Swiss citizens' assembly wants sugar tax
In Switzerland, a Citizens' Assembly is in favour of an incentive tax on sugar. The mini-public presented this and five other reform proposals for health promotion and prevention in Bern on 15 April 2025.
The proposals aim to promote health and reduce healthcare costs in the long term, including increasing the existing tax on alcohol and tobacco. The incentive tax should help people to consume less of these products, as higher prices would make them less attractive.
Strengthening health skills
The proposal to strengthen health skills at all stages of life received the most support, as the final report revealed. To this end, more educational programmes and more targeted training for specialists should be created so that people can make informed decisions about nutrition, exercise and mental health.
The Citizens' Assembly also proposed the introduction of a national health law, the creation of a competence centre for health promotion and prevention, the expansion of national information campaigns and a stricter ban on advertising products containing nicotine and alcohol. Four of the measures discussed failed to gain a majority: the extension of basic insurance to include preventive examinations and check-ups, the cancellation of subsidies for alcohol and tobacco production and marketing, an obligation for employers to implement health promotion measures and a label for companies that improve the well-being of their employees.
With its work, the mini-public aims to provide impetus for health policy. It will present its final report to Health Minister Elisabeth Baume-Schneider in Bern on 20 May.
100 participants
The national Citizens' Assembly on the topic of ‘rising healthcare costs’ in Switzerland began on 16 November 2024. 100 randomly selected residents from all over the country took part in the mini-public. The assembly was also a research project on the question of whether and how citizens' assemblies can enrich democratic debates and create space for differentiated discussions.
‘The quality of public debates and democratic dialogue are under pressure. Increasing polarisation and changing media habits are making it more difficult to create a common understanding of key challenges within society and to hold respectful and solution-oriented discussions without ideological blinkers,‘ says the website of the Citizens’ Assembly, which is run by the Universities of Geneva and Zurich.
Counteracting challenges
One of the aims of the ‘Citizens' Assembly 2025’ project is to analyse the extent to which new forms of democracy can counteract these challenges. The focus is on the question of the extent to which mini-publics are suitable for conducting important social debates, promoting understanding of different points of view and thus contributing to a constructive and diverse public debate.
In order to investigate these questions, this research project also analyses the extent to which the results of the citizens‘ assembly contribute to the opinion-forming of people who were not themselves part of the discussions in the assembly.
Healthcare costs are a particularly pressing issue
In April 2024, 22,000 people from all over Switzerland were invited by letter to take part in the Citizens' Assembly. All those invited were able to choose one of five proposed topics. More than 40 per cent of respondents opted for the topic of ‘rising healthcare costs’ - ahead of energy supply, neutrality policy, pension funding and European policy.
The most common reason given by respondents for their choice of topic was the increasing financial burden on households, which is becoming unbearable for a large proportion of the population. Many also saw the Citizens' Assembly as an opportunity to conduct a solution-orientated discussion without the influence of interest groups and to provide new impetus. The extent to which the population is affected also plays an important role:
Discussion about healthcare
In Switzerland, there are discussions about whether a healthcare system that emphasises personal responsibility should be pursued or one that places greater emphasis on solidarity between the sick and the healthy. There are also differing opinions on how competences should be divided between the federal government and the cantons. Another issue is whether the Swiss want a healthcare system that is more cost-orientated or one that focuses more on the quality of services.
‘The Citizens' Assembly will not be able to solve the challenges in the healthcare system conclusively,’ it says on its website. Rather, the mini-public creates a space in which a diverse representation of the population can negotiate these conflicting goals together and contribute to the discussion on possible reforms in the healthcare system.
22,000 people invited
Around 22,000 people over the age of 16, regardless of their citizenship, were randomly selected from the Federal Statistical Office's register and invited in writing to take part in the Citizens' Assembly. 2,004 interested people applied to take part.
When compiling the mini-public from these applications, age, gender, place of residence (city, rural area or something in between as well as the region), highest level of education and political views of the applicants were taken into account. The ‘Voting frequency’ category was used to record how regularly the registered persons take part in elections and referendums and the results were taken into account accordingly when compiling the group. According to these criteria, the Citizens' Assembly is an approximate reflection of the population.
Three weekends, four online meetings
The assembly participants met on three weekends in Zurich, Neuchâtel and Bern. Four online meetings were also held. In the first phase, the 100 participants found out more about the topic of ‘rising healthcare costs’ and decided which focus they wanted to work on. In the second phase, they shared their opinions with each other and discussed with politicians. Now, they prepare the findings and proposals in a final report for the public and politicians.