News

17. April 2024

Ba­ro­me­ter for re­ne­wa­ble ga­ses in Switz­er­land, edi­ti­on 5, April 2024

After four editions focusing exclusively on hydrogen, we are now opening the Barometer to renewable methane (synthetically produced or from biogas). Overall, we currently assess the investment climate in Switzerland for renewable methane as better than for hydrogen. A comparison of technology options shows that while existing energy infrastructure can still be used for synthetic methane and biomethane, for hydrogen, the energy yield per available area is greater. In Switzerland, around 8% of total gas consumption comes from self-produced or imported biomethane, a high figure compared internationally. From 2025 onwards (subject to a referendum), the injection of biomethane into the Swiss gas grid will be promoted, which can also help to further exploit the production potential for biogas. In the hydrogen sector, we introduce the newly launched H₂ marginal cost index HySuiX and summarize the importance of the Federal Council's hydrogen “Auslegeordnung”. However, the industry expects major policy decisions only from the Federal Government's hydrogen strategy announced for autumn. These topics are covered in the new Barometer, published by the Swiss Gas Industry Association in collaboration with E-Bridge Consulting and Polynomics. The Barometer is published twice a year and available in German and French. You can receive future issues by registering here: https://gazenergie.ch/de/h2-barometer.
02. April 2024

Non-Im­ple­men­ta­ti­on of CBAM – Im­pli­ca­ti­ons for the Ce­ment In­dus­try and the En­vi­ron­ment

What impact will the renunciation of a carbon border adjustment mechanism (CBAM) have on the Swiss cement industry and thus on the achievement of Switzerland's net zero targets? A Swiss CBAM means that Swiss builders have to take CO₂ costs into account in all their cement purchasing options: they can either buy CO₂-free cement or the CO₂ content in the cement is internalised via the CBAM levy or through the purchase of emission certificates. Without a Swiss CBAM, or without other measures with a comparable effect, there is a risk that the cement industry or clinker production moving abroad. As long as builders are not willing to pay a significant premium for CO₂-free cement, CO₂-contaminated cement will continue to be used in Switzerland in future. This would jeopardise the achievement of the net-zero target. A Swiss CBAM does not protect the domestic cement industry. Builders can still import cement from Europe or third countries. However, since the same system of CO₂ emission rights exists in Europe and for imports from third countries, the CBAM surcharge at the border would create a level playing field for EU, non-EU and Swiss cement suppliers.
12. March 2024

Epi­de­mio­lo­gy of Sick­le Cell Di­se­a­se in Switz­er­land

Sickle cell disease is a rare hereditary blood disorder, in which the red blood cells contain an altered form of haemoglobin (haemoglobin S), causing them to become sickle-shaped, thereby easily clump-ing together and clogging blood vessels. In this report, we make a rough estimation of the preva-lence (frequency of the disease: How many cases are there?) and incidence (new occurrences of the disease: How many cases are added annually?) of sickle cell disease for Switzerland. The existing data for Switzerland are of poor quality, which is why we transfer estimates for Germany to Switzer-land. It appears that there can be assumed to be between 200 and 700 existing cases in Switzerland (prevalence) as well as annually 8 to 16 births with sickle cell disease (incidence).
24. October 2023

H2 Ba­ro­me­ter Switz­er­land, edi­ti­on 4, Oc­to­ber 2023

Compared to the previous year, the assessment of the investment climate in the Swiss hydrogen industry has deteriorated all along the value chain: three out of four respondents evaluate it negatively. Explanations can be found in the government conditions, which are consistently assessed as less good, but also in the persistently high electricity prices. Despite or precisely because of the uncertainties about the future role of hydrogen, Switzerland should not miss the opportunity to connect to the European Hydrogen Backbone (EHB) - the European hydrogen transport infrastructure. This requires swift and decisive action by the state to keep options open for the energy mix of the future. The activities of neighboring countries show that Europe is not waiting for Switzerland to build up its hydrogen supply. These topics are covered in the new H₂ Barometer, published by the Swiss Gas Industry Association in collaboration with E-Bridge Consulting and Polynomics. The Barometer is published twice a year and available in German and French. You can receive future issues by registering here: gazenergie.ch
17. October 2023

Out­pa­ti­ent ca­re struc­tu­re for me­di­cal la­bo­ra­to­ry ana­ly­ses in Switz­er­land

The FOPH's transAL-2 project is currently revising the analysis list and its tariffs, i.e. the medical laboratory services that are reimbursed by the OKP. Polynomics has analysed outpatient laboratory care in Switzerland with health insurer data as part of transAL-2. The analyses show that the types of hospital laboratory defined in Article 54 KVV do not exist in reality. Overall, contract and hospital laboratories provided medical analyses worth around CHF 1.2 billion at the expense of the OKP in 2019. The heterogeneity between the service providers is very high. For example, the seven largest laboratory chains provided 80% of the gross services of the contract laboratories and the five university hospitals provided 40% of the gross outpatient services of the hospital laboratories. The range of services, measured by the number of different tests, also varies greatly. It can also be seen that the contract laboratories tend to be located in the large cities and regional centres, while the regional distribution of the hospital laboratories is more diverse.
04. October 2023

Eco­no­mic im­portance of the in vi­tro dia­gno­stics in­dus­try in Switz­er­land

The Swiss in vitro diagnostics industry plays a central role in public health. Through precise and timely diagnoses, diseases can be detected early and effective treatments can be initiated. Based on a survey of hospital and private laboratories as well as manufacturers and distributors of in vitro diagnostics, Polynomics calculated the economic importance of the industry. With around 12,000 employees, the industry generated a gross value added of CHF 2.8 billion in 2022. The industry's contribution to coping with the Covid 19 pandemic is also reflected in the value added, which increased by around 17% in 2021 compared to the previous year and declined again in 2022. The vast majority of companies invest in personnel, capital and research and development. In this context, companies are challenged by the shortage of skilled workers, cost pressure in compulsory health insurance, tariffs and increasing regulation. Thanks to improved diagnostic accuracy, laboratory diagnostics contributes to reducing the social costs of diseases. It is also an important pillar in the fight against communicable diseases, as the tests for the Sars-CoV-2 virus have impressively shown in recent years.
14. September 2023

Frame­work for Hy­dro­gen in Switz­er­land

Hydrogen has the potential for playing a key role for decarbonizing Switzerland's energy supply. To be able to use it, fundamental decisions and measures must be taken, especially during the initial phase of the hydrogen deployment. The wide range of scenarios for hydrogen demand shows that the primary goal is to keep perspectives for hydrogen open initially. Key to this is having an appropriate hydrogen strategy and creating the conditions for integration into the planned European hydrogen infrastructure. In addition to these aspects, our study identifies further regulatory areas for shaping the framework conditions for hydrogen in Switzerland. Due to hydrogen's role in sector coupling and decarbonization, the conditions for electricity, gas, and CO₂ are also significant.
11. April 2023

H2 Ba­ro­me­ter Switz­er­land, edi­ti­on 3, April 2023

Independent assessment of the hydrogen economy in Switzerland by E-Bridge and Polynomics. A comparison of the VSE's Energy Future 2050 and the SFOE's Energy Perspectives 2050+ on the future importance of hydrogen in the energy system shows the broad spectrum of possible scenarios. Central to the role of hydrogen in Switzerland are import prices and possible reconversion to electricity in the winter months. The import prices and also the available quantities are in turn strongly dependent on the development of the import corridors. For business models with domestic hydrogen production, the tariff regulation for electricity purchases from the electricity grid is particularly relevant. The exemption of H2 electrolysis from grid usage fees is still politically open: Should the focus be on promoting energy storage in order to advance the transformation of the energy system, or on grid-serving use? In order to include the potential for hydrogen in local energy planning, bottom-up analyses are necessary. The example of such a study for Germany shows that there are many different solutions for heat supply and that local conditions are decisive. Findings from local analyses should also be used in Switzerland to substantiate top-down scenarios of the federal government. The H2 Barometer is published by the Swiss Gas Industry Association in collaboration with E-Bridge Consulting and Polynomics. The Barometer is published twice a year and available in German and French. You can receive future issues by registering here:
30. November 2022

Im­pact of the SFOE's En­er­gy Per­spec­ti­ves 2050+ on the elec­tri­ci­ty dis­tri­bu­ti­on grid

The study analyses the effects of the Energy Perspectives 2050+ of the SFOE on the electricity distribution network, determines the network development requirements and states the resulting network costs and network tariffs until 2050. For this purpose, the developments of then main drivers, “electric mobility”, “heat pumps” and “photovoltaics”, that are forecast in various scenarios in the Energy Perspectives are distributed across Switzerland on the basis of a model that accounts for every individual building. A model network analysis is used for determining the resulting network infrastructure requirements and evaluating them in a network cost model. The thus determined real investments needed until 2050 amount to a minimum of CHF 45 billion for the “business as usual” [weiter wie bisher – WWB] scenario and a maximum of CHF 84 billion for the “net zero by 2050 with intensive electrification” [Netto-Null bis 2050 mit starker Elektrifizierung – ZERO A] scenario. This leads to an increase in network usage fees at network level 7 between 27% and 70%, taking into consideration the increasing use of electricity due to population growth and electrification.
15. November 2022

Sys­tem sta­bi­li­ty and ef­fi­ci­en­cy: the con­tri­bu­ti­on of tra­ding to Switz­er­lan­d's elec­tri­ci­ty sup­p­ly sys­tem

The current political and economic developments in Europe have led to a strong dynamisation of the energy markets with historic price peaks. In the search for causes and measures, electricity trading and in particular the trading activities of large electricity producers are increasingly being questioned. In the report, we show how today's trading system came into being, how it works, what role electricity trading plays for system stability and for an efficient exchange of energy, and why a close link between production and trading is important in this context.
24. October 2022

Spi­tex-Bench­mar­king-Platt­form

The Spitex Benchmarking Platform creates the data basis required for needs-based care, supports operational management with intuitive key figures and strengthens the negotiating position of the organisations vis-à-vis social insurance companies and residual financing partners through improved cost transparency. It is being developed by Polynomics as part of an Innosuisse project in collaboration with Lucerne University of Applied Sciences and Arts, Heyde AG and partner organisations and will be available from spring 2023. The participating organisations will make their harmonised data available on the platform to enable comparisons across institutions. Clearly defined contracts between the participating organisations and Polynomics define the scope of the data and permissible evaluations. The participants regularly receive standardised analyses and reports on specific topics. In addition, they can also request individual evaluations. Evaluations include comparisons of key figures and statistical analyses to investigate the impact of structural and operational indicators on the cost structures. Evaluations provide insights into process improvements and allow for an objective discussion on financing. The platform is aimed at all Spitex organisations, irrespective of their size, sponsorship or legal form, as well as independent care professionals.
12. October 2022

H2 Ba­ro­me­ter Switz­er­land, edi­ti­on 2, Oc­to­ber 2022

Independent assessment of the hydrogen economy in Switzerland by E-Bridge and Polynomics. The second «H₂ Barometer Switzerland» provides – in addition to the authors’ view – a survey of 116 H₂-market-participants on their perception of the current investment situation (which 60% value as «rather bad» or «bad») and their expectation up until 2050 (where 75% belief that H₂ will play an important role for the Swiss energy system). The path towards this goal is becoming increasingly concrete at the political level, at least in the EU. Whether political actions can keep pace with the development of the goals, however, remains uncertain. The H₂ Barometer is published by the Swiss Gas Industry Association in collaboration with E-Bridge Consulting and Polynomics. The Barometer is published twice a year and available in German and French. You can receive future issues by registering here: gazenergie.ch.
06. October 2022

Po­ly­no­mics Bench­mar­king­platt­form (Po­ly­Bench) für das BMT

Für die Teilnehmenden am verbändeübergreifenden Projekt Benchmarking Transparent (BMT) haben wir eine webbasierte Applikation entwickelt. Dank der PolyBench können die Teilnehmer des BMT-Projektes auf Basis der von der BNetzA veröffentlichten Daten eigenständige Kennzahlen- und Effizienzanalysen durchführen. Dank PolyBench können die Nutzer die veröffentlichten Daten einfach und übersichtlich miteinander vergleichen und die Auswirkungen verschiedener Unternehmensszenarien auf den eigenen Effizienzwert bestimmen. Weitere Informationen auch für die Anmeldung eines Testzugangs für BMT-Teilnehmer entnehmen Sie dem Flyer.
03. August 2022

Au­dit man­da­te re­gar­ding re­gu­la­to­ry sand­bo­xes

Rigid regulations can stifle innovation and make it difficult for start-ups and small and medium-sized enterprises (SMEs) to enter the market. Therefore, the question arises: How can we design innovation-friendly regulations? And how can obsolete regulations be adapted to new technological developments? With this in mind we are examining the use of «regulatory sandboxes» on behalf of the State Secretariat for Economic Affairs (Seco).
28. June 2022

New em­ployee

As of the first of June 2022, the Polynomics team has been joined by Vera Frei. Ms Frei holds a Bachelor's degree from the University of St. Gallen (HSG). She subsequently completed an interdisciplinary Master's programme in "Sustainable Development" with a focus on economics at the University of Basel and an in-service training course (CAS) in "Advanced Statistical Data Science" at the Institute of Mathematical Statistics and Actuarial Science at the University of Bern. She also worked as a consultant at the Institute for Economic Studies Basel (IWSB). Thanks to her empirical and economic expertise, Ms Frei strengthens our team of advisors and we look forward to working with her.
27. June 2022

The so­cial cos­ts of Du­chen­ne mus­cu­lar dys­tro­phy in Switz­er­land

Duchenne muscular dystrophy (DMD) is a degenerative muscle disease that is inherited via the X-chromosome. The gradual degeneration of the muscles leads to complete paralysis of the extremities and thus to the loss of the ability to walk. Both breathing and the heart are affected during later phases of the disease. There are no licensed therapies in Switzerland at present that can stop the degenerative progress of the disease. We calculated the social costs of DMD in Switzerland for the first time. We determined the direct, indirect and intangible costs for each of the four stages of the disease. Wherever possible, we referred to Swiss information on prices and quantities. Alternatively, we used information from international literature or expert estimates. The social costs of DMD totalled CHF 48 million in 2020, which corresponds to CHF 157,400 per patient. Of this amount, CHF 34.2 million, or 66%, were indirect costs, i.e. loss of productivity in the labour market. The indirect costs were significantly higher than the direct costs in all of the four stages of the disease. The majority of the social costs (90%) were incurred during the stages of the disease in which the patient had already lost their ability to walk.
27. June 2022

The so­cial cos­ts of se­ve­re hae­mo­phi­lia A and B in adults in Switz­er­land

Haemophilia is a rare genetic blood coagulation disorder. It (almost) exclusively affects men. Affected persons bleed longer after injuries or suffer spontaneous bleeding even with little exertion. There are two main types in haemophilia: haemophilia A and B. We have calculated the social costs of severe haemophilia in adults in Switzerland for the first time. We determined the direct, indirect and intangible costs for haemophilia A and B, respectively. Wherever possible, we referred to Swiss data sources. Alternatively, we used information from international literature. We estimate the social costs of severe haemophilia in 2020 to be around CHF 55 million, with 93%, or CHF 51 million, being factor therapy costs, in other words the replacement of the insufficiently produced coagulation factor. At a total of CHF 2.9 million, the indirect costs were relatively low compared with the total costs.
20. May 2022

Tem­po­ra­ry li­qui­di­ty sup­port for power sup­p­ly

Economic analysis with regard to the «Federal law on subsidiary financial assistance for the rescue of system-critical companies of the electricity industry» on behalf of Axpo. On 18 May 2022, the Swiss Federal Council passed the legislation and the dispatch on «Subsidiary financial assistance for the rescue of system-critical companies of the electricity industry». The bill regulates federal loans to electricity companies which may face short-term liquidity constraints due to extreme price distortions on the stock exchanges. Within the framework of the present economic analysis, incentive-compatible, balanced liquidity support measures are approved. This is a pre-emptive measure which should prevent Swiss energy companies being excluded from the stock exchange in the energy market due to liquidity constraints. Ultimately the structure of liquidity support measures must focus on avoiding increasing systemic risk. In this regard, liquidity support measures should be available to all electricity companies active on the stock exchange. They should guarantee that all electricity companies can hedge their production on the stock exchange in spite of extraordinary market developments. The current crisis is caused by extreme price increases and fluctuations, which could intensify further as a result of the war in the Ukraine. In contrast to the UBS rescue the energy companies are profitable, precisely because of the high energy prices. It is highly improbable that the electricity companies will use the liquidity support measures or, in the event of utilisation, that they cannot be repaid. It is therefore important that the conditions for the liquidity support measure are proportionate.
31. March 2022

H2 Ba­ro­me­ter Switz­er­land, edi­ti­on 1, march 2022

Independent assessment of the hydrogen economy in Switzerland by E-Bridge and Polynomics. The barometer provides orientation on the H2 market ramp-up in Switzerland and assesses the investment climate taking into account European developments. Hydrogen plays an important role in the decarbonisation of the Swiss energy system. Reliable framework conditions are required to give more momentum to the activities already underway at all levels of the value chain. In contrast to its EU neighbours, the work of the administration on a hydrogen road map is only just beginning in Switzerland. In the basic information available so far, the Energy Perspectives 2050+, hydrogen still plays a subordinate role compared to neighbouring countries. The H2 Barometer is published by the Swiss Gas Industry Association. The Barometer is published twice a year and available in German and French. You can receive future issues by registering here:
11. January 2022

Ex­cel-ba­sier­te El­Com-Kos­ten­rech­nung für Elek­tri­zi­täts­ver­teil­netz­be­trei­ber

Zur Erfassung der ElCom-Kostenrechnung für Tarife 2023 bietet der VSE in Zusammenarbeit mit Polynomics eine Excel-Lösung inklusive Konvertierung in XML-Format an. Spätestens ab Frühling 2022 ändert sich für Elektrizitätsverteilnetzbetreiber die Datenerfassung mit dem neuen Datenliefersystem der ElCom (EDES) grundlegend. Die ElCom hat angekündigt, mit der Kostenrechnung für die Tarife 2023 die bisherige offizielle Excel-Vorlage nicht mehr bereitzustellen. Die Dateneingabe erfolgt direkt in der Datenmaske im Browser oder via Import und Export per XML-Datei. Dieses Format eignet sich gut für einen flexiblen Datentransfer, ist jedoch ungeeignet für die systematische Bearbeitung oder Erfassung von Daten oder deren Versionierung. Im Rahmen des VSE / AES Datenpool© stellt der VSE ab der Erfassung der Kostenrechnung für die Tarife 2023 eine Excel-Lösung inklusive Konvertierung in XML-Format zur Verfügung. Dies erlaubt Ihnen, Ihre Daten im bekannten Excel-Format zu erfassen und ohne Zusatzaufwand in das ElCom-konforme XML-Format zu übertragen. An der Arbeit mit Excel werden insbesondere die Möglichkeiten geschätzt, gleichzeitig an verschiedenen Versionen zu arbeiten, ganze Datenblöcke mittels Copy-and-paste zwischen Arbeitsmappen auszutauschen sowie Kommentare und Berechnungen direkt in der Erfassungsmaske zu tätigen und Auswertungen darauf zu basieren. Die Excel-Arbeitsmappe wird sich an der Struktur der vergangenen Kostenrechnungen orientieren und wird Ihnen – abhängig vom konkreten Zeitplan der ElCom – voraussichtlich jeweils Anfang Mai zur Verfügung gestellt. Für weitere Informationen können Sie uns gerne kontaktieren oder sich beim VSE unter https://www.strom.ch/de/service/shop/vse-aes-datenpool anmelden.
25. November 2021

Com­pre­hen­si­ve phar­maceu­ti­cals be­ne­fit as­sess­ment

On behalf of Bristol Myers Squibb, Polynomics has developed an instrument for the standardised benefit assessment of oncology drugs and proven its practicability for Switzerland in a cancer drug. The model based on the MCDA (Multi-Criteria Decision Analysis) method accounts for both patients’ and society’s use of pharmaceuticals. Experts from the various groups of players in the healthcare sector were involved in the tool’s development and validation. The proposed model can be used anywhere where pharmaceuticals benefit assessments are required in a regulatory context.
16. November 2021

Pa­tent law re­form

In December 2019, the Swiss Parliament passed Motion No. 19.3228 "Towards a modern Swiss patent", dubbed the "Motion Hefti". The implementation of the Motion Hefti essentially requires that Swiss patents should be granted whenever the Swiss Federal Institute of Intellectual Property (IPI) can verify the novelty and attest an inventive step for the requested patent. As the responsible authority, the IPI has prepared a preliminary draft for the reform of the national intellectual property law and also presented an explanatory report on this reform. On behalf of the IPI, Polynomics conducted a Regulatory Impact Analysis on this preliminary draft, i.e., we examined how the reform would affect individual groups of stakeholders and the economy as a whole, and to what extent alternatives to the reform exist.
13. October 2021

Die agi­le Or­ga­ni­sa­ti­on von Po­ly­no­mics

Für die Zusammenarbeit mit unseren Kunden stellen wir massgeschneiderte Teams aus unseren Fachspezialisten zusammen. Diese agile, flexible Arbeitsweise, die unsere Projektarbeit seit vielen Jahren charakterisiert, nutzen wir nun auch für die interne Organisation von Polynomics. Mit unserer agilen Organisation ermöglichen wir unseren Experten noch mehr Eigenverantwortung und Entscheidungsbefugnisse als Antwort auf unser dynamisches Marktumfeld. In Anlehnung an das «Holokratie-Prinzip» arbeiten wir seit Januar 2021 mit dem Kreismodell. Dieses passt am besten zu unserer Arbeitsweise und erlaubt es, uns auch in Zukunft als besonders attraktive Arbeitgeberin zu positionieren. In der gewählten Reorganisation sehen wir grosses Potenzial für die Weiterentwicklung unserer Expertise und Experten. Damit bleibt Polynomics ein verlässlicher Wert für Kunden und Partner.
13. October 2021

Un­ser öko­no­mi­sches Be­ra­tungs­an­ge­bot

Ob Unternehmen, Behörde oder Verband: Wir erstellen für Sie Studien, Gutachten und datenbasierte Analysen, unterstützen Sie bei der Erarbeitung Ihrer Strategie bis zur Umsetzung oder dienen Ihnen einfach als Sparring-Partner. Unsere Branchenschwerpunkte liegen in der Energieversorgung, dem Gesundheitswesen, dem Finanzsektor und im Telekom- und Medienbereich verankert. Unsere Beratungsleistungen in den Themen Wettbewerbsökonomie, Regulierungsökonomie und Regulierungsfolgenabschätzung, Kostenrechnung und Pricing sowie Präferenzmessung und Discrete-Choice-Experimente bieten wir branchenübergreifend an. Insbesondere ist unser Erfahrungsschatz in der Erstellung wirtschaftspolitischer Analysen, der Datenanalyse, Benchmarking und Effizienzmessung ein wichtigter Baustein, um Ihnen eine umfassende Beratungsleistung anbieten zu können. Unsere individuellen innovativen Lösungen erarbeiten wir mithilfe wissenschaftlich abgestützter und praxiserprobter Methoden. Dabei können wir auf langjährige Erfahrungen in der datenbasierten ökonomischen Analyse zurückgreifen. Diese Grundlage ermöglicht uns eine zuverlässige Beratung im sich laufend verändernden Markt- und Regulierungsumfeld.
01. September 2021

Con­fe­rence on Gas­mar­ket Ac­cess and An­ti­rust Law

Our conference at the Kosmos in Zurich showed: Opening of the gas market via antitrust law is a fact. In order for the gas market to hold its ground efficiently in a dynamic environment, a special legal regulation is urgently needed.
01. June 2021

Fur­ther net­work and en­er­gy ta­riff de­ve­lo­p­ments

Our study shows the possibilities for further developing the tariff setting principles in the electricity sector in view of the changes in electricity supply caused by the energy transition and digitalisation. It contains proposals to take into account electricity production near end consumers in distribution networks whilst considering cost reflexivity. Other analyses concern the structure and time variability of tariffs as well as the cost allocation method. The study shows that network operators’ payments to producers give incentives to set up production plants where they relieve the electricity network. These payments are independent of the purchasing of electricity and therefore independent of transactions. Prominent approaches in the political debate, which provide for reduced network fees for locally purchased electricity based on the purchasing of electricity (dependent on transactions), on the other hand, are less cost reflexive.
10. March 2021

Eco­no­mic im­portance of hos­pi­tals pro­vi­ding pu­blic he­alth ser­vices in Bern

Polynomics has been commissioned by diespitäler.be and the Verband der Privatspitäler des Kantons Bern (VPSB) to perform a study on the economic importance of hospitals providing public health services in the Canton of Bern. The findings show that the hospitals providing public health services are an important employer in the canton and have contributed significantly to the rise in the number of jobs and value creation in the canton in recent years. Patients in Bern benefit from a broad product portfolio and are very satisfied with the services. The hospitals’ reserve services also ensure that healthcare is quickly provided throughout the canton, which is a preference expressed by the public. The hospitals providing public health services in Bern provide all of these services in a market with increasingly complex and strict government requirements.