Too old, too expensive? The impact of health costs on senior citizens in Switzerland

Increased life expectancy, which reflects progress in living conditions, medical knowledge and technology, has given rise to an aging of the population. Thus, the number of older subjects requiring care has increased. As a result, the resources that modern state must devote to healthcare are increasing, directly affecting the cost of health insurance premiums to taxpayers. This has resulted in a certain social stigma surrounding medical costs of older persons, causing them to feel insecure and guilty, sometimes to the point where they forgo care or even envisage assisted suicide, lest they become an economic burden on their loved ones. Explicit rationing of access to care or reimbursement of medical services does not seem to globally reduce healthcare costs (reduction of outpatient costs, but a strong increase in hospital costs). Therefore, an ethical approach established equitably and knowingly through shared decision-making by clinicians and patients could consent to omitting certain diagnostic procedures or onerous and futile care, thereby, contributing, in parallel, to restricting increases in health costs.