One instructive lesson in reforming American healthcare may be to adopt the Swiss model, which is regulated by the Federal Health Insurance Act of 1994, and made health insurance compulsory for all residents. Previously, Switzerland had an American-style system, which became a national outrage when studies revealed that five percent of the population lacked any coverage.
Today, 99.5 percent of the Swiss people are insured with coverage funded by the individual who generally pays the full cost of premiums. Government subsidies are provided for the poor, with approximately one-third of all Swiss citizens receiving the subsidy. “These subsidies are designed to prevent any individual from having to pay more than 10 percent of income on insurance.” All insurance is private and physician compensation is negotiated between the insurance companies and doctors on a canton-by-canton basis.
The down side is that Swiss healthcare is expensive, with costs rising 10 to 20 percent every year. Monthly health insurance costs for a family with one child can amount to CHF 1,000 ($944). Deductibles can be adjusted, though, from CHF 300 ($283) to CHF 2,500 ($2,360). The state will help with the costs if income (married/without children) is around CHF 30,000 ($28,920) or (married/with children) around CHF 60,000 ($56,581). In those circumstances, the government pays half the cost of insurance. Options are available that will lower the monthly costs, similar to the American HMO model. In these plans, the person must consult with their physician prior to seeing a specialist.
“The mix that Switzerland represents between private enterprise and general state regulations that make healthcare accessible to everyone is really an interesting example for the United States,” said Felix Gutzwiller, a Radical Party senator and head of Zurich University’s department of public health. In Switzerland, administrative costs consume on average five percent of health insurance revenue. In the United States, it’s closer to 20 percent.
In terms of satisfaction, the World Health Organization puts Switzerland in 20th place in its rankings of healthcare systems around the world. The United States ranks 37th, sandwiched between Costa Rica and Slovenia.
