Opening weekend

On the weekend of 16–17 November 2024, the Citizens’ Assembly began at the University of Zurich. Around 100 randomly selected participants from across Switzerland came together to get to know one another, explore the topic of healthcare costs, and lay the foundation for their joint work.

Day 1: Getting to know each other and introduction to the topic
Before 9 a.m., the first participants arrived at the University of Zurich, where they received their name badge, notebook, and pen at the reception. Equipped and full of anticipation—though surely also a little nervous—they climbed the stairs to the auditorium for the first time. There, with coffee and croissants in hand and headphones for translation, they took their seats.

Daniel Kübler, Professor at the University of Zurich, opened the day, explaining: "With this project we want to test a new form of democracy." The aim, he said, was to bring together people from different walks of life, break through echo chambers, and discover new perspectives. His co-initiator, Prof. Nenad Stojanović of the University of Geneva, added: "The project does not pursue a political agenda. The topic of 'rising healthcare costs' was chosen through a broad process because it affects us all and is meant to reinvigorate a stalled debate."

The moderation team from Interface then provided an overview of the procedure of the Citizens’ Assembly and initiated the first interactions: participants positioned themselves in the room according to age group and place of residence, or gathered around everyday Saturday activities such as “still in bed” or “at the gym.”

Chantal Grandchamp from Unisanté then introduced the Swiss healthcare system and presented the key challenges: limited resources, pressure on the principle of solidarity, and rising costs. Andreas Balthasar from Interface delved deeper into the issue of healthcare costs, explaining the path through the Swiss healthcare system and the five key areas: basic health insurance, hospitals, coordination of healthcare provision, increase in treatments, and health promotion and prevention. Participant Norma Widmer-Hueber from Graubünden was impressed: "With simple and clear words, we were shown what the real cost drivers are. We never get to see this so clearly in everyday life. Why is it always presented in such an unnecessarily complicated way?"

In the afternoon, participants explored the five focus topics (Posters) in an interactive marketplace. Experts were available at stands for questions and discussions, which led to lively exchanges. The first day ended with a shared dinner in the University of Zurich cafeteria—full of new ideas and eager anticipation for the upcoming discussions.

Day 2: Discussion and focusing
Sunday was devoted to selecting the focus topic. After reflecting on the insights from the previous day, Andri Heimann from the Centre for Democracy Aarau gave input on goal conflicts in health policy.

Together, the participants worked out the basis for the vote, in which the majority chose “Health promotion and prevention” over the second-ranked option, “Coordination of healthcare provision.” Participant Baptiste Favre from Valais put it aptly: "It is time not only to treat diseases, but to orient our healthcare system more strongly toward prevention and promotion." The aim is to tap into unused potential and address root causes in order to save costs preventively. After the topic was chosen, participants met for the first time in regional groups to get to know one another and to delve deeper into the selected focus topic.

A successful start
The starting weekend marked the launch of a project that actively integrates the diversity of perspectives from the population into the debate on health policy. The participants showed strong commitment and motivation to negotiate viable solutions to healthcare costs in the months ahead.

The energy and curiosity that shaped the weekend give reason to expect exciting and constructive next steps. The regional groups will now continue their work online before the Citizens’ Assembly reconvenes in mid-February in Neuchâtel for the discussion weekend.

Inputs from:

• Prof. Dr. Daniel Kübler, University of Zurich
• Prof. Dr. Nenad Stojanović, University of Geneva
• Chantal Grandchamp, Unisanté
• Andreas Balthasar, Interface Politics Studies Research & Consulting AG
• Andri Heimann, Centre for Democracy Aarau

Experts (for questions & discussion with the participants)

• Andreas Balthasar (Professor für Gesundheitspolitik, Universität Luzern & Interface)
• Carlo de Pietro (Professor für Gesundheitspolitik, Scuola universitaria professionale della Svizzera italiana SUPSI)
• Chantal Grandchamp (Gesundheitsökonomin, Unisanté & Universität Luzern)
• Christian von Plessen (Arzt & Professor für Gesundheitspolitik, Unisanté)
• David Weisstanner (Assistenzprofessor für Gesundheits- und Sozialpolitik, Universität Luzern)
• Francesca Bosisio (Professorin & Leiterin der Kompetenzgruppe für Management im Gesundheitssystem, Haute École d'Ingénierie et de Gestion du Canton de Vaud HEIGVD)
• Marc Höglinger (Professor und Leiter Versorgungsforschung, Zürcher Hochschule für angewandte Wissenschaft ZHAW)
• Monika Rüegg (Stableiterin, Bundesamt für Gesundheit BAG)
• Stefan Felder (Professor für Gesundheitsökonomie, Universität Basel)
• Valérie d'Acremont (Professorin für globale Gesundheit, Unisanté)

 A project team at the Centre for Democracy Aarau is responsible for the organization and implementation of the 2025 Citizens’ Assembly.

An experienced team from Interface Politikstudien Forschung Beratung AG is responsible for the process design and moderation of the 2025 Citizens’ Assembly.