Since 2012, cantons have had the option under the new Art. 64 of the Federal Health Insurance Act (KVG) to keep a list of individuals who default on their premium payments. Cantons using such a list can therefore blacklist insured persons who haven’t paid their basic insurance premiums despite debt collection proceedings. Insured persons on this list will have their benefits suspended and be covered only for medical emergencies, although they can always pay for the treatment themselves. With this measure, the cantons that keep a blacklist are hoping to prompt individuals to improve their payment behaviour in the health sector and thus to achieve savings.
Every canton can decide individually whether to keep a blacklist. As of June 2018, nine cantons have done so, which means that health insurers there are obliged by law to notify the cantonal authorities about insured persons who are subject to debt collection proceedings due to unpaid premiums or co-payments. Some of these nine cantons have already done away with these blacklists again or intend to do so because it costs money to maintain the lists but does not improve payment behaviour.
Our analyses have also failed to detect any change in payment behaviour in cantons that have introduced a blacklist, and we therefore consider this measure to be ineffective. A study
by the Health Department of Canton Zurich has come to the same conclusion. In fact, the findings there have shown that premium debt in those cantons has reached a record high. Since notifying the cantonal authorities about insured persons incurs additional administrative costs, fails to produce the desired effect, and negatively impacts customer satisfaction, SWICA rejects the use of a blacklist.