Manage or Perish

The Situation in Switzerland
  • Ursula Steiner-König


Until a few years ago Swiss people, medical doctors included, may have thought that too much treatment was harmless, but too little treatment terrible. It is only in the last few years that ideas about managed care began to grow. Therefore, there does not yet exist a nationwide consensus about the definition of managed care. In a health-care environment that features increasing demand for economic analysis, cost containment and managed care or managed competition, it is only natural that health-care providers should be concerned with preserving their traditional role as advocates of optimal diagnosis and treatment. In the future difficult choices are likely to be disproportionately based on cost analyses, without due consideration to gains in effectiveness. The point of view defended by the Swiss Medical Association is that if rationing of health-care expenditure is to occur, it should be the outcome of an open review based on scientific principles.1 Health-care professionals should be key participants in this process. In order to play this role, they need to improve their skills in the population health sciences, data management and evaluation and the synthesis of evidence-based arguments. We strongly hope to avoid critical health-care decisions’ being made on the basis of political considerations alone, without due reference to the scientific analysis that should inform policy.


Health Technology Assessment Cost Containment Basic Health Insurance Somatic Illness Social Insurance Company 
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  1. 1.
    H.H. Brunner: Quality in Medicine and Cost Containment. Schweiz. Aerztezeitung 78, 7, p. 217–221, 1997.Google Scholar
  2. 2.
    R. Cranovsky, Y. Matillon, and D. Banta: EUR-ASSESS project subgroup report on coverage. Internat. J. of technology assessment in health care 13, 2, p. 287–332,1997.CrossRefGoogle Scholar
  3. 3.
    GRAT (Gesamt-Revision Arzt-Tarif) not published yet.Google Scholar
  4. 4.
    G. Mattanza/Bundesamt f. Sozialversicherung: Kriterien zur Standardisierung der Prüfung von Wirksamkeit, Zweckmässigkeit und Wirtschaftlichkeit von Psychotherapiemethoden, 5. Entwurf, Februar 1998.Google Scholar
  5. 5.
    E Stiefel, P. Cochand, and P. Guex und die ECLW: Qualitätsmanagement im Konsiliarpsychiatrischen Dienst einer Universitätsklinik. Schweiz. Aerztezeitung 77, 48, p. 1955–1960, 1996.Google Scholar
  6. 6.
    Sanacare/Kerngruppe Projekt “Gatekeeping ambulante Psychiatrie” Winterthur 1997, not published.Google Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Ursula Steiner-König
    • 1
  1. 1.Member, Central Committee of the Swiss Medical AssociationLyssSwitzerland

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