Rising health insurance costs and the cost of living crisis are likely leading to an increase in unpaid health insurance bills in many countries. In Switzerland, a particularly drastic measure to sanction defaulting insurance payers is employed. Since 2012, Swiss cantons – who have to cover most of the bills of defaulting payers - are allowed by federal law to blacklist them and to restrict their access to medical care to emergencies.In our paper, we briefly describe blacklisting in the context (...) of the Swiss healthcare system before we examine the ethical issues involved in light of what is known about its social and health impacts. We found no evidence that blacklisting serves as an effective way of recovering unpaid health insurance contributions or of strengthening solidarity within the health insurance system. Furthermore, the ambiguous definitions of what constitutes an emergency treatment and the incompatibility of the denial of medical care with the obligation to provide professional assistance complicate the implementation of blacklists and expose care providers to enormous pressure.Therefore, we conclude that blacklists and the (partial) denial of medical care not only pose profound ethical problems but are also unsuitable for fulfilling the purpose for which they were introduced. (shrink)

BackgroundPatients who follow a specific religion may experience specific moral conflicts when interacting with the health care system. Health care providers’ awareness of and sensitivity to such issues can be beneficial to patients and increase the quality of care they receive. The aims of this study were to investigate which potential ethical issues were considered to be relevant to Muslim patients and to examine if these assessments varied between Muslim non-medical, Muslim medical, and non-Muslim medical students.MethodsAn online questionnaire with n (...) = 205 students from different universities in Zurich, Switzerland was conducted. The questionnaire contained a list of ethical issues of presumed relevance to Muslim patients, which had been compiled based on a literature search and an expert consultation.ResultsMuslim non-medical students considered 33% of the ethical issues as morally problematic to Muslim patients. In contrast, Muslim medical students regarded 19%, and non-Muslim medical studen... (shrink)