ÖKK supports competition in the health insurance sector. It encourages diversity, innovation and quality. This is also the view of the voting Swiss public. It yet again rejected the initiative to establish a system of unified health insurance in September 2014, with 62% voting against it. A clear message: policyholders want to continue receiving the best benefits for a fair price in a system of freely organised healthcare.
The systematic assessment of quality and services for medical treatments help keep costs better under control. Together with the service providers, we ensure that the results of representative quality assessments are made accessible to policyholders. Transparent services encourage competition, increase quality and reduce costs.
In terms of quality, the Federal Government should introduce better framework conditions, so that insurers and service providers can fulfil the roles assigned to them under the KVG and increase the quality of their work. Decisive factors in this regard include effective, directly applicable sanctions, which must be stipulated in the KVG. These can be used to discipline service providers that refuse to provide high-quality services.
ÖKK promotes integrated care, which makes the management of patients throughout their entire course of treatment binding. This increases the quality of treatment and leads to savings in terms of benefit costs.
However, the incomplete balancing of risks and compulsory contracts under the KVG prevent the integrated care models from being rolled out across the board; this includes the general practitioner model, the HMO model or the model with telemedical advice.
ÖKK wants the process for balancing risks to be refined and for differentiated tariffs to be introduced. This will allow progress to be made in the area of integrated care. However, the balancing of risks may not result in an equalisation of costs.
The development of costs represents a real challenge for ÖKK – and indeed for all other health insurers. This is primarily because costs are not likely to stabilise any time soon.
Healthcare costs can only be contained if all benefits provided under compulsory health insurance are effective, expedient and economical. A benefit can only be accepted into the basic catalogue of benefits if it fulfils all three of these criteria. In addition, a benefit must fulfil the principles of evidence-based medicine.
Integrated healthcare models must be promoted consistently and structured in an attractive way. Furthermore, the upper limits for ordinary and optional deductibles must be set as high as possible.
For ÖKK, a politically independent, efficient and transparent system of supervision is important. However, ÖKK is against further interference in a company's freedom to make entrepreneurial decisions. We are in favour of framework conditions that allow sufficient room for individual and innovative insurance options. Policyholders must be protected at all times.
Who manages ÖKK?
Members of the ÖKK Executive Board