Summary

The information platform clarus.news surveyed 38 SGK members of Parliament in March/April 2026 on four central questions of the Swiss healthcare system. Of 38 parliamentarians contacted, only five responded with substantive positions: Barbara Gysi (SP/NR), Peter Hegglin (Mitte/SR), Andreas Glarner (SVP/NR), Andri Silberschmidt (FDP/NR) and Baptiste Hurni (SP/SR). The topics covered deductible increases, emergency fees, conflicts of interest and service offerings. After advance submission, two statements were submitted and included in the analysis.

Persons

Topics

  • Deductible increases and cost shifting
  • Emergency fees and empirical evidence
  • Conflicts of interest in Parliament
  • Structural reform potential

Clarus Lead

The survey reveals a significant contrast point in parliamentary health discourse: while party lines clearly divide on symbolic measures (deductibles, fees), even conservative parliamentarians like Glarner diagnose systematic conflicts of interest as a central reform blockade – a cross-party finding that calls for action. With an annual cost growth in basic insurance of 2.3 billion francs, Parliament is under pressure to move from patchwork to structural solutions.

Detailed Summary

The increase in deductibles from 300 to 400 francs reveals the core problem: an expected saving of around 300 million francs is offset by cost growth of 2.3 billion francs – a ratio of 1:8. This makes the measure primarily a demand dampener and cost shift to patients, not a structural cost reduction. Gysi warns of the burden on the elderly and chronically ill; Hurni announces a referendum.

The emergency fee of 50 francs was narrowly passed in the National Council with 96:91 votes, but faces rejection in the Council of States – an empirical weakness: Helsana data shows that the proportion of minor emergency cases declined from over 8 to around 5 percent over ten years. The justification "prevent trivial cases" is thus on uncertain ground.

On the topic of conflicts of interest, the central structural problem becomes evident. The INFRAS/ZHAW study (2019) estimates the savings potential for OKP services at 7 to 8.4 billion francs annually without quality losses. Key reform proposals such as reference pricing systems for generics were rejected in 2020/21. Glarner explains: "Every innovation is buried with 'patient safety' and 'supply security.'" Hegglin justifies his position by stating that parliamentarians are also consumers of healthcare – an answer that Gysi and Hurni criticize as a weakness: pharma, insurer and doctor lobbies are the main problem. Particularly relevant: Hegglin chairs the association of small and medium-sized health insurance funds (RVK) and submitted Motion 24.3220, which aims to loosen the contract requirement – a strengthening of insurers' bargaining power. Following his statement, the motion focused on laboratory services; however, official sources (Council of States debate, NZZ, Tages-Anzeiger, H+) document the general orientation toward doctor and hospital contracts.

On service offerings, the respondents mention: expansion of HTA (Hegglin), abolition of contract requirements with competition for the MIGEL list (Glarner), and a public health insurance fund according to the SUVA model (Gysi).

Key Findings

  • Five of 38 SGK members responded substantively; the low participation underscores communication barriers
  • Deductible increases and emergency fees act as cost shifting, not structural solutions
  • Parliamentary conflicts of interest systematically block substantive reforms with 7–8 billion francs savings potential
  • Cross-party diagnosis (including SVP-Glarner): conflicts of interest are central to reform blockades
  • Empirical basis for emergency fee is weak (proportion of minor cases declined from 8 to 5 percent)

Critical Questions

  1. Data Quality: The Helsana analysis on the development of minor emergency cases (8% → 5%) is justified by Hegglin with "prevent trivial cases" – how representative is this Helsana sample for Switzerland, and are there more recent health insurance data (2025/2026)?

  2. Conflicts of Interest – Transparency: Lobbywatch records 38 "connections" for Hegglin; the editorial office corrected this to three in healthcare. By what criteria are conflicts of interest published in Parliament, and why is there no systematic disclosure as with Gysi (own website)?

  3. Motion 24.3220 – Causality: Hegglin presents the motion as "competition in laboratory services"; official sources confirm general freedom of contract (doctors, hospitals). What mechanism explains this discrepancy – faulty self-assessment or different emphasis on the same proposal?

  4. Empirical Basis for Deductible: The 300 million franc savings from the deductible increase: how was this quantified, on what elasticity assumption is it based, and do more recent studies refute the model?

  5. INFRAS/ZHAW Update: The study is from 2019 (data base 2016). Are the 7–8.4 billion franc potentials re-evaluated in current reform debates, or have the findings been superseded by market changes (digitalization, generic share)?

  6. Constitutional Law on Earmarking: Gysi argues that earmarking the emergency fee would be unconstitutional (causal levy). What Federal Council or Federal Department of Justice statements on this are available, and why isn't this constitutional question systematically addressed by the SGK?

  7. Implementation Risks of Contract Requirements: Glarner and Hegglin favor selective contract freedom. What scenarios for fragmentation or supply gaps in peripheral regions were modeled before such motions were submitted?

  8. Referendum Viability: Hurni announces a referendum against the emergency fee and deductible. How realistic is signature collection given chronically low parliamentary participation on health policy (five of 38 responded)?

Further News

  • Motion 24.3636 (Friedli, SVP): Deductible increase in consultation since March 13, 2026; implementation expected 2027/2028
  • GLP Initiative Emergency Fee (Hässig): Narrowly passed in NR (96:91), not yet treated in SR; Federal Council and cantons oppose

Source Directory

Primary Source: Health Policy Survey – Analysis of Parliamentary Responses – clarus.news (30.04.2026, Version 3) https://clarus.news/de/blog/gesundheitspolitische-umfrage-analyse-der-parlamentarischen-antworten-20260430-de

Supplementary Sources:

  1. INFRAS/ZHAW Study: Savings Potential for OKP Services (2019, Data Base 2016)
  2. Helsana Analysis of Hospital Emergency Visits (cited in NR Debate 18.03.2026)
  3. Motion 24.3220 Hegglin – Relaxation of Contract Requirements (Curia Vista, parlament.ch)
  4. FMH Statement: History of Contract Requirement (Swiss Medical Journal)
  5. Lobbywatch.ch – Conflicts of Interest for Parliamentarians (as of 2025)
  6. Press Releases H+ The Hospitals of Switzerland (17.01.2025, 11.03.2025)
  7. Media Coverage: NZZ, Tages-Anzeiger, swissinfo.ch, SRF (2024–2026)

Verification Status: ✓ 28.04.2026

This text was created with support of an AI model. Editorial Responsibility: clarus.news | Fact-Check: 28.04.2026