Deloitte survey of policyholders: health insurers are in a bind

Marcel Thom, Health Insurance Lead at Deloitte, explains: “Cost pressure is making people open to the idea of change: an ever-increasing number of policyholders are switching provider, seeking alternatives for supplementary insurance, looking more favourably on digital solutions or even backing the concept of a unified health insurance fund. The fierce debate during the course of the two popular initiatives on healthcare costs and the close results in some of the voting underline the urgent need for further reforms, although there is still nothing approaching a consensus on the way forward. However, the fact that people are still so willing to switch is undoubtedly putting health insurers in a bind. They are having to become even more innovative and efficient and fight hard for customers.”

Digital services gaining in importance

Digital technologies harbour a great deal of potential for making the Swiss healthcare system even more efficient. According to the study, 43 per cent of respondents feel it is important for their health insurer to provide attractive, state-of-the-art digital services. In addition, nearly three-quarters of people in Switzerland (74 per cent) can currently see themselves using digital government solutions like the electronic patient record (EPR) to store their health data in digital form and say who is allowed to access it. In a representative survey conducted by Deloitte in Switzerland in 2022, only just over a third (35 per cent) of people were in favour of their own health data being collected and stored electronically.

“Although it is a good thing that people in Switzerland are becoming more open to the idea of healthcare going digital, state-backed solutions such as the electronic patient record are only delivering minimal actual benefit at the moment – and the health insurers aren’t involved in the EPR either,” says Marcel Thom. “To harness the significant efficiency savings that digital technologies can bring to healthcare and demonstrate their practical benefits, we need target group-relevant information and even more persuasion work from all players in the healthcare sector, as well as the creation of a clear legal basis.”

Healthcare data must be protected and secure at all costs

As many as 84 per cent of those surveyed said that the protection and security of their own health data was either important or very important. Although health insurers have realised this, Deloitte’s experience and assessments suggest that actually putting it into practice is a real challenge. Some cyber-attacks in recent years have led to personal data being compromised too, and most health insurers are expecting major incidents of this kind to continue.

“People’s trust in digital solutions depends to a large extent on how well their personal data is protected. Health insurers have no choice but to implement the requirements of the new Data Protection Act rigorously while also taking the risks of cyber-attacks seriously and putting robust defensive and preventive measures in place. Successful cyber-attacks could seriously jeopardise the progress achieved so far in making healthcare digital,” warns Marcel Thom.

Hopes of lower premiums fuelling popularity of ‘unified fund’ idea

Deloitte’s study also reveals that around two-thirds (65 per cent) of the Swiss population are in favour of abolishing the health insurance funds in their current form. Backing for a single national scheme is especially high in French-speaking Switzerland and Ticino, and among 30- to 44-year-olds. Forty-two per cent of those in favour would like to see a unified fund eliminate advertising, while 28 per cent are hoping that it would involve less effort on their part and 22 per cent even have their sights set on better medical care. However, the main argument – backed by 83 per cent – is lower premiums.

More than a quarter (26 per cent) of all respondents even believe that a unified fund would push basic healthcare premiums down by 20 per cent or more. But the Deloitte study also sounds a note of caution against people getting their hopes up too high: “The administrative costs for compulsory health insurance are already very low at around 5 per cent,” Marcel Thom points out. “Even if a unified national fund were to work highly efficiently, it is very hard to see any scope for achieving significant reductions in premiums. People are expecting far too much from such a scheme.”

Pharmaceutical industry mostly responsible for rising healthcare costs

Despite the backing for a unified health insurance fund and the savings that people are hoping it would bring, only a minority of respondents (36 per cent) hold the health insurers chiefly responsible for the rising cost of healthcare. They believe that costs are being driven mainly by the pharmaceutical industry (63 per cent) and themselves (59 per cent). The ageing population and the fact that treatments are getting ever more expensive are other suspected reasons for rising costs in the healthcare sector. By contrast, only 22 per cent of those surveyed believe that government bodies are responsible for rising healthcare costs (see Figure 2).

More focus on policyholders’ health

Only 40 per cent of people in Switzerland regard their health insurer as a reliable and competent ‘healthcare partner’, even though providers have spent a lot of time and effort in recent years on improving their image in this area with new services and communication channels. Only a single fund achieved an approval rating of over 50 per cent on this score. At the same time, the study has identified significant potential for improvement as far as healthcare-related solutions are concerned – especially those for elderly policyholders and for families: health insurers could differentiate themselves with tailored services and programmes and thereby generate more trust among policyholders.

“Despite investing a great deal of money and hard work, health insurers are still not fully managing to showcase the added value that they bring to their customers and the healthcare system convincingly enough,” says Marcel Thom. “The financial challenges posed by the rising costs mustn’t be underestimated either. In the future, health insurers will therefore have to make it crystal clear to policyholders how they can help them live healthier lives and set out their constructive contribution to supporting a Swiss healthcare system that is fit for the future.”

About the study

Deloitte’s survey “Health insurance in Switzerland 2024” (German) is based on a representative online survey of 1,246 people living in Switzerland and was conducted in March 2024. The survey covers all relevant demographic groups in order to paint a comprehensive picture of policyholders’ opinions and preferences. Deloitte has also compiled a fact package on the Swiss health insurance market (in German) from various publicly available data.