“Two patchwork healthcare systems, and two stories of reform”
Published 2 Nov 2017 | swissinfo.ch
by Tony Ganzer and Geraldine Wong Sak Hoi, with input from Veronica DeVore
“In some ways the Swiss health care system before reform looked a lot like the core of the United States’ system, which might be why many eyed Switzerland during the wrangling over the Affordable Care Act. What changes did the Swiss make and what’s been the result?
In this first article in our series looking at health care on both sides of the Atlantic, we answer that question, sent in by one of our readers. He wondered what the Swiss system was like before reform and how it came about.
Why was there a desire for reform?
Before reform, insurance in Switzerland was not compulsory, rather voluntary, paid for in large part by premiums and co-pays. There was federal and cantonal support to help people who needed it, but that made up only 15 percent of financing. Some have argued that one “American” characteristic of this pre-reform system may have been the trend of private insurers snapping up non-profit “mutual” health plans, and refocusing on profits. This led private insurers to compete for “wealthy and healthy clients” because it’s cheaper and more profitable to insure people who are, well, healthier. Regulation existed in this pre-reform Helvetia, but wasn’t too heavy-handed.
It’s important to say that, even with more of an “American-style” system, Switzerland was still covering more than 90% of the population. (Some estimates put it at 96%). Why? Maybe one reason is because the Swiss are more risk averse, and have a strong sense of personal responsibility when it comes to health care.”
