The state of the Swiss health system is a matter of concern: health insurance premiums are rising, as are people’s expectations of medicine – and the number of people who have chronic illnesses or are dependent on care. Clearly, the resources required by the health system in its current form are not available to an unlimited extent. What can be done to make the health system more sustainable?
In response to this question, the SAMS has issued a new position paper on sustainable development of the health system. The aim is to relaunch the debate on this important issue. The paper explains the SAMS’ conception of a sustainable health system, defines the goals to be pursued and discusses possible future developments. Eight general measures are formulated, with the Triple Aim framework serving as a compass to provide orientation:
- The health system actors are guided by the Triple Aim framework.
- Cantons combine to form a small number of health regions.
- Efforts to promote health literacy begin in childhood.
- Switzerland knows how many health professionals are required and adjusts the number of training places accordingly.
- The data required for quality assurance and health services research is available.
- Interventions no longer needed are removed from the list of reimbursable services.
- New reimbursement models reduce perverse incentives.
- The federal government sets a ceiling on increases in health expenditures.
The position paper is supplemented by a roadmap, defining specific measures and responsibilities.
In 2011, the SAMS launched the «Sustainable healthcare» project, which was designed to raise awareness of this issue among the medical profession and the population at large, to stimulate debate and to identify possible solutions. In 2012, the SAMS published the position paper «Sustainable medicine», which identifies factors undermining the sustainability of medicine and outlines numerous measures to promote greater sustainability. Based on this position paper, the Swiss Academies of Arts and Sciences prepared a roadmap comprising seven goals and an action plan for the period 2013–2017. An assessment of the progress made under this roadmap was included in the 3/2017 edition of the SAMS Bulletin (available in French/German).