The enigmatic independence of Switzerland is perhaps best demonstrated in the fact that its healthcare system manages to satisfy both free marketers and the statist-socialists in the country. It is a giant social safety net woven by individual responsibility and self-made wealth. Health insurance is almost entirely consumer-based, though there are strict cantonal regulations and some governing federal laws. Coverage is not created, provided or managed by the federal or by cantonal governments, but is sold and managed by private-sector insurance companies to individuals. It is not provided by employers, except in the case of large multinationals and then only partially. There are no free state-provided health services. There is no Medicare. Subsidies are provided in extreme cases (poverty, the infirm) with strict conditions, including the recipient having to pay back those subsidies eventually.
Once voluntary, insurance coverage is now, since 1996, compulsory. Public sector care such as hospitals or the administration of public assistance is paid for by taxes.
A Consumer-Driven Private Insurance Model
To begin with, everyone buys basic and supplementary insurance for himself, the first being mandatory. One purchases it from a choice of just over eighty private insurers that offer competing canton-by-canton plans through which individuals are free to select the insurer they want and may choose any doctor they wish — to ask a doctor if he is “on” a particular plan will be greeted by a confused stare. In addition, with the basic insurance, fees for services are regulated by the state and insurers cannot legally earn profit on those basic benefit packages.
Otherwise, the system of premiums and deductibles is familiar territory to Americans learning about this system. Individuals (not entire families, but each individual family member) pay a premium that varies between cantons and will soon average about $450 a month; on the high-end, this will average about $2500 a month, with children under the age of 18 paying less. The annual deductibles run about these rates, as well. The most someone is allowed to pay for insurance in Switzerland is 8 % of income; anything in excess of that amount may be deducted from taxes.
The basic package is generous by most countries’ standards. The insurance covers the costs of medical treatment and hospitalization, but the insured person has to pay part of the cost of treatment. This is done via an annual deductible also ranging canton-to-canton. Furthermore, a copayment of about $15 a day is required for hospital stays. There are many out-of-pocket costs, but the care is superb. Doctors and hospitals are the very best on the continent. There are no waiting lists, either.
