As Swiss Society for Interventional Pain Management (SSIPM), we are taking a firm stance against the daily billing cap proposed for the upcoming TARDOC medical tariff system. In our formal communication to Swiss parliamentarians and social security commissions, we have voiced our deep concern: capping billable physician services at 1,577 tariff points per day will compromise the care of our patients, severely damage outpatient medical infrastructure, and ultimately increase overall costs for Swiss taxpayers.

While we recognize the intention of tariff partners to manage healthcare spending, limiting performance points based on a theoretical 12-hour daily average (1,577 points) rests on a fundamental misunderstanding of specialized practice.

Why the 1,577-Point Cap Fails in Practice

In interventional pain management, standard “billing minutes” assigned to complex procedures—such as image-guided nerve blocks, injections, and rhizotomies—do not reflect real clock time. Because our specialists work with precision and high efficiency, we hit the theoretical point ceiling far faster than the system assumes.

Under this cap, an experienced specialist treating high-need pain patients could reach their daily billing limit after seeing only a handful of individuals. This creates an absurd and dangerous reality where specialized practices could be forced to turn away suffering patients by early afternoon simply because they have reached an arbitrary administrative ceiling.

Undermining Outpatient Care and Practice Viability

Switzerland’s healthcare strategy rightly emphasizes “outpatient over inpatient” care (“ambulant vor stationär”) to keep costs manageable. This proposed cap directly contradicts that vision. When outpatient specialists are capped, chronic and acute pain patients will be pushed into overloaded hospital emergency departments, leading to longer wait times and higher overall treatment costs.

Additionally, this cap threatens the financial foundation of independent medical practices. Practice infrastructure in Switzerland is already severely underfunded—covering only about two-third of actual operational costs. Outpatient physicians rely on service fees to cross-subsidize their facilities, specialized equipment, and staff. Restricting medical performance points without addressing infrastructure costs will make running private practices unsustainable.

Our Urgent Call to Action

While SSIPM fully supports sustainable and cost-effective healthcare delivery, we urge the Federal Council to reject the 1,577 tariff point cap in its present form. We demand a thorough re-evaluation grounded in real-world clinical data to ensure that Swiss patients continue to receive timely, specialized, and high-quality pain treatment.