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Semi-Private Patients:
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pyramide.ch

HEALTH POLITICS

The new hospital planing due to be introduced in 2012 will fundamentally change the health care system. Prices are to be standardised at a national level, transparency increased and costs reduced through the introduction of diagnosis-related group (DRG) payments. The number of hospitals and range of medical services offered is to be streamlined and the quality and efficiency increased. And: Private clinics are finally eligible for base subsidies. But what at first looks like the relief for ever-increasing health care costs that everyone has been longing for, is, on closer examination, actually an illusion. This is especially true for private clinics which have established themselves in the market through an uncompromising focus on quality and efficiency.

The end of patient-focused medicine
Clinics wanting to claim base subsidies must apply for a place on the hospital list. The decision on inclusion on the hospital list lies with the cantonal health directorates - i.e. the same bodies that lead public hospitals. In addition, the criteria for inclusion are associated with significant business risks, particularly for smaller clinics like the Pyramid Clinic. And they contradict the philosophy of free medicine. Because a private hospital that receives a list place still keeps its private funding. However, the canton will have the say here - not the board as previously, not the doctors, not the shareholders. For us, this is tantamount to the end of free, patient-focused medicine. In the end, it will no longer be the doctor who will make the decisions in the best interests of patients, but a hospital manager in line with the his or her clear targets. The patient is the loser.

Private medicine is not a mass-market business
Private clinics such as the Pyramid Clinic at the Lake are niche providers. The Pyramid Clinic will continue to focus on this role in future: as a contracted hospital working in partnership with insurance providers. Thanks to its manageable size, its high standard of care in select medical fields, the commitment of its independent specialists and its unique hospitality services, the Pyramid is already positioned as an exclusive private clinic. The proportion of self-paying patients - patients with general insurance who cover the additional cost of treatment in a private hospital themselves - is already above average. As part of the hospital planning for 2012, the Pyramid will more consistently apply its successful strategy of exclusive service. We have been running our two locations in Zurich and Schwerzenbach based on separate insurance categories since 2010: The headquarters in Zurich as an exclusive clinic for privately insured and self-paying patients, and our second location in Schwerzenbach as a clinic for semi-private patients. These patients can arrange an upgrade to be treated in Zurich. And as previously, patients with general insurance can of course cover the costs themselves for treatment in Zurich (privately) or in Schwerzenbach (semi-privately).

Real added value for privately insured and self-paying patients
As well as being important for health policy reasons, the relocation of the semi-private segment and the strict separation of the insurance categories on two sites, i.e. having two departments, is also important for economic reasons. Despite maximum efficiency, most semi-private rates do not provide adequate cost coverage. For public hospitals with deficit guarantees from the state, cross-subsidising is part of their daily business. An exclusive private hospital such as the Pyramid cannot cross-finance the semi-private sector to the detriment of privately insured and self-paying patients. Patients with private insurance or who are self-paying must receive clear added value. The hospitality services are just a small part of this. The main benefit is in the the commitment and availability of the specialist.

The first-class segment of the future
Sustainable business development has been the guiding principle for the Board and the participating specialists throughout the history of the Pyramid Clinic. Profits have always been reinvested. In addition, despite substantial investments, our positioning as an exclusive clinic for privately insured and self-paying patients has not brought any increase in costs for patients, but has meant a significant increase in quality. With the introduction of diagnosis-related group (DRG) payments in the public sector, we are already seeing the opposite: The hospitals are already engaging in a huge arms race, because investments can be written off via the DRG system. Experts believe this will lead to the biggest explosion in costs, at well over 8 billion Swiss francs, and the biggest increase in premiums, that the Swiss health care system has ever experienced.

The future of free medicine
We are convinced that other leading clinics will also embrace our approach in the medium term. It is crucial that we work together with other contracted hospitals and insurance partners to develop new services for the top segment. Herein lies the future of free, patient-focused medicine.

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