How will you vote on the 28. November?

How will you vote on the change for the covid-19 law?
  • Yes
  • Don’t know
  • No

0 voters

How will you vote on the nursing initiative?
  • Yes
  • Don’t know
  • No

0 voters

How will you vote on the justice initiative?
  • Yes
  • Don’t know
  • No

0 voters

3 Likes

Covid-19 Law: NO
nursing initiative: NO
justice initiative: YES

Covid: Yes
Nursing: No
Justice: No

3 Likes

I’ll vote yes for the nursing initiative.

The current situation of the employment market clearly shows that employers are not willing or able to make offers that are in line with the market.

This is a huge problem as with less qualified personel, the working conditions detoriate even more and worsen the quality of care. Nobody wants to wait in their shit for hours or get the wrong medication because care workers are overworked.

The current planned economy in care work employment needs to end and care services need to be compensated at fair rates to give employers the resources make offers that are in line with the market.

A no to the nursing initiave is a no to good care and a yes to continuing the status que of planned economy.

6 Likes

The median salary for people with vocational training only is at 5400 CHF and the median salary for people with tertiary education like HF is at around 7400 CHF. Then you usually have free or very cheap lunch in hospitals, in many cases cheaper than a student canteen, extra compensations for night shifts etc.

Don’t you think that’s an adequate compensation for such work and the educational requirements?

How much should nurses earn? 8k? 9k? 10k? And even if, most hospitals are government owned so they could just pay higher wages if they want there’s no need for central regulation by the federal government.

I see the problem that the market is difficult at the moment but if now one profession gets regulated by the federal government and in the constitution it will be a precedent for other professions as well.

It will probably take 2 hours after the acceptance of the initiative until some labour unions come up with the next bunch of professions that have to be regulated and demand a 10k salary for sales staff at Migros, hairdressers, etc.

2 Likes

The salary isn’t the problem, it’s the working conditions. People quit the job soon because of it, not because the pay sucks.

I voted no despite my mother working in this field.

2 Likes

I don’t know what an offer that is in line with the market would be. I want the market to figure that one out.

We clearly have too few nurses, so current offers are below that.

Median Salary for somone that works in care with a tertiary education is somewhere in the 80’000 per year.

Median salary for someone with a tertiary eduction exculuding university is around 100’000 chf per year.

So the salary is well below the median for work that is in very high demand and where you are constantly exposed to moral injury (beeing forced to not give adequate care) This does not happen in a functioning market.

In addition, working 80% is really comon for nurses because a 100% pensum is not really feasable for a prolonged time for most people.

Yes, this is true. Salary is just part of any job offer.

The most important part of the initiative is, that care services need to be compensated fairly.

This gives the employer the resources to hire enough nurses(at market rates) so that nurses can do their job without constantly violating their internal ethical standards.

So as far as I understand the salary is not the problem, the problem seems to be that there are not enough people and because of that the more people leave, the worse it gets for all the others. In that case I would suggest something like:

  • Get rid of the numerus clausus in all medical professions. Even if you want to sign up for a HF to become a nurse or whatever, there is a numerus clausus like process where applicants need to go through a long and annoying process and maybe after 1 year focusing on that, you get told: no sorry - and you have to look for something else because there were some students better in mathematics than you. If I would need to choose a profession now, I wouldn’t choose anything which is over-regulated and after I spent 1 year to get in, they can just tell me no sorry. I would prefer a profession where if I meet the requirements, I get in as easy as possible without some annoying regulatory processes and bureaucracy.

  • We have lots of foreigners with non-EU diplomas in Switzerland but they are all not allowed to work (in medical professions) because Switzerland can only accept EU diplomas as equivalent (in medical professions). If they want to work, they need to go through a process to have their diplomas accepted. Also a problem of overregulation. To get your non-EU diploma accepted is a long and annoying process, depending on the profession. For physicians it’s a matter of several years for nurses maybe a bit less complicated. I don’t know how complicated it is for the specialised nurses in the ICUs but we don’t need to wonder if we make it as hard as possible for people with a non-EU diploma to work here, when there are not enough people. Such people affected by this just look out for other professions and work in other areas as a result of over-regulation. We should make it as easy as possible for them to get their diplomas accepted and provide some training if needed to catch up with the Swiss system. But this division between EU / non-EU is a bit nonsensical because I can’t imagine that for example a Romanian or Bulgarian nurse (where they still smoked cigarettes in the OP rooms not so long time ago) is so much better qualified than a Canadian one for example.

  • Open immigration for people in professions in high demand, not only from the EU but from everywhere. Free B-permits and free onboarding training from the hospitals.

I guess those problems would be solved in no time (well, of course there is no magic). But again as we can see, all these issues are a result of over-regulation.

There is no “the problem” it is a combination of multiple factors.

A no just keeps the current planed economy in place. We need to allow market forces to work in order to get enough nurses so that adequate care can be provided.

It is not an easy job that everyone who wants can do. There is no numerus clausus for nurses. You can only attract talent if the employment conditions are attractive enough and in line with the market.

If we fail to do that then the quality of care will deteriorate further and cause suffering and additional costs because of complications.

Care services provide value. This value needs to be compensated.

How much is it worth to you to get the right medication or not having your O2 running out?

1 Like

To meet the demand in 2029 on nurses with a tertiary education, we need or would have needed to educate around 4’300 nurses per year since 2019. Currently only 3’000 get a degree. There is already a deficit of more than 5’000 nurses with a tertiary education.

Employment conditions attractive enough so that young people want to become nurses.

In any functioning market you would pay 6 figures to someone that enters a field that is in such high demand.

They call it aptitude assessment or something similar, which is a process that costs money and takes around 1 year (or even more depending where you’re coming from - from another medical field or directly out of the Gymnasium or another profession) once you decided to sign up and there are a limited amount of places.

It’s not a numerus clausus but very similar. It’s a cost factor and a factor of uncertainty. People don’t like uncertainty. If you don’t pass, you lost money and around 1 year of your life. It’s a deterring factor which I could imagine makes this choice quite unattractive for many people. Why should I go and risk 1 year of my life and money if I can go straight to another field and start studying in the same summer once I get out of school or decide to change my field?

Because of that there is even a market for private schools that work together with foreign EU-Universities because the Swiss schools are so annoying with their assessments and limited places, so many people who wanted to study cannot, so they go to an EU accredited private school. So once you finish that school you get a diploma from an EU University which in turn is then automatically accepted by Switzerland. But not everyone can afford the higher tuition fees, so those people then just have to look for another profession.

That’s why my proposal focuses on deregulation, rather than more regulation to make it easier for people to get into that profession which is currently very bureaucratic and annoying. And it also focuses not only on making access to such kind of education easier but to include also much more people who are already educated in the field through easier immigration, free B-permits (just show your work contract with a hospital and the B-permit gets issued automatically without questions), etc. or make it easier for people who already live here with a corresponding diploma but it’s not accepted because of bureaucratic formalities.

If that’s needed why not. I just don’t want this to be regulated by the federal government because then everyone else with lower salaries wants it to. Salaries should be competitive of course and I don’t mind paying them 6 figures if that’s needed but I don’t want to pay more taxes for it and health insurance premiums need to be affordable. Just keep in mind the implications this may have on similar professions e.g. assistant doctors have around 7500 CHF during their assistant years after 6 years of studying and a dissertation and they probably don’t want to earn less than a nurse. So … and then come also all the other medical professions etc.

How would you deal with that so the costs don’t explode? Maybe change the health insurance franchises to from 0 - 2500 CHF to 2500 - 10000 so that more of the smaller costs have to be covered by the patients rather than the insurances so they don’t have to increase premiums? This would maybe even help that people go less to the doctor for smaller things and help to save costs.

Some practical experience is needed to start, yes. This is common practice in nearly every tertiary education that is not gymnasium → university. This practical experience can also be an apprenticeship in a related field.

Improving the access to education is certainly a good idea and should be done, but it is not nearly enough to manage the current crisis.

Just a small point. Forcing franchises to be lower would lower the total costs of our health care system. People that don’t go to the doctor when they should, cost a lot later.

Similarly enough qualified nurses in old age homes or spitex can prevent unnecessary hospitalizations. The cost reduction potential is roughly 1.5 billion chf per year.

It may be that the higher salaries and higher staffing requirements may cost more than the cost reductions, but we get higher quality care for it.

If we want high quality care, then quality needs to have a price. Currently it doesn’t and quality is only a cost. It should be clear what that means in a market economy.

It’s not only the practical experience that is needed. They also have everywhere that “Eignungsverfahren / Eignungsabklärung” where a practical module is only one part of the process.

There is a practical module they need to pass. There are written tests, and a structured interview. If then they have let’s say 50 places but 200 applicants, the best 50 will get the places. It’s very similar like a numerus clausus. It can take more than a year overall the whole process and if you don’t belong to the best 50, you wasted 1 year for nothing.

Maybe a word on this. What means high quality? I thought about this many times when I was considerering if I wanted additional covering of my health insurance such as free choice of doctor and hospital etc. private insurance or other additional insurances. Yes it would be very nice that if I have to go to the hospital that I can choose the most nice clinic and have a private room like in a hotel. But then I thought, this will cost me a significant amount of additional money, is it really worth it? Probably not. If some time I have to go to the hospital, well then I will survive a few days or even weeks if necessary to be in a room with other people etc. Of course, the private option etc. would be more nice but it also costs much more. So I don’t think it’s worth it for me.

In the same sense I don’t need everything to be perfect and a supper luxury service - I don’t want high quality - I want sufficient in quality but also affordable.

I’m going to vote NO for the nursing initiative, because I’m liberal or even libertarian.

I’m a paramedic but I don’t think that the involving of our Conferderation in a liberal market is a good option. It has never been. But the contre-projet of this initiative is relevant, focused on the improvement of studies (and no, university degrees are not a solution, who needs a Phd nurse in our hospital ? when you are between life and death nobody expect an expert of nursing science and ontology) sorry a little bit sarcastic :slight_smile:

2 Likes

I’m pretty unsure on the nursing and justice initiative.

If the nursing initiative is rejected, the government is going to spend 1 billion on education in the field in the coming years. Which seems like quite a lot (but I don’t know if it really is). And the gov. setting prices is usually not a great idea in the long-run. A surplus in people in the field could follow and lead to a highly undesirable Pork cycle - Wikipedia. But maybe there are some market inefficiencies there? I don’t quite get why the salaries aren’t higher, if they’re lacking employees. Or on the other hand: why the current salaries don’t incentivise more people joining the field.

The justice initiative seems like a good idea. The current way judges are elected seems problematic. But nobody seems to have any idea, whether the current system actually leads to bad outcomes or if the new system would lead to better outcomes. (All papers I find on the topic are from the last couple of years. Would be interested in additional resources.)

Can you explain more about this? what is preventing employers raising salaries today that the proposal would fix?

I am not trying to be funny at all, I am not in the details of the topic, but intuitively the federation getting involved sounds like going in the opposite direction (I am currently “Don’t know” in the poll above)

1 Like

Also interested about that. There is a shortage of workers in a very important field. Why is the market failing to automatically rise the salaries given those “textbook” circumstances?

1 Like

Currently, a hospital doesn’t really profit if it offers quality care. Even if good care has value to everyone.

From the view of a hospital, care services are only a cost, there is no incentive to keep patients longer than absolutely necessary even if the patient may not be ready and an early release could leads to a unnecessary hospitalization a week later.

Thats what I mean when I say that if we want quality care, quality needs to have a price.

Quality care saves costs, the potential is around 2 billion CHF per year. Quality care may cost more, but the higher quality care means that you are less likely to die due to errors (around 243 people die each year due to mistakes in hospitals) and are more likely to receive a dignified death.

Also it is really fucked up that we train nurses how to care and then constantly force them to not do it right.

That is what this article about moral injuries is about:

Because not the salaries are the problem but the circumstances and to get into the profession.

If you can choose between 2 fields of study, and one of them is significantly more complicated to get in with the chance that you will get rejected after the process and then you wasted 1 year for nothing, then many people will decide for the easier way where they can get in immediately. All medical professions have this strange numerus clausus like procedure to get into the study programme.

You have the choice between:

Medical professions including nurses: Meet the requirements + pass internship module + pass written tests + pass structured interview (process can take around 1 year until you get in).

Almost all other professions: Just meet the requirements and you’re in and can start studying.

Second problem is that it is way too complicated to get a non-EU diploma accepted. Waste of resources as a result of bureaucracy and over-regulation.

I think it is. It takes away power from the parliament and like that judges are more independent in their decisions and don’t have to do what their parties and the parliament wants in order to get re-elected. No diversity and inclusion bullshit where people get elected only because they’re a women or from a specific canton etc. People should get a job because the are qualified for it and not because they meet some gender or whatever criteria. I see this a lot now in large companies that men have troubles to get into certain positions because they are men, but women get promoted just because they’re women even the the male person was better qualified. Just because they have to meet certain quotas.

Actually, I’m quite surprised to see that 14 people are going to reject the Covid law - I thought I was the only here against it. Looks like when it’s anonymous people are more brave :slight_smile:

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