At the Geneva University Hospitals, it was necessary to buy beds, protective equipment for staff, visitors, patients and volunteers, respirators, syringe pumps or even set up a tent and transform an aula into a screening center … According to Brigitte Rorive Feytmans, CFO of HUG, all this has already cost 15 million francs. “And that will not be included in the reimbursement provided for by the DRGs (note: the tariff system for hospital care),” she said.
This example illustrates the financial difficulties that healthcare facilities face with the coronavirus epidemic. And they shouldn’t just invest in equipment, said Anne-Geneviève Bütikofer, director of H +, the umbrella organization for hospitals in Switzerland. The costs of taking charge are high, in particular because of the isolation measures and the ventilation time which is sometimes long. “If Covid patients are billed in the same case plan when billing other patients who are not seriously ill, hospitals will lose money,” she said.
Miss to win
If Curafutura, one of the umbrella companies of health insurers, says that everything is in place to bill for care adequately, hospitals do not agree. “We asked for a rapid adaptation of the system. In the meantime, the HUG have not started their invoicing, “explains Brigitte Rorive Feytmans. According to the Federal Office of Public Health (FOPH), information will be provided to stakeholders in the coming days. As for the additional costs linked to infrastructure, hospitals like Curafutura consider that they are not subject to the usual law on health insurance, but that of epidemics. And that the Cantons must intervene in their financing.
Unfortunately, the difficulties of the hospitals do not end there. “With the coronavirus, our financial concern is above all the absence of non-Covid patients,” explains Stephan Hänsenberger, acting director of the Brant Inter-cantonal Hospital (HIB). To cope with the announced crisis, the establishments have sent back all interventions which are not essential, as the Federal Council demanded, and the beds have been emptied.
All of this leads to losses. The HIB, for example, only has one operating room in operation, compared to 2.5 usually, and its Emergencies only turn 40%. Stephan Hänsenberger expects “a huge cash flow problem in June-July”. In Geneva, the HUG estimated that, if the situation does not improve, the shortfall will amount to 30 million francs at the end of June.
Last week, the “Tages-Anzeiger” announced that clinics had applied for partial unemployment, particularly for employees in the restaurant industry. The situation actually varies from canton to canton, depending on how the sick have been divided between the private and public sectors.
The issue is also more complicated with medical staff. To avoid a shortage of arms at the height of the crisis and provide employees with the necessary rest time, caregivers deprived of their usual work must be able to be assigned to managing the pandemic.
What public aid?
According to Anne-Geneviève Bütikofer, institutions will have to assume this shortfall, as do other companies. Will the authorities help them? Catherine Cossy, communications delegate from the Vaud Department of Health, replies that the Conference of Directors of Health Affairs (CDS) is in discussion with H +, in order to define to what extent the Cantons should participate in this coverage. This includes knowing which elements could be taken into account uniformly across the country.
“For the moment, everyone has mobilized, in the private as in the public, without asking for financial guarantees,” said Adrien Bron, director general of health in Geneva. In an emergency, his services asked the professionals to carefully list the charges linked to the Covid-19, so that they could settle things later.
If Adrien Bron expects that “significant” costs will be passed on to the Cantons, he does not articulate an amount. “There will be discussions, as in other sectors of the economy,” he concluded. And we will also have to consider whether something should fall to the Confederation. ”
Created: 01.04.2020, 10:06 p.m.
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