Health Plan Case Study: Switzerland

Kenna Major, Jessica Moore and Megan Schleigh

Description of Nation Summation of Health Health Coverage Access to Care Cost Prevention
Plan
In 2015, Switzerland Switzerland has Health coverage is Easy access to all levels Since the year 2000, The mandatory health
had a population of 8.3 universal healthcare mandatory in of care, without need for reforms to the insurance only covers
million people (Thompson, 2019). Switzerland a referral, has been a key mandatory health select preventative
(Nations Online, n. d.). (Thompson, 2019). characteristic of insurance (MHI) services (Sturny, n. d.).
The Swiss Federal Law Switzerland’s health care system have changed For example, women
Switzerland’s capital on Health Insurance All residents are system (Sturny, n. d.). the financing of who have a family
city is Bern and the controls regulations required to obtain hospitals, strengthened history of breast cancer
largest city is Zürich (Sturney, n. d.). coverage within 3 Residents of Switzerland regulations in the area are allowed one
(Nations Online, n. d.). months of arrival into have access to several of pharmaceuticals and mammogram per year
There are no free state- the country care options (Sturny, n. the control of (Sturny, n. d.).
Spoken languages provided health (Thompson, 2019). d.). epidemics, and
include German, services, however, harmonized regulation Only select vaccines and
French, Italian and private health insurance Insurance policies are In 2015, 38.2 percent of of human resources general health exams are
Rumantsch (Nations is compulsory for not sponsored by outpatient doctors in across the country (De covered (Sturny, n. d.).
Online, n. d.). persons residing in employers and Switzerland were Pietro et al., 2015).
Switzerland (Wikipedia, typically apply only to classified as general Dental care is generally
According to the n. d.) individuals so separate practitioners (Sturny, n. In addition, there has excluded from coverage
World Happiness plans must be obtained d.). been a slow (and not as well (Sturny, n. d.).
Report (2015), the The healthcare system is for dependents (Lenz & always linear) process
Swiss Confederation is geared toward public Staehelin Law Firm, While general towards more Overall, there is a
the happiest nation on health promotion and 2018). practitioners are utilized, centralization of general lack of national
Earth (Nations Online, cost reduction while residents do not have to national health coordination of
n. d.). encouraging individual Non-residents that are register with a general policymaking (De prevention activities
responsibility visiting Switzerland practitioner to pursue Pietro et al., 2015). (Sturny, n. d.). However,
Geographically the (Schwartz, 2014). temporarily must pay other types of care maternity care is fully
country is divided for services up front or (Sturny, n. d.). For In 2013, total health covered (Sturny, n. d.).
between the Alpine Insurance covers claim expenses on any example, residents can expenditure (THE) was
 region of the Swiss medical treatment and coverage they hold in see a specialist, and this well above the
Alps in the South, the hospitalization cost their own country does not require a European Union (EU)
Swiss Plateau with its (Swiss Health, 2019). (Sturny, n. d.). referral from a general average, in particular
rolling hills, plains, Coverage is provided practitioner. in absolute terms but
and large lakes, and The insured person is by competing nonprofit also as a percentage of
the mountainous Jura responsible for a portion insurers supervised by In 2014, there were 289 gross domestic product
in the Northwest of the treatment cost, the Federal Office of hospitals in Switzerland (GDP) (11.5%) (World
(Nations Online, n. d.). through means of Public Health (Sturny, and hospital care Bank, 2015).
annual deductible. n. d.). represented one-third of
The country is a These range from US total health expenditures According to De Pietro
famous tourist $184 to a maximum of (Sturny, n. d.). Residents et al. (2015), when
destination for its ski US $1,534 for an adult also have access to looking at per capita
resorts and hiking and by a charge of 10% mental health options, spending on health,
trails (Nations Online, of the costs over and long-term care, and Switzerland spends US
n. d.). above the excess up to a social support services $ 6,187 (when
stop-loss amount of US (Sturny, n. d.). measured in
Banking and finance $429 (FDHA, 2014). purchasing power
are key industries, and parities, PPP)
Swiss watches and approaching double the
chocolate are world EU average of US
renowned (Nations $3,379; in Europe, only
Online, n. d.). Luxembourg and
Norway spend more.
Resources are collected
mostly through taxes
(32.4% of THE in
2012) and MHI
premiums (30.0% of
THE) but a
considerable part of tax
resources are
subsequently allocated
to the different social
 insurance schemes, in
particular as subsidies
to lower- and lower
middle-income
households for the
purchase of MHI.
MHI premiums have
increased more quickly
than incomes since
2003 (De Pietro et al.,
2015).

Premiums are
community-rated, i.e.
they are the same for
every person enrolled
with a particular
insurance company
within a given region
(meaning a canton or
part of a canton)
independent of gender
or health status (De
Pietro et al., 2015).

Progressively higher
premiums apply to
three different age
classes: (1) from 0 to
less than 19 years; (2)
from 19 to less than 26
years; (3) 26 years and
above (De Pietro et al.,
 2015).

By European
standards, share of out-
of-pocket payments is
extremely high at 26%
of the total health
expenditure (compared
to the EU average of
16%) (Schleiniger,
2014).

Low- and middle-

income households
contribute a greater
share of their income
to the financing of the
health system than
higher-income
households (De Pietro
et al., 2015).

Flawed financial
incentives exist at
different levels of the
health system,
potentially distorting
the allocation to the
allocation of resources
to different providers
(De Pietro et al., 2015).

Furthermore, the
 system remains highly
fragmented as regards
both organization and
planning as well as
health care provision
(De Pietro et al., 2015).

References:

De Pietro, C., Camenzind, P., Sturny, I., Crivelli, L., Edwards-Garavoglia, S., Spranger, A., Wittenbecher, F., & Quentin, W. (2015).

Switzerland: Health system review. Health Systems in Transition, 17(4), 1-288. Retrieved from http://www.euro.who.int/__data

/assets/pdf_file/0010/293689/Switzerland-HiT.pdf

Federal Department of Home Affairs [FDHA]. (2014). The compulsory health insurance in Switzerland: Your questions, our answers.

Retrieved from https://www.bag.admin.ch›bag›broschuere-sie-fragen-wir-antworten-e

International Health Care System Profiles. (n.d.) The Swiss health care system. Retrieved from https://international.commonwealthfu

nd.org/countries/switzerland/

Lenz & Staehelin Law Firm. (2018). Employee health insurance in Switzerland. Retrieved from https://www.lexology.com/library/det

ail.aspx?g=7711f369-657a-4c65-8be2-8e544f5aa095

Schleiniger, R., (2014). Health care cost in Switzerland: Quantity-or price-driven? Health Policy, 117(1):83-89. Retrieved from https:

//www.sciencedirect.com/science/article/abs/pii/S0168851014001031
Schwartz, N. D. (2014). Swiss health care thrives without public option. The New York Times, 10(14). Retrieved from https://www.

nytimes.com/2009/10/01/health/policy/01swiss.html

Sturney, I. (n. d.). The Swiss health care system. Retrieved from https://international.commonwealthfund.org/countries/switzerland/

Swiss Health. (2019). Health care system. Retrieved from https://www.swisshealth.ch/en/ueber-die-schweiz/gesundheitswesen.php

Thompson, G. (2019). How to get health insurance in Switzerland. Retrieved from https://www.academics.com/guide/health-insur

ance-switzerland

Wikipedia. (n. d.). Healthcare in Switzerland. Retrieved from https://en.wikipedia.org/wiki/Healthcare_in_Switzerland

World Bank. (2015). World development indicators database. Retrieved from http://databank.worldbank.org/data/reports.

aspx?source=world-development-indicators