Healthcare in Switzerland
Encyclopedia
Healthcare in Switzerland is universal
and is regulated by the Federal Health Insurance Act of 1994 (Krankenversicherungsgesetz - KVG). Health insurance
is compulsory for all persons residing in Switzerland
(within three months of taking up residence or being born in the country). International civil servants, members of permanent missions and their family members are exempted from compulsory health insurance. They can, however, apply to join the Swiss health insurance system, within six months of taking up residence in the country.
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 excess
(or deductible
, called the franchise), which ranges from CHF
300 to a maximum of CHF 2,500 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.
Switzerland has an infant mortality rate of about 3.9 out of 1,000. The general life expectancy
for men is 79.4 years compared to 84.2 years for women.
Anna Seiler founded the first hospital in Bern, Switzerland
.
, which covers a range of treatments detailed in the Federal Act. 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.
Regulations also restrict the allowable policies and profits that a private insurer may offer, as noted by healthcare economics scholar Uwe Reinhardt
in a review in JAMA
. Reinhardt writes that,
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 any additional premium.
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 hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done:
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 (Ger.
Krankenkassen, Fr.
caisses-maladie, It.
casse malati), 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 hospitalisation, etc.).
In 2010, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are:
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 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 Act) to which one pays a premium, usually on a monthly basis.
The list of officially-approved insurance companies can be obtained from the canton
al authority.
. Out-of-pocket healthcare payments average US$1,350.
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
and is regulated by the Federal Health Insurance Act of 1994 (Krankenversicherungsgesetz - KVG). Health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
is compulsory for all persons residing in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
(within three months of taking up residence or being born in the country). International civil servants, members of permanent missions and their family members are exempted from compulsory health insurance. They can, however, apply to join the Swiss health insurance system, within six months of taking up residence in the country.
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 excess
Excess
Excess may refer to:* Angle excess, in spherical trigonometry, quantity, used to calculate the area of polygon on a sphere* Excess, in insurance, similar to deductible* Excess, in chemistry, describing any reagent that is not the limiting reagent...
(or deductible
Deductible
In an insurance policy, the deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses. It is normally quoted as a fixed quantity and is a part of most policies covering losses to the policy holder. The deductible must be paid by the insured,...
, called the franchise), which ranges from CHF
Swiss franc
The franc is the currency and legal tender of Switzerland and Liechtenstein; it is also legal tender in the Italian exclave Campione d'Italia. Although not formally legal tender in the German exclave Büsingen , it is in wide daily use there...
300 to a maximum of CHF 2,500 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.
Switzerland has an infant mortality rate of about 3.9 out of 1,000. The general life expectancy
Life expectancy
Life expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience...
for men is 79.4 years compared to 84.2 years for women.
History
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
.
Compulsory coverage and costs
Swiss are required to purchase basic health insuranceHealth insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
, which covers a range of treatments detailed in the Federal Act. 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.
Regulations also restrict the allowable policies and profits that a private insurer may offer, as noted by healthcare economics scholar Uwe Reinhardt
Uwe Reinhardt
Uwe E. Reinhardt is a professor of political economy at Princeton University and holds several positions in the healthcare industry. Reinhardt is a prominent scholar in health care economics and a frequent speaker and author on subjects ranging from the war in Iraq to the future of Medicare.-...
in a review in JAMA
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...
. Reinhardt writes that,
"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 under the 1994
statute. The insurers were 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).
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..Overall, then, the Swiss health system is a variant of the highly
government-regulated social insurance systems of Europe..that rely on
ostensibly private, nonprofit health insurers that also are subject to
uniform fee schedules and myriad government regulations."
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 any additional premium.
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 hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done:
- by means of an annual excessExcessExcess may refer to:* Angle excess, in spherical trigonometry, quantity, used to calculate the area of polygon on a sphere* Excess, in insurance, similar to deductible* Excess, in chemistry, describing any reagent that is not the limiting reagent...
(or deductibleDeductibleIn an insurance policy, the deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses. It is normally quoted as a fixed quantity and is a part of most policies covering losses to the policy holder. The deductible must be paid by the insured,...
, called the franchise), which ranges from CHFSwiss francThe franc is the currency and legal tender of Switzerland and Liechtenstein; it is also legal tender in the Italian exclave Campione d'Italia. Although not formally legal tender in the German exclave Büsingen , it is in wide daily use there...
300 to a maximum of CHF 2,500 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 per year (excluding medication).
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 (Ger.
German language
German is a West Germanic language, related to and classified alongside English and Dutch. With an estimated 90 – 98 million native speakers, German is one of the world's major languages and is the most widely-spoken first language in the European Union....
Krankenkassen, Fr.
French language
French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...
caisses-maladie, It.
Italian language
Italian is a Romance language spoken mainly in Europe: Italy, Switzerland, San Marino, Vatican City, by minorities in Malta, Monaco, Croatia, Slovenia, France, Libya, Eritrea, and Somalia, and by immigrant communities in the Americas and Australia...
casse malati), 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 hospitalisation, etc.).
In 2010, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are:
- CHF 351.05 for an adult (age 26– years)
- CHF 293.85 for a young adult (age 19–25 years)
- CHF 84.03 for a child (age 0–18 years)
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 dental treatment and private ward hospitalisation 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
The Swiss healthcare system is a combination of public, subsidised private and totally private systems:- public: e. g. the University of GenevaUniversity of GenevaThe University of Geneva is a public research university located in Geneva, Switzerland.It was founded in 1559 by John Calvin, as a theological seminary and law school. It remained focused on theology until the 17th century, when it became a center for Enlightenment scholarship. In 1873, it...
Hospital (HUG) with 2,350 beds, 8,300 staff and 50,000 patients per year; - subsidised private: the home careHome careHome Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...
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 Act) to which one pays a premium, usually on a monthly basis.
The list of officially-approved insurance companies can be obtained from the canton
Cantons of Switzerland
The 26 cantons of Switzerland are the member states of the federal state of Switzerland. Each canton was a fully sovereign state with its own borders, army and currency from the Treaty of Westphalia until the establishment of the Swiss federal state in 1848...
al authority.
Statistics
Healthcare costs in Switzerland are 10.8% of GDPGross domestic product
Gross domestic product refers to the market value of all final goods and services produced within a country in a given period. GDP per capita is often considered an indicator of a country's standard of living....
. Out-of-pocket healthcare payments average US$1,350.