The Swiss Healthcare System: A Model For US Health Care Reform

Swiss Health Model Gains Admirers
ZURICH — Like every other
the Swiss system involves some
system is different from virtu-
country in Europe, Switzerland
trade-offs that U.S. consumers,
ally every other country in the
guarantees health care for all its
insurers and health care provid-
world,” said Regina Herzlinger,
citizens. But the system here does
ers might find hard to swallow.
a Harvard Business School pro-
not remotely resemble the model
The Swiss government care-
fessor who has studied the Swiss
of socialized medicine often cited
fully regulates drug prices and
approach.
by opponents of universal cover-
fees for lab tests and medical
“What I like about it is that
age in the United States.
devices. It also requires patients
it’s got universal coverage, it’s
Swiss private insurers are re-
to share some costs — at a higher
customer driven, and there are
quired to offer coverage to all citi-
level than in the United States —
no intermediaries shopping on
zens, regardless of age or medi-
so they have an incentive to avoid
people’s behalf,” she added. “And
cal history. And those people, in
unnecessary treatments. And
there’s no waiting lists or ration-
turn, are obligated to buy health
some doctors grumble that cost
ing like in the U.K. or Canada.”
insurance.
controls are making it harder
Since being made mandatory
That is why many academ-
these days for a physician to
in 1996, the Swiss system has be-
ics who have studied the Swiss
make a franc.
come a popular model for experts
health care system have pointed
The Swiss government also
seeking alternatives to govern-
to this nation of about 7.5 million
provides direct cash subsidies to
ment-run health care. The Swiss
as a model that delivers much of
people if health insurance equals
approach is also popular with pa-
what Washington is aiming to ac-
more than 8 percent of personal
tients like Frieda Burgstaller, 72,
complish — without the conten-
income, and about 35 to 40 percent
who says she likes the access that
tious option of a government-run
of households get some form of
the private system provides. “If
insurance plan.
subsidy. In some cases, employ-
the doctor says it has to be done,
By many measures, the Swiss
ers contribute part of the insur-
it’s done,” said Burgstaller. “You
are healthier than Americans,
ance premium, but, unlike in the
don’t wait. And it’s covered.”
and surveys indicate that Swiss
United States, they do not receive
Still, along with lower costs and
people are generally happy with
a tax break for it. And unlike the
the freedom to choose doctors
their medical system. Switzer-
United States, where the Medi-
come bigger bills for individual
land, moreover, provides high
care program costs taxpayers
patients. On average, out-of-pock-
quality care at costs well below
about $500 billion a year, there is
et payments come to $1,350 annu-
what the United States spends
no special break here for the el-
ally. That is well above the $890
per person.
derly.
average for the United States.
And yet, as a potential model,
“Switzerland’s health care
NELSON D. SCHWARTZ