International Health Care Systems

Swiss Healthcare System: Part II

In November, I wrote a post about the Swiss healthcare system. Today, I am giving you a bullet-point summary, offering more detail concerning healthcare in Switzerland. Most of this information comes from Frank and Lamiraud’s working paper.

In the Swiss healthcare system:

  • there is an insurance mandate for all individuals,
  • the government defines a what the insurance benefit will be for all standard health insurers,
  • insurance companies are not allowed to deny coverage to any individual,
  • health insurance and medical procedure prices are made publicly available,
  • in exchange for providing health insurance to consumers, insurance companies receive premiums from consumers and risk-adjustment payments from the government in order that insurance companies are not punished if they decide to insure a sicker population,
  • premiums are community rated, meaning that sick and healthy individuals pay the same price within each age group (the age groupings are 0-18, 19-25, >25 years old).
  • individuals are allowed to purchase supplement insurance as well (there is no regulated benefit for supplemental insurance),
  • there is significant cost sharing in all insurance plans (i.e.: deductibles, 10% coinsurance rates up to an annual ceiling),
  • open enrollment occurs twice per year (June and Ddecember).

In 2003, 49.7% of Swiss individuals choose ordinary deductible health insurance, 42.0% choose higher deductible health insurance, and 8.2% chose insurance with limited choice of provider networks (HMO-style contracts). Since only 8% of individuals are in managed care insurance firms, quality is fairly homogeneous across insurance companies.

Tomorrow, we will discuss other findings of the Frank and Lamiraud working paper.