Ideas for reducing costs are numerous, but it is impossible to evaluate their effectiveness because we do not know exactly where and how the money is spent.

Proposal

The Confederation mandates the Federal Statistical Office to conduct an annual study of healthcare finances. To this end, all insurers will provide the FSO with detailed data to quantify each service individually: medical procedures, medications, premiums, deductibles, reimbursements, co-payments, etc. Analysis with such fine granularity will enable an understanding of healthcare finances that was previously impossible.

Advantages

It would be possible to rigorously quantify the savings achievable for each proposed measure. This would allow:

• Precise management of health policy, without unknowns.
• Shortening debates, currently based on savings assumptions.
• Making decisions quickly, knowing exactly the consequences.
• Choosing measures that will generate the greatest cost reductions.
• Dismissing discussions around clearly insignificant measures.
• Identifying price distortions.
• Detecting abuses.
• Making unexpected discoveries, for example: Around Lake Lucerne, medication X is prescribed 3 times more than average, why?

Predictable Objections

It will be expensive

Healthcare costs in Switzerland in 2021 were CHF 827 per inhabitant per month, or CHF 86,344,000,000. Even if the initial study costs a few million, this is insignificant compared to potential savings.

Violation of medical confidentiality

The FSO will specify how data will be aggregated, likely by locality, age and sex of the patient. It would thus be impossible to identify an individual.

This data belongs to insurers

Data is generated when a person undergoes treatment or pays for a service; this data belongs to the person who creates it. Individually it is personal to them, aggregated it belongs to the community. Insurers host this data, they are not its owners. Moreover, this data already exists with doctors, pharmacists and hospitals; it is simply more efficient to collect it from insurers.

Disclosing this data would be unfair to insurers

If all insurers must participate, none would be (dis)advantaged. If they have nothing to hide, they have nothing to fear.

The quantity of data would be unmanageable

Suppose all inhabitants are in continuous treatment and that one A4 page is needed to describe each person’s treatment, each month. 9,000,000 inhabitants × 12 months × 3,000 bytes = 324 GigaBytes. A 512 GigaByte USB key costs CHF 31.