Health Care - Regulation or Chaos? Your Choice (Is the Swiss Health Care System Our Future?)
Posted: Monday, March 01, 2010
by e
Dhammabucha Rocksprings Meditation
The Swiss system is consumer driven. Employers are not involved and are therefore free to compete fairly in the global economy. It's mandatory that all Swiss citizens purchase their own health insurance (from 85 competing private insurance companies). Their government sets fixed prices for health care and medications. Citizens are free to see any doctor, and pay less for their health care insurance than Americans. As a ratio per million population, the Swiss have about 50% more physicians, nurses, acute hospital beds, MRI Units, and CT Scanners.
The Swiss are required to purchase basic health insurance, which they can carry with them wherever they go. They are not tied down to an employer. .
Healthcare is the same throughout the country and avoids double standards in healthcare.
Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition.
The insurers are not allowed to earn profits from the mandated benefit package, although they have always been able to profit from the sale of actuarially priced supplementary benefits (mainly superior amenities, i.e. private hospital rooms and dental).
Regulations also restrict the allowable policies and profits that a private insurer may offer.
To compete in the market for compulsory health insurance, a Swiss health insurer must be registered with the Swiss Federal Office of Public Health, which regulates health insurance.
Regulations require a 25-year-old and an 80-year-old individual pay a given insurer the same premium for the same type of policy.
The insured pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, then the government gives the insured a cash subsidy to pay for additional premiums.
The universal compulsory coverage provides for treatment in case of illness or accident and pregnancy. Health insurance covers the costs of medical treatment and hospitalization of the insured. However, the insured person pays part of the cost of treatment.
This is done by means of an annual excess (or deductible, called the franchise), which ranges from CHF 300 (approx. $300) to a maximum of CHF 2,500 (approx. $2500) as chosen by the insured person (premiums are adjusted accordingly); and by a charge of 10% of the costs over and above the excess. This is known as the retention, and is up to a maximum of 700 CHF (approx. $700) per year (excluding medication).
In case of pregnancy there is no charge. For hospitalization, one pays a contribution to room and service costs.
Insurance premiums vary from insurance company to company; the excess level chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (dental care, private ward hospitalization, etc.).
In 2009, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland were:
* CHF 322.86 (approx. $323) for an adult (age 26 + years)
* CHF 258.52 (approx. $260) for a young adult (age 19-25 years)
* CHF 76.36 (approx. $77) for a child (age 018 years)
Private cover: The compulsory insurance can be supplemented by private "complementary" insurance policies that allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalization. This can include dental treatment and private ward hospitalization which are not covered by the compulsory insurance.
As far as the compulsory health insurance is concerned, the insurance companies cannot set any conditions relating to age, sex or state of health for coverage. Although the level of premium can vary from one company to another, they must be identical within the same company for all insured persons of the same age group and region, regardless of sex or state of health. This does not apply to complementary insurance, where premiums are risk-based.
The insured person has full freedom of choice among the recognized healthcare providers competent to treat their condition (in his region) on the understanding that the costs are covered by the insurance up to the level of the official tariff. There is freedom of choice when selecting an insurance company provided it is an officially registered or a private insurance company authorized by the Federal Act to which one pays a premium, usually on a monthly basis.
Healthcare costs in Switzerland are 10.8% of GDP.
In contrast, current estimates put U.S. health care spending at approximately 16% of GDP, second only to East Timor (Timor-Leste) among all United Nations member nations. The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017.
At least 15% of the population in the U.S. is completely uninsured, and a substantial additional portion of the population is "underinsured", or less than fully insured for medical costs they might incur. More money per person is spent on health care in the United States than in any other nation in the world, and a greater percentage of total income in the nation is spent on health care in the U.S. than in any United Nations member state except for East Timor. Despite the fact that not all citizens are covered, the United States has the third highest public healthcare expenditure per capita. A 2001 study in five states found that Medical debt contributed to 62% of all personal bankruptcies. Since then, health costs and the numbers of uninsured and underinsured have increased.
Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, and quality. Many have argued that the system does not deliver equivalent value for the money spent. The US pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy.
Currently the U.S. has a higher infant mortality rate than most of the world's industrialized nations. The USA's life expectancy lags 42nd in the world, after most rich nations, lagging last of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th). The USA's life expectancy is ranked 50th in the world after the European Union (40th). The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study). A 2008 report by the Commonwealth Fund ranked the United States last in the quality of health care among the 19 compared countries.
According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." While a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance. More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care was estimated in a 1997 analysis to be nearly 100,000 per year.
From an article by Julie Rovner:
(Interviewing a Swiss consumer of health care insurance)
. . . . Yet Rappaz looks puzzled when asked about people in the United States who say that it would be intrusive to mandate health insurance.
"I'm not sure that I get you," she says, cocking her head.
When the question is put another way, she laughs. "Oh, I see. That's really an American question. You are so used to having this individualistic way of thinking, and that's why you don't have these social [safety] nets. You still have this pioneer mentality where everyone has to take care of themselves."
That's not how people in Switzerland think about it, she says. That pioneer mentality, "is good for people who have no problems, but there are a bunch of people who ... need a social net.
"I'm really happy to give part of my salary to a solidarity system," she says.
(Some Information and statistics based on Wikipedia)
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Top-level comments on this article: (3 total)Sounds great. Is the corruption in our government and / or our fondness for special interests and lobbyists that is keeping us from doing something that should be so simple?Great article, and an eye-opener! Thanks.America is declining rapidly. A nation historically is judged on its treatment of the underprivileged, when that fails the country fails.I like the Swiss lady's comment: "That's not how people in Switzerland think about it, she says. That pioneer mentality, "is good for people who have no problems, but there are a bunch of people who ... need a social net."
Best......e
We can always compare America to other countries, but as you know it does not help. America is still the best country there is and everyone knows that. If people really hate it here then I ask them to leave. It will help the traffic on my way to Starbucks. I want everyone to really stop looking at the negatives and start putting the energy to really getting involved and changing what it is that they don't like. Corruption, power, greed. These are all excuses for sitting back and watching vs standing up with positive power energy and making changes. We are the people! All of us, we can make a change. I'm sure George Washington's peers felt the same way when things sucked back then. Now a days with technology and maybe a little more brains, we don't needs a war, just some people to step up.Thank you for your comment.
8% of annual income, pre tax or post tax?323 per month per adult & 77 per child that's over 700 monthly= >8400 a year that's alot. I mean how does this affect a family of 3 with a yearly income of 50-60k?Last year my wife and i only made 55k pre tax- thats nothing. What do want, 16% of that (8 * 2 = 16%) ? What are people supposed to do? After mortage (mine is less than rent on a 2/2 ) property insurance, food, car insurance (no payments) school expense( yeah, no aid here) there's nothing left. What should people do? Don't tell me to take public transport, it's awful. Maybe live in box, but we'll have insurance, right?Now dont get me wrong, the situation is ridiculous but i just don't have 16% to spend.I hear you John. I understand what you are going through. Many in this country are facing the same realities. Regarding the Swiss system, 8% of 60,000 is $480.00 for your family. I’m not certain if it is based on gross income or net income.
The problem is, small employers are dropping coverage here because it is too expensive for them, and if you went out in the marketplace right now for individual coverage, it would cost about $500 min each member of your family, for pretty lousy insurance. Employers don’t have to cover their employees, and don’t cover part timers, and are getting away from even covering full timers. If you employer drops you, good luck in getting individual coverage, insurance companies only want perfect, young healthy people. If you had as much as one irregular test from a doctor, even twenty years ago; i.e. high liver count, cholesterol, etc, they will turn you down for pre existing condition. They don’t want you and they don’t have to take you.
Even large employers are absorbing less and less of the cost. Look at WalMart. Also, even if you have insurance, employer provided or individual, and have paid your premiums for a long time with no illnesses, as soon as you, your wife, or your child comes down with something, say leukemia or some other illness that will involve hundreds of thousands of dollars, insurance companies can drop you whenever they feel like it, because there are no laws against that.
They are in it for the profit, they don’t want sick people. They are not your friend, believe me. No guarantees whatsoever, which means that you would lose your house and be in debt the rest of your life.
That wouldn‘t happen in the Swiss system, or any other system in the entire industrialized world, who care about their people, only here where only the bottom line counts, not people. Our system is a travesty and threatens the life savings of every person in the country unless you are very wealthy. Why should people work hard all their lives to try and get ahead if some crooked insurance company, and not even crooked, the biggest are just as prone to cancel you as the fly by nighters?
Many other considerations are involved, but unless you have personnel experience with an insurance company, you have no idea of the stress involved, more than the illness itself. People who have never been sick haven’t a clue, but they will one day, and it will be a big shock. Our system is set up for the wealthy. The middle class person like yourself is going to end up with no insurance and have only the emergency room to rely on. When the wealthy get tired of paying those costs, they will close those down too, Then we can go to our priest or Rabbi!
i compleatly agree. My wife has insurance through her job, none for me so i take extremly good care of myself, what i eat, vitamins, exercise.But your absolutly right, the system is set up for the wealthy. I try not to think about these things, you know , the future, the economy, it's all gonna go to $%&*@$%&, we'll be eating soylent green and you can't change it.Medical costs are just too high. There's nothing you can do there's no hope. the income gap will just contiue to grow. every great civialzation of the past has fallen, america is no different. this system can't function forever. like i said i just try not to think about it, just keep going to school and maybe ekk by in this $%&*@$%& hole.There is a hopelessness growing in America that is not healthy. When people are scared, they don't participate and give up. This is why when the income is not distributed equally, the wealthy think that they are getting away with something, such as low wages and no benefits, which lines the wealthy's pockets. But they forget that they don't have the numbers, only the influence - for now. Historically when the common man and women get fed up, it's like a steamroller going through the country, and guess who gets steamrolled!
Good luck John, fight for what's right. Don't believe the lies.
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