Regional Health Care Data in the federated health care policy system of Switzerland - a promising tool to optimize governance?

Abstract

Background: legal setting and public discussion In Switzerland political responsibility for the health care system is divided vertically between the Confederation and the Cantons. In the general public each year there is an increasingly heated debate about rising premiums for sickness funds (4.7% growth per year on average since major health law revision in 1994). The actions taken by federal authorities have – to formulate positively - slowed down the total expenditure growth to only 3.2%. Of course – like everything in Switzerland - this growth is different from canton to canton. This is valid for total expenditure as well as for sickness fund premiums.

Problem description The Swiss discussion about rising health care costs (78 bn in 2015) has from a governance perspective the following limitations: - Federal government is held responsible for rising health care costs, but is limited to regulate sickness funds (with minor exceptions). - A narrowed focus in the public debate on mandatory health