In some ways, Switzerland’s healthcare system is more similar to USA’s than to that of its European neighbours.
The main difference between the Swiss and European health systems is that the latter is public, while the former is private.
It is this private versus nationalised (or, as some say, socialised) aspect that brings Switzerland closer to the USA’s system than to Europe’s.
That is one similarity, but there is another as well.
For instance, both countries’ systems are very costly: at $12,318 per person (10,941 francs at a current exchange rate), the US spends more than any other country in the world on healthcare. Switzerland is in the third position, with $7,179 (6,377 francs) per capita.
So much for the similarities; now let’s look at the main differences.
Employer versus individual
Most US residents who are employed get their health insurance through their company.
In Switzerland, on the other hand, individuals are responsible for purchasing their own policies from one of the dozens of insurance providers.
It is difficult to say which approach is better; however, not having one’s health insurance tied to (and dependent on) a specific employer means that a person won’t be left without a coverage if he or she loses their job.
Mandatory versus optional
While in the United States health insurance is optional, in Switzerland the basic coverage (KVG in German and LaMal in French and Italian) is obligatory.
The consequence of this system (as mentioned above) is that if a US person becomes unemployed, losing the company health plan in the process, and chooses not to purchase their own coverage, he or she is not insured.
While they will be treated in emergencies, they will have to pay the cost of medical care out of their own pocket.
In Switzerland, such a situation won’t happen.
Did you say 'costs'?
Both Switzerland and the US have a high standard of health care, in terms of facilities, technology, and general services.
However, the difference in prices for the same medical treatments is tremendous.
For instance, the average price for a knee replacement surgery in the USA is $35,000 (about 31,000 francs).
The cost of the same procedure in Switzerland varies by cantons and hospitals, but the highest price is 16,900 francs.
Insurance will pay most of this cost, but for people in the US who have no health coverage and are not very wealthy, paying this amount out of pocket often means going into debt.
In fact, statistics show that nearly a quarter of Americans have medical debt — which means they are not able to pay their health bills out of pocket.
Such a situation cannot happen in Switzerland.
Access to health services
This is another area with a wide gap between the two countries.
According to a Harvard University publication, “the current US healthcare system has a cruel tendency to delay or deny high-quality care to those who are most in need of it but can least afford its high cost. This contributes to avoidable healthcare disparities."
Also, the same publication points out that many health insurance companies in the US “restrict expensive medications, tests, and other services by declining coverage until forms are filled out to justify the service to the insurer."
This practice discourages care deemed appropriate by a physician, it added.
In Switzerland, on the other hand, such a scenario is unrealistic.
Even the National Institutes of Health, an official US government body, noted in a report that the Swiss system "offers a high degree of choice and direct access to all levels of care with virtually no waiting times.”
And speaking of waiting time
According to a survey by the Organisation for Economic Cooperation and Development (OECD) on how long patients in various countries typically wait for an appointment, Switzerland has among the shortest waits for medical tests and procedures, as well as for specialist visits.
The survey indicates that it is rare for residents of Switzerland to have to wait many weeks to be seen by a doctor or to schedule a surgery, except in exceptional cases.
“The share of people reporting that they sometimes, rarely or never get an answer from their regular doctor’s office on the same day is low in Switzerland (12 percent) but high in the United States (28 percent),” OECD reported.
Referrals
In the United States, a written referral from a physician is required for a patient to see a specialist.
If a patient sees a specialist without a proper referral, insurance company may refuse to pay the bill.
In Switzerland, you can consult specialists without a referral from your doctor — unless your insurance policy states otherwise.
In principle, KVG / LaMal covers “unreferred” specialist visits, provided the doctor is officially recognised and not an unlicensed, back-alley practitioner.
However, there are exceptions to this rule.
If you don’t have a ‘regular’ plan but a cheaper, more restrictive policy (such as HMO, Telmed, or family doctor model), you are limited in your unreferred specialist visits.
READ ALSO: How to see a specialist doctor in Switzerland without a referral
Other differences
While the Swiss have the world’s highest life expectancy — due in large measure to its efficient and accessible healthcare system — “Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” according to a report from The Commonwealth Fund, an organisation that researches global healthcare issues.
As this OECD chart indicates, life expectancy in the US is even below China’s.
The Commonwealth Fund pointed out that the US health system "can seem designed to discourage people from using services… Affordability remains the top reason why some Americans do not sign up for health coverage, while high out-of-pocket costs lead nearly half of working-age adults to skip or delay getting needed care.”
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