BERN. The Federal Council has thrown its weight behind a cap on the pay of health insurance executives, endorsing a parliamentary initiative that would limit compensation for work on mandatory basic insurance to the salary of a federal councillor: CHF 478,166 a year, gross, at current rates.
The proposal comes from the National Council’s social security and health committee and is based on a parliamentary initiative by the Neuchâtel Social Democrat Baptiste Hurni. The government said this month it would enter into the matter, while proposing a simpler mechanism than the original draft: instead of a formula tied to the number of insured persons, the ceiling would be set at a federal councillor’s salary, a variant put forward by the Vaud Green Sophie Michaud Gigon.
The target of the measure is the pay of management and board members for their activities in compulsory basic insurance under the LAMal law. It does not touch what the same executives might earn from supplemental insurance business, a distinction that will matter when the industry counts the cost and decides how loudly to complain.
The politics have been building for years. In 2023 the Council of States rejected a proposed cap of CHF 250,000 as too rigid. Since then, published pay at CSS, Sanitas and Helsana has reached record levels, with several senior figures approaching or passing CHF 1 million, against a backdrop of premiums that have risen four years in a row. The anger that combination produces is now large enough to move a government that prefers not to set salaries.
The Federal Council was careful, almost ostentatiously so, to limit expectations. The cap, it said, is unlikely to reduce insurers’ administrative costs or the premiums themselves. It is aimed instead at the fairness question: whether executives paid from mandatory premiums, in a system residents are legally obliged to fund, should out-earn the members of the government that regulates them.
The timing is not accidental. The official 2027 premium figures arrive in late September, with forecasts clustered around a 3.7 per cent rise, and federal data published this month put average health costs at CHF 4,834 per person over the past twelve months, up 21 francs on the year. Home care, psychotherapy and physiotherapy led the increases. Into that atmosphere, a pay cap lands as the one measure every voter can understand without a briefing.
Reaction divided along familiar lines. The left welcomed the endorsement as a first step and asked why the ceiling should not sit lower. The centre right warned against the state setting pay in a competitive labour market, then added, in the next sentence, that the optics of million franc salaries were indefensible. The insurers’ association noted that executive pay is a rounding error in a CHF 100 billion system, which is true, and which has never been the point.
The committee draft now returns to the National Council’s health commission before debate in both chambers. If it survives, Switzerland would have one of the strictest pay regimes for any insurance sector in Europe, applied to the one part of the system where customers are compelled by law to be customers.
For households opening their premium letters in four weeks, none of this changes the number on the page. The levers that move a bill remain the dull ones: the model, the deductible, the insurer, and the 30 November switching deadline. The cap answers the anger. It does not answer the bill, and the government, to its credit, is the first to say so.