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Alternativna medicina nič več ‘outsider’ v švicarskem zdravstvenem sistemu



V letu 2009 sta dve tretjini prebivalcev Švice glasovali za vključitev alternativne medicine na ustavno listo storitev, ki jih krije zdravstveno zavarovanje. Po prvi integraciji v l. 1999 jo je vlada odstranila s seznama v letu 2005 med obdobjem porasta nacionalnih stroškov z argumentom, da ni izpolnila kriterijev učinkovitosti, stroškovne učinkovitosti in ustreznosti.


Kot rezultat volitev iz leta 2009 je bilo pod osnovni paket zavarovanja (obvezno za vse prebivalce Švice) poskusno vključenih pet vrst alternativnih terapij - homeopatija, holistična medicina, zeliščna medicina, akupunktura in tradicionalna kitajska medicina, s tem da je moralo biti zagotovljeno, da storitve nudi certificiran zdravnik oz. izvajalec. Ta poteza je prinesla alternativno medicino nazaj v nabor običajne zdravstvene oskrbe. Oblasti si niso več mogle privoščiti ignoriranja dejstva, da je ponovno upravičena do deleža nacionalnih stroškov zdravstva.


Alternativna medicina: zavarovanje in diplome


Pet alternativnih terapij - homeopatija, holistična, zeliščarstvo, akupunktura (ter ostale terapije, ki vplivajo preko živčnega sistema) in tradicionalna kitajska medicina - je vključenih pod švicarski osnovni paket zdravstvenega zavarovanja. Stroški zdravljenja so povrnjeni samo, če storitev izvaja zdravnik.


Stroški vseh ostalih alternativnih in komplementarnih terapij so povrnjeni samo, če se pacient odloči za ločeni dopolnilni paket zdravstvenega zavarovanja, ki stane več. Kljub temu niso vse discipline prepoznane s strani zavarovalničarjev.


Možno je pridobiti dva tipa federalnih diplom iz alternativne medicine. Diploma na višji stopnji se podeljuje za naziv naturopata, kjer lastnik diplome lahko diagnosticira težave in predpisuje zdravljenja, kot so zeliščni pripravki. Priznane discipline vključujejo homeopatijo, tradicionalno kitajsko medicino in tradicionalno evropsko medicino. Izvajalci s to diplomo iz naturopatije lahko pridobijo kantonsko delovno licenco.


Druga kategorija federalne diplome je diploma za komplementarnega terapevta. Slednji nudi specializirana zdravljenja, kot so masaže z olji za zdrave ljudi ali ljudi z manjšimi težavami, vendar nimajo dovoljenja za diagnozo bolezni. Discipline, ki so priznane s strani vlade, so joga, shiatsu, kraniosakralna terapija in evtonija.


Priložnosti in izzivi


Z začetkom leta 2015 je bilo naturopatom iz področij homeopatije, ajurvede, tradicionalne kitajske medicine in tradicionalne evropske medicine na voljo pridobitev diplome, ki je priznana po celi državi.


Uvedba federalne diplome je prav tako spodbudila številne kantone - npr. Lucerno - da so uvedle ali ponovno uvedle delovne licence za naturopate. Za pridobitev mora naturopat predložiti svoje osebne podatke in kopijo svoje federalne diplome.


Uradna licenca pomeni, da so prejemniki federalne diplome iz naturopatije oproščeni plačila DDV. Prav tako so samodejno vključeni v Nacionalni register profesij zdravstvene oskrbe in smatrani za delavce zdravstvene oskrbe: velik preskok iz obrobja.


‘S kantonskim delavskim dovoljenjem smo vključeni v primarni sistem zdravstvene oskrbe, npr. zdaj med krizo Covid-19 nam je dovoljeno, da nadaljujemo z delom,’’ pravi Alexandra Nievergelt, podpredsednica Švicarske strokovne organizacije za tradicionalno kitajsko medicino, ki je opomnila, da se morajo tudi naturopati prilagoditi na ista pravila in omejitve kot ostali zdravniki med obdobjem koronavirusa.


Celotni članek:

https://www.swissinfo.ch/eng/going-mainstream_alternative-medicine-no-longer-an--outsider--in-switzerland-s-health-system/45706024


prevod: Tanja Topić

vir fotografij: internet




Alternative medicine no longer an ‘outsider’ in Switzerland’s health system


In 2009 two-thirds of Swiss citizens voted for the inclusion of alternative medicine on the constitutional list of services covered by health insurance. First integrated in 1999 they were struck off the list by the government in 2005 amid rising national health costs using the argument that they failed to meet the criteria of efficacy, cost-effectiveness and suitability.


As a result of the 2009 vote, five alternative therapies – homeopathy, holistic medicine, herbal medicine, acupuncture and traditional Chinese medicine – were included under the basic health insurance package (compulsory for all Swiss residents) on a trial basis provided they are administered by certified medical doctors. This move brought back alternative medicine into the fold of the mainstream healthcare. Authorities could no longer afford to ignore it now that it once again accounted for a share of national health costs.


Alternative medicine: insurance and diplomas


Five alternative therapies – homeopathy, holistic, herbal and neural therapies and traditional Chinese medicine – are included under the Swiss basic health insurance package. Cost of treatments are reimbursed under basic insurance only if administered by a medical doctor.


The cost of all other alternative and complementary therapies will only be reimbursed if the patient opts for a separate complementary health insurance package that costs extra. However, not all disciplines are recognised by insurers.


Two types of federal diplomas in alternative medicine are offered. The advanced one is that of a naturopath where diploma holders can diagnose ailments and prescribe treatments such as herbal preparations. Disciplines recognised include homeopathy, traditional Chinese medicine and traditional European medicine. Practitioners in possession of this naturopathy diploma can get a cantonal work licence.


The second category of federal diploma is that of a complementary therapist. Holders provide specialised treatments like oil massages to healthy people or those with small ailments but they are not allowed to diagnose a disease. Disciplines recognised by the government include yoga, shiatsu, craniosacral therapy and eutony.


Opportunities and challenges


Starting in 2015, naturopaths in the fields of homeopathy, Ayurveda, traditional Chinese medicine and traditional European medicine were able to obtain a diploma that was recognised throughout the country.


The introduction of the federal diploma also prompted many cantons – like Lucerne – to introduce or reintroduce work licences for naturopaths. To get one, naturopaths must submit their personal details and a copy of their federal diploma.


Official licensing means that those who get a federal diploma in naturopathy are exempt from paying value-added tax (VAT). They are also automatically included in the National Registry of Healthcare Professions and considered to be healthcare workers: a big leap from being on the fringes.


“With a cantonal work permit we are included in the primary healthcare system, for example now during the Covid-19 crisis we are allowed to continue working,” says Alexandra Nievergelt, co-president of the Swiss Professional Organization for Traditional Chinese Medicine, noting that naturopaths must also adhere to the same rules and restrictions as doctors amid coronavirus.


Full article:

https://www.swissinfo.ch/eng/going-mainstream_alternative-medicine-no-longer-an--outsider--in-switzerland-s-health-system/45706024




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