15 May 2020 – Policy Brief
A complicated mechanism currently determines who pays for testing. As a national testing strategy is of national interest, we recommend that the Confederation acts as a single payer.
Testing for SARS-CoV-2serves two purposes. The first one is individual, by bringing information needed for the therapeutic course of action and the measures for the prevention of infections during treatment.
The second goal of testing has national relevance: the identification of infected individuals helps to limit the spread of the virus by allowing for contact tracing and quarantine, within the strategy “Test, trace, isolate and quarantine”. In addition, broad testing provides important data about geographical and socio-economic characteristics of the epidemics, and its evolution. This information helps to deploy containment measures which are targeted, local and cost-effective. Testing is therefore not just as a therapeutic intervention but should also beconsidered as a preventive measure to control an epidemic outbreak.
The current situation regarding covering the costs of virological tests to diagnose SARS-CoV-2 is complex. Tests are paid by five different actors: the Confederation, the Cantons, health or accident insurances, and the individuals. This allocation is governed by on a complicated mechanism which includes the severity of the symptoms.
In many cases, this system puts a high burden on the tested individual both in monetary and non-monetary costs (such as time spent testing, discomfort, and the hassle to get reimbursed). Some persons might consequently decide not to get tested. This would hinder the social benefits brought by a strategy of widespread and uniform testing across Switzerland.
Based on a cost-benefit analysis, the preventive nature of testing, as well as equity considerations, we recommend that the testing costs should be borne by a single payer, the Confederation, including for systematic local testing campaigns that are of national interest. Deductibles and co-pays should be suspended for these preventive measures. Cantons should nevertheless have the possibility of topping up the Federal testing budgets should they seek to carry out more tests.