Psychotherapy Costs Rise: National Council Committee Calls for Stricter Rules
New Measures Aim to Curb Rising Basic Health Insurance Expenses
The relevant National Council committee wants to restrict access to psychotherapies paid for by basic health insurance. The background is the sharply increased costs in this area.
Psychiatrist Visit to Become Prerequisite
The National Council's Committee for Social Security and Health (SGK-N) adopted a motion by 16 votes to 9: In the future, a diagnosis by a psychiatrist must be available before a psychological psychotherapy can commence. With this, the committee aims to reduce healthcare costs and simultaneously ensure better access to care for people with severe mental disorders. A second motion (13 votes to 9) calls for a database to record the prevalence of mental illnesses in Switzerland.
Important for context: These are proposals from a committee, not a decision by the Federal Council. The motions must first be adopted by the National Council and the Council of States; only then would the Federal Council be tasked with implementing corresponding rules. Nothing has been decided or enacted yet.
Costs Nearly Doubled Since 2022
Basic health insurance expenditures for psychological psychotherapy have risen sharply: In 2024, they were almost twice as high as in 2022, reaching nearly one billion Swiss Francs. A significant reason is the system change: Since July 2022, the referral model has been in effect. Since then, psychological psychotherapists can bill independently through basic health insurance upon a physician's order, instead of working under the delegation of a doctor as previously. This has increased the number of providers and demand.
The commission states that in many cases today, complaints without actual disease value are being treated. Furthermore, specialists without a specialization in mental illnesses are currently allowed to order psychotherapy – which further drives up costs.
Criticism: Risk of Rationing
Opponents of such restrictions warn of a rationing of care. A mandatory prior visit to a psychiatrist could delay or complicate access to therapy. Critics also emphasize that mental illnesses often require lengthy treatments, and hindered access can lead to higher long-term follow-up costs.
Part of a Larger Cost Debate
The discussion surrounding psychotherapy costs is part of the general debate on rising healthcare expenditures and health insurance premiums in Switzerland. Medication prices, hospital costs, and the number of doctors are also on the political agenda. How the conflict between cost containment and quality of care will be resolved remains open until the councils have decided on the motions.
