Dear Patient
For some time now, the press has been reporting on the conflict between independent doctors and insurers. The conflict stems from a FINMA directive requiring both parties to improve the clarity of private fee billing, both for medical procedures and hospitalization.
This is rather good news.
However, insurers have seized this opportunity to demand a reduction in medical fees, and are now trying to impose a flat-rate fee rather than a fee-for-service fee, as may be the case for hospitalization in a general ward (under the LaMal scheme, commonly known as “basic insurance”).
Supplementary insurance means that patients can choose the practitioner who will take care of them from A to Z, and can count on this person to take care of them personally, even in the event of complications, emergencies, at night, on weekends, etc. On the other hand, fee-for-service remuneration, an integral part of a (semi-)private division service contract, values personalized, ongoing care. On the other hand, fee-for-service remuneration, an integral part of a service contract in a (semi-)private ward, places a premium on personalized, ongoing care.
Since the beginning of the year, for example, insurers have decided to reimburse sums that are sometimes considerably lower than the amounts invoiced to patients who have benefited from treatment by an independent doctor. The result is that some patients who have paid premiums for years can no longer access the benefits to which they are entitled.
At present, professional societies such as the Société vaudoise de médecine (SVM) and the Association des médecins genevois (AMGe) are trying to find ways out of this crisis, which is severely detrimental to patients.
While you’re waiting for an agreement to be reached, speak frankly to your doctor, who will be able to advise you on the best option for you:
- Defer your treatment (for non-urgent or comfort treatment)
- Contact the insurance company (some insurers are more “flexible” than others)
- Resort to a payment arrangement until the crisis is resolved
Don’t give up on treatment for financial reasons: there’s always a solution, and your health is our priority.
For more information, here are a few useful links:
Vaud doctors denounce abandonment of private patients” (Blick, 02.04.25) | Société Vaudoise de Médecine (SVM)
AMGe: Association des Médecins du Canton de Genève
Your dedicated
PD Dr Med Marco V. Corniola