council of States member Hegglin have suggested corrections and clarifications. This version takes their statements into account and distinguishes between:

  • Factually justified corrections (e.g., current function Spitex Association instead of Curaviva; Board of Directors instead of Board santésuisse) – these have been incorporated into the text.
  • Statements that contradict public facts (e.g., content of Motion 24.3220) – these are quoted verbatim and compared with available sources.

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