Healthcare in Switzerland

Health Expenditure per capita (in PPP-adjusted US$) among several OECD member nations. Data source: OECD's iLibrary^[1]

Life Expectancy of the total population at birth from 2000 until 2011 in Switzerland compared to several other nations. Data source: OECD's iLibrary^[2]

Statue of Anna Seiler, founder of Bern's hospital in 1354.

Healthcare in Switzerland is universal^[3] and is regulated by the Swiss Federal Law on Health Insurance. Health insurance is compulsory for all persons residing in Switzerland (within three months of taking up residence or being born in the country).^[4][5][6] International civil servants, members of embassies, and their family members are exempted from compulsory health insurance. Requests for exemptions are handled by the respective cantonal authority and have to be addressed to them directly.^[7]

The whole healthcare system is geared toward the general goals of promoting general public health and reducing costs while encouraging individual responsibility.

Health insurance covers the costs of medical treatment and hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done (a) by means of an annual deductible (called the franchise), which ranges from CHF 300 (PPP-adjusted US$ 184) to a maximum of CHF 2,500 (PPP-adjusted $ 1,534) for an adult as chosen by the insured person (premiums are adjusted accordingly) and (b) by a charge of 10% of the costs over and above the excess up to a stop-loss amount of CHF 700 (PPP-adjusted $ 429).

Switzerland has an infant mortality rate of about 3.6 out of 1,000. The general life expectancy in 2013 was for men 80.5 years compared to 84.8 years for women.^[8] These are among the world's best figures.^[9]

Compulsory coverage and costs

Percentage of overweight or obese population in 2010, Data source: OECD's iLibrary, http://stats.oecd.org, retrieved 2013-12-12^[10]

Percentage of obese population in 2010, Data source: OECD's iLibrary, http://stats.oecd.org, retrieved 2013-12-13^[11]

Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Swiss Federal Law on Health Insurance (ger: Krankenversicherungsgesetz (KVG); fre: la loi fédérale sur l’assurance-maladie (LAMal); ita: legge federale sull’assicurazione malattie (LAMal)). It is therefore 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. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.^[3]

The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.^[3]

The universal compulsory coverage provides for treatment in case of illness or accident (unless another accident insurance provides the cover) 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 these ways:

• by means of an annual excess (or deductible, called the franchise), which ranges from CHF 300 (PPP-adjusted US$ 184) to a maximum of CHF 2,500 (PPP-adjusted $ 1,534) for an adult 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 700CHF (PPP-adjusted $ 429) per year.

In case of pregnancy, there is no charge. For hospitalisation, one pays a contribution to room and service costs.

Insurance premiums vary from insurance company to company (health insurance funds; ger: Krankenkassen; fre: caisses-maladie; ita: casse malati), the excess level chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (complementary medicine, routine dental care, half-private or private ward hospitalisation, etc.).

In 2014, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are the following:^[12]

• CHF 396.12 (PPP-adjusted US$ 243) for an adult (age 26+)
• CHF 363.55 (PPP-adjusted $ 223) for a young adult (age 19–25)
• CHF 91.52 (PPP-adjusted $ 56.14) for a child (age 0–18)

Private coverage

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 hospitalisation. This can include complementary medicine, routine dental treatments, half-private or private ward hospitalisation, and others, 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.

Organization

Children's hospital in Basel, Switzerland.

The Swiss healthcare system is a combination of public, subsidised private and totally private systems:

• public: e. g. the University Hospital of Geneva (HUG) with 2,350 beds, 8,300 staff and 50,000 patients per year;
• subsidised private: the home care services to which one may have recourse in case of a difficult pregnancy, after childbirth, illness, accident, handicap or old age;
• totally private: doctors in private practice and in private clinics.

The insured person has full freedom of choice among the recognised 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 caisse-maladie or a private insurance company authorised by the federal law) to which one pays a premium, usually on a monthly basis.

The list of officially-approved insurance companies can be obtained from the cantonal authority.

Hospitals

View of the University Hospital of Lausanne (CHUV) and Lake Léman.

Statistics

Healthcare costs in Switzerland are 11.4% of GDP (2010), comparable to Germany and France (11.6%) and other European countries, but significantly less than in USA (17.6%). Benefits paid out as a percentage of premiums were 90.4% in 2011. Total gross benefits per person and per year in 2011 were CHF 3,171 (PPP-adjusted US$1,945), of which CHF 455 (PPP-adjusted $279) are cost sharing.^[13]

In a sample of 13 developed countries Switzerland was fourth in its population weighted usage of medication in 14 classes in 2009 and seventh in 2013. The drugs studied were selected on the basis that the conditions treated had high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross border comparison of medication use.^[14]

Notes and references

See also

• List of hospitals in Switzerland
• Healthcare in Liechtenstein
• Healthcare in Europe
• Medical schools

External links

• Federal Office of Public Health
• Expat advice on Swiss healthcare
• Health insurance in Switzerland
• Price comparison of health insurances
• Swiss Federal Law on Health Care