GR: sectors weigh increasingly on the quote

Context

TL;DR

• Expected deficit: almost 100 million francs
• Contributions to third parties: +24,8% in four years
• Budget item: +34,5% between 2023 and 2027
• EFAS: almost 20 million annually from 2028

Key facts

• Location → Canton of Graubünden
• Contributions to third parties → +24,8%, amounting to 296,3 million francs
• Budget → deficit of almost 100 million francs
• Budget item 2023-2027 → +34,5%, amounting to 41,4 million francs
• EFAS → almost 20 million francs per year from 2028

The expected deficit of the Canton of Graubünden for next year is close to 100 million francs. The pressure comes as contributions to third parties have increased by 24,8% over the last four years, an absolute increase of 296,3 million francs. Keystone-ATS asked what the reasons for this growth are.

The items indicated by the Canton

During today's press conference, the director of the Graubünden Department of Finance and Municipalities, Martin Bühler (PLR), clarified that the increases are not concentrated in a single area.

Comparing the 2023 actual accounts with the 2027 budget, the budget item recorded growth of 34,5%, amounting to 41,4 million francs. The main factor is individual reductions in health-insurance premiums. Since health-insurance premiums increase every year, the support needed to reduce them for insured persons in modest financial circumstances also grows and, consequently, so does the amount of the Canton's contributions.

In the sector comprising hospitals, healthcare facilities and nursing homes, contributions have grown by 10,9% since 2023. Factors driving expenditure include contributions for medical services governed by the Federal Health Insurance Act, as well as population ageing, a higher hospitalisation rate and the greater average severity of treated cases. From 2028, the transition to uniform financing of outpatient and inpatient services (EFAS) will entail additional costs of almost 20 million francs per year.

Over four years, spending on public transport has increased by 25,51 million francs, or 31,4%. The Canton attributes the increase to a decrease in federal funding and several investment projects, including those concerning Chur West railway station, Tiefencastel station and the Ilanz/Glion bus terminal. Moreover, in 2027, the implementation of Simon Gredig's (Greens) motion will affect costs and entail the transfer of burdens from the municipalities to the Canton, amounting to three million francs for 2027 and 2028.

For special education, the financial burden has grown by 45,5%, or 25 million francs.

Operational details

Reading budget pressure

The increase in contributions to third parties should be read as the sum of different mechanisms. For anyone following a canton's accounts, the first practical distinction is between premium subsidies, healthcare services, regional transport and special education: the source brings them together in the same dynamic, but attributes different causes to each.

Four mechanisms to separate

This separation avoids confusing premium growth with hospital expenditure. In the first case, the chain described is linear: rising health-insurance premiums, higher individual reductions and a greater cantonal contribution for insured persons in modest economic circumstances. The figure therefore concerns the relationship between premiums and support, not a single investment project.

For hospitals and nursing homes, the indicated factor is demographic and clinical: population aging is associated with a higher hospitalization rate and greater average severity of the cases treated. The outlook changes from 2028, when EFAS will entail almost 20 million francs per year in additional costs in the sector.

In public transport, the reading must take funding and investments together. The reduction in federal funding is indicated as the cause of the increase; several projects are cited in the same sector. The 2027 motion also makes the financial relationship between the Canton and the municipalities visible: the message quantifies the transfer of costs from the municipalities to the Canton at three million for 2027 and three million for 2028.

Special education follows a different trajectory: the Canton links the increase to the growth of integration projects, the creation of jobs and staff employment percentages. To read the budget without losing the causal link, it is therefore advisable to examine separately the item, the indicated cause and the year in which the increase has an impact. This breakdown shows how costs are distributed among insured persons, healthcare facilities, transport, municipalities and special education services.

Key points

A practical procedure

To follow the message about the budget without mixing data from different periods, the reader can use a simple sequence. The starting point is the time references cited by the source: 2023 actuals, 2027 budget and 2028 outlook.

Four steps

1. Put the 2023 actuals in a first column and the 2027 budget in a second. This keeps the comparison anchored to the period used for the budget item that increased by 34,5%, amounting to 41,4 million francs. It should not be confused with the overall figure for contributions to third parties over the last four years.

2. Divide the items by cause. For individual premium reductions, note the annual increase in health-insurance premiums and the reference to policyholders in modest financial circumstances. For hospitals, healthcare facilities and nursing homes, note instead medical services, population ageing, hospitalisation and severity of cases.

3. Open a separate section for public transport. This should record the reduction in federal funding, the Chur West railway station, Tiefencastel station and Ilanz/Glion bus terminal projects, as well as the motion implemented in 2027. The transfer of costs indicated for the Canton is three million francs in 2027 and three million francs in 2028.

4. Keep the 2028 outlook distinct. The transition to EFAS will entail additional costs of almost 20 million francs per year in the healthcare sector. For special education, however, the review must instead follow integration projects, new jobs and staff employment percentages.

This framework helps prevent chapters that the Canton describes separately from being read as a single expense. For policyholders interested in the evolution of premiums, the operational step is to compare the health insurers with compare the health insurers.

Source: swissinfo.ch