Are operations expensive or just greed of the doctors?

Horrible fees - that's what doctors get at Hirslanden clinics

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the essentials in brief

  • Doctors earn a lot of money with patients with additional insurance.
  • «Kassensturz» publishes confidential fee lists. They show explosive things: Doctors in the Hirslanden clinics in Zurich charge many times more than in public hospitals.
  • Many medical professionals turn over millions in this way - year after year.
  • Health economist speaks of “unethical” fees. Helsana no longer wants to accept the excessive fees.

Whistleblowers pass confidential documents to “Kassensturz”: fee lists from the Hirslanden Clinic in Zurich and the private Hirslanden Clinic in the Park. They show how much a doctor earns from interventions on those with additional insurance. Every medical intervention is listed, next to it is the price that a doctor can charge for his work.

"Kassensturz" makes the comparison with the fee list of an Aargau canton hospital. With the help of experts, the consumer magazine compares the doctor's fees for the same interventions. The price differences are massive: if a doctor operates in the Hirslanden Clinic in Zurich, he can charge many times more for his work than in the Aargau Cantonal Hospital.

For example, for injecting bone cement with a vertebral fracture: The doctor at the Aargau Cantonal Hospital can charge 2015 francs for his work, at the two Hirslanden clinics in Zurich it costs three times as much: 6300 francs. The procedure takes just under half an hour. Hirslanden writes: "The comparison of fees between a public hospital and one with an attending doctor system is only possible to a limited extent."

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Unethical and unacceptable medical fees

Health economist Heinz Locher also advises the Federal Council as an expert. He thinks the Hirslanden fees are clearly exaggerated: "They do not correspond to the value of the service." For Locher, they are "unethical and unacceptable." Because the basic insurance also pays for patients with additional insurance. Therefore, all premium payers are affected, especially since such high fees would motivate doctors to undertake unnecessary interventions.

The health insurances have so far earned well with supplementary insurance products and accepted excessive medical fees. That is changing now. Helsana, the largest health insurance company in Switzerland, is demanding more transparency from Hirslanden. "For us, such fees for the free choice of doctor are clearly too high," says Daniela Zimmermann, who negotiates the tariffs with the hospitals for Helsana: "We want to bring the prices down, and we are willing to escalate." Escalation means, for example: Helsana has not paid any more interventions to be carried out at the Hirslanden Clinic in the park since the beginning of the year. Too expensive.

Doctors earn millions of people with additional insurance

Another leaked document shows that there are top earners among Hirslanden doctors in Zurich who turn over millions: one surgeon achieved sales of over 1.7 million francs in 2017 with patients with additional insurance, another 3.7 million and a third over 5 million Francs in 2016.

In addition, there is the income from the treatment of those with general insurance. The corporate communications department of Hirslanden AG writes about the millions in income of their attending physicians: “The amount of the fees does not correspond to the earnings of an attending physician. These correspond to the turnover of a practice, for which practice costs, personnel, etc. have to be deducted. "

The financial market supervisory authority (Finma) has recently been tightening the reins: the authority writes “Kassensturz”, the health insurers are only allowed to accept hospital bills that are “in a reasonable proportion to the costs charged”. It is questionable whether “fantasy fees”, as health economist Locher calls the Hirslanden fees, are appropriately related to medical work. In any case, the consequences of such high fees for those with additional insurance are clear: the premiums are becoming more and more expensive and fewer and fewer insured can afford them.

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  • Comment from Werner Bachmann (webawerni)
    I will take a referendum to ensure that Hirslanden & Co and health insurers that offer additional insurance are no longer allowed to settle accounts through the KVG. Such behavior does not fit into our efforts to provide the cheapest possible health care. Remember that even the tax administration waived the collection of value-added tax (formerly WUST) in the interests of cheap health care.
    No, the KVG is no longer allowed to cover such excesses.
    Agree agree to the comment
    1. answer from Andreas Egli (andreasegli)
      As a guide: The fees complained of are private fees and are reimbursed via the supplementary insurance according to the agreed private tariff. The supplementary insurance is subject to the VVG, according to which the premiums are set according to age and risk level. A patient can also be excluded from supplementary insurance. This is in contrast to patients with basic insurance. The KVG has nothing to do with the excessive fees, it only covers the part of the basic insurance.
      Agree agree to the comment
    2. Show answers
  • Commentary by Alexander Krafft (Alexander Krafft)
    Where is the point of inviting a guest into the studio when there is already a preconceived and incontrovertible opinion? Stone Age Journalism!
    Outpatient baptisms do not cover costs for either the doctors or the hospitals. A 30-minute operation still requires the "journey" to the operating theater, the report, and the discharge. With supplementary insurance in the inpatient area, the patient has the option of choosing a doctor they trust and who will take care of the care 24/7.
    Agree agree to the comment
  • Comment from Markus Lüttin (markus48)
    Had my own experience! what made the doctor appear to me as a greedy man.
    About the incidents in Hirslanden
    Billions could truly flow back into the health insurance if one would use the same laws that were applied to the banks.
    For me this is legitimate fraud.
    Question are they legitimizing accomplices?
    I'm glad I'm not the only one who doesn't just see it as being cheeky
    Agree agree to the comment
    1. answer from Andreas Egli (andreasegli)
      It is not a fraud, to whom? The patient always takes out additional insurance VOLUNTARILY and pays an individual premium according to risk and age. The private fees are paid by the supplementary insurance and not by the KVG, which is only responsible for the basic insurance!
      Agree agree to the comment
    2. Show answers

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