EXPLAINED: How the Swiss health insurance system is based on solidarity
Much has been said about Switzerland’s compulsory health insurance, most of it pertaining to its high — and continually growing — costs. But there is also another aspect of the scheme many people may not know about.
For many people in Switzerland, the obligatory medical insurance is a sore point.
Premiums will likely rise by an average of 5 percent in the fall, and many people could even see their rates soar by more than 10 percent in 2023 — the sharpest hike in premiums in 20 years.
While there are some ways to save money on a health plan, overall these policies are expensive, and you will hear many people grumble about this cost — even though Swiss healthcare system is known for its excellent level of care.
What you may have not known is that the whole scheme is based on the principle of solidarity, the extent of which is rare in other nations’ health insurance systems.
What exactly does this mean?
Rather than applying an individual approach to healthcare insurance, Switzerland’s system is based on the idea that all insured people form a group.
You can think of this system in terms of a huge pot to which each resident of Switzerland makes a contribution (that is, premium payments), so that in an emergency there are enough resources available to give someone the help they need when they need it.
This kind of ‘one for all’ approach takes precedence over the ‘to each his own’ attitude prevalent in many other countries.
"This means that even those who are in perfect health and never need to see a doctor pay their monthly premiums and thus indirectly provide for those who are ill and need more medical support", according to a report by the WIRE research think tank.
In other words, all the people of the same age group living in the same canton pay the same premium, rather than different rates based on their income or other personal circumstances.
This applies only to the obligatory basic insurance (KVG / LaMal); supplemental insurances have a different rate base.
Under this system, “it is the task of the federal government, cantons, municipalities and health insurance companies to keep this group balanced<2, the report says. "That’s why decisions in the Swiss healthcare system are always taken in the interest of the group as a whole».
How did this system originate?
This principle of solidarity between the healthy and the sick has a long tradition in Switzerland and is even enshrined in the health insurance law.
"In practice, this also results in solidarity between young and old, because young people on average have little need of medical care, but the risk of illness increases with age”, the WIRE report points out.
"Uniform premiums also mean that there is solidarity between men and women, as the latter generally claim more medical benefits due to pregnancies and births and longer life expectancy,” it added.
How does this system compare with health policies in other countries?
According to the report, in an international comparison, the Swiss health system "displays greater solidarity than the US health system”, where anyone who is not insured has to pay for medical treatment out of their own pocket, “which is why many people get into debt”.
Switzerland’s approach is "also more liberal than Germany’s where health insurance premiums depend on a person’s income”.
Likewise, it is also more liberal than the health systems in France and the UK, “which rely more on fiscal contributions from the state”.
As for the question whether those countries’ health system are superior to Switzerland’s, the report notes that “this is doubtful because state healthcare systems financed by taxes are also forced to compensate for dwindling tax revenues, for example by increasing deductibles, which reduced the solidarity between the insured in different income bracket”.