LAMal premium increases: the policy rebounds responsibilities (cross-border guide)

Context

In brief

• Annual increases in LAMal premiums are as punctual as the seasons.
• Politics bounces responsibility between the Confederation and the Cantons.
• Proposal: make health insurance premiums tax-deductible.
• The cost conditions the quality of life for Swiss families.

Key facts

• Problem: Continuous increase in mandatory health insurance premiums.
• Responsibility: Bounces between federal, cantonal, hospitals, and insurance funds.
• Impact: A cost that conditions rent, taxes, and daily spending.
• Proposal: Full deductibility of premiums from taxes.

The mechanism of institutional bouncing

Every year, with the punctuality of the seasons, come the increases in mandatory health insurance premiums. With them come the explanations, justifications, and the political refrain: 'It is not up to us', 'We cannot do anything'. It is a mechanism that repeats cyclically, where competencies pass from one institutional level to another without the final bill changing its recipient.

Healthcare is a topic that explodes, but politics seems incapable of intervening on the deep causes. The debate often focuses on who is responsible: the Confederation, the Cantons, hospitals, doctors, or health insurance funds. In reality, while responsibilities bounce around, the economic weight always falls on the pockets of citizens. For many Swiss families, the premium is no longer a simple budget item, but a cost that directly impacts the quality of life, on par with rent, mortgage, taxes, energy, and transport.

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Operational details

Analysis of System Responsibilities and Inefficiencies

The original text highlights a structural fragility of the Swiss healthcare system: the separation between defining competencies and assuming economic responsibility. When it comes to health, blame tends to be fragmented among multiple actors. The Confederation manages federal aspects, the Cantons local ones, but hospitals, doctors, and health insurance funds also contribute to cost trends. This fragmentation prevents a unified intervention on the main causes of healthcare inflation.

There are concrete questions that politics should address transparently. Which services can be rationalized? How much do bureaucracy, duplicated structures, and special interests impact system inefficiencies? Currently, the system seems to continuously generate new costs, but there is a lack of willingness to intervene at the root. This creates a sense of powerlessness in citizens, who perceive a lack of concrete protection. Citizens pay several times: premiums, taxes, deductibles, and co-payments. This multiplication of fiscal and contributory burdens weighs on purchasing power and limits families' economic freedom of choice.

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Key points

Concrete proposal: tax deductibility of premiums

The source proposes a concrete and immediately applicable measure to alleviate the burden of increases: making mandatory health insurance premiums fully tax-deductible. This solution would not solve the root problem, nor would it reduce overall healthcare costs, nor would it replace necessary structural reforms. However, it would have an immediate effect: it would reduce the tax burden on families and citizens, returning to them a portion of what they are currently forced to allocate to mandatory coverage. The central argument is simple: we wouldn't want to tax the same income twice, would we? If healthcare costs increase, deductibility would partially offset this increase, maintaining more purchasing power in the hands of taxpayers.

For residents in Switzerland, this measure would require careful verification in their tax declaration. It is crucial to assess how the deduction would integrate with current deductions for medical expenses and deductibles. Since federal direct tax and cantonal taxes operate on separate levels, the impact of deductibility varies depending on the canton and overall income. Citizens should consult their declaration to verify how healthcare expenses are already treated and if a regulatory change would bring a significant net benefit.

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