Several health ministers have non-medical psychotherapists stating that they can pay their benefits directly with basic insurance. For almost 40 years, this is only possible indirectly: when psychologists are delegated by a psychiatrist. In the delegation model, psychologists are in a working relationship with the medical psychotherapist and work under his supervision.
After decades of waiting, the Federal Council has finally fulfilled the desire of psychologists this summer: In the future, those who have specialized psychotherapy training will be able to settle on their own basic insurance if ordered by a physician.
Instead, a "low threshold bid" is created.CVP in the letter
But the proposal comes in for advice on strong criticism, so Health Minister Alain Berset is likely to go on the books of the sea again. Although the Federal Council may introduce an amendment without parliament by regulation, it is with the CVP, FDP and SVP but three bourgeois parties opposed the proposal.
The CVP in its letter to the Federal Council doubts that there is a shortage in outpatient psychotherapy care, which justifies easier access to psychotherapy psychologists. Instead, a "low threshold offer" is created, which leads to more treatments and additional costs for basic insurance. Given the constantly rising premiums, this is "not justified".
SVP: Eliminate psychotherapy as a mandatory service
FDP also lacks psychotherapists, warns of "uncontrollable" cost increases, and calls for basic template adjustments, such as greater training requirements for non-medical therapists. Health insurance companies should be able to choose which psychologists to contract with. For doctors and other health care providers such as physiotherapists, health insurance is now required to sign all contracts (mandatory contract).
According to the SVP, psychotherapies should not pay for basic insurance, not even psychiatrists.
Finally, the SVP requires the Federal Council to "march". Changing the arrangement model are only reasonable measures against justified cost increases. In fact, according to the SVP, psychotherapies generally should not pay for basic insurance, not even psychiatrists.
Contrary to the arrangement model, there is also a medical connection FMH. And medical psychotherapists' associations warn of huge additional costs for a basic insurance of half a billion francs a year instead of the 100 million cited by the Federal Council. The arrangement must also be reserved for psychiatrists.
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They tell you what it's like to be employed by a psychiatrist to settle on basic insurance.
Photo credit: Khue Bui (Keystone)
An application for mediation is made by the Association of Psychiatric Hospitals and Services (SMHC). Family doctors should be able to order psychotherapy for mild crises, but only 10 sessions instead of 15, as suggested by the Federal Council. Health insurance companies only accept an arrangement model if the arrangement is reserved primarily for psychiatrists.
Psychologists rely on the Federal Council and the cantons
The Federation of Swiss Psychologists (FSP) considers that the complaints are unfounded. FSP points out that in addition to the SP and GLP the cantons and the Pediatricians Association support the Federal Council's model of organization. Cantons and family doctors are important players in the health sector. The FSP therefore hopes that the Federal Council will stick to its plans.
This arrangement was far less interesting to the doctors than the delegation.
Studies by the Federal Office of Public Health have shown that there is a shortage of supply in the field of psychotherapy, says FSP spokesman Philipp Thüler. Those who take the view that the care of psychotherapy psychologists is sufficient today neglect the lack of coverage by basic insurance. This hit is especially the weakest, who couldn't afford the extra insurance or therapy costs.
The condition of some participants in counseling that only psychiatrists can order therapy from a psychologist could even make the outcome of the current situation worse, Thüler warns. This arrangement was far less interesting to the doctors than the delegation. This could lead to a decrease in the number of doctors willing to order compared to the number of doctors who are being delegated today.
The Federal Council is currently evaluating the statements and intends to make a final decision to change the system by mid-2020 at the latest.
Created: 07.11.2019, 21:36 hour