Healthcare in Switzerland: Difference between revisions
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==Compulsory coverage and costs== |
==Compulsory coverage and costs== |
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Swiss are required to purchase basic [[health insurance]], which covers a range of treatments |
Swiss are required to purchase basic [[health insurance]], 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 may not make a profit off this basic insurance, but can on supplemental plans.<ref name="NYtimes">{{cite news |author=Schwartz, Nelson D. |date=October 1, 2009 |title=Swiss health care thrives without public option |
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|newspaper=[[The New York Times]] |page=A1 |url=http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?pagewanted=all}}</ref> |
|newspaper=[[The New York Times]] |page=A1 |url=http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?pagewanted=all}}</ref> |
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Revision as of 00:23, 9 November 2009
Healthcare in Switzerland is regulated by the Federal Health Insurance Act of 1994. 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.
Compulsory coverage and costs
Swiss are required to purchase basic health insurance, 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 may not make a profit off this basic insurance, but can on supplemental plans.[1]
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,
"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."[2]
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.[1]
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 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 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. 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 2009, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland were:[3]
- CHF 322.86 for an adult (age 26– years)
- CHF 258.52 for a young adult (age 19–25 years)
- CHF 76.36 for a child (age 0–18 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 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 Geneva Hospital (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 Act) 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
Statistics
Healthcare costs in Switzerland are 10.8% of GDP. Out-of-pocket healthcare payments average US$1,350.[1]
External links
References
- ^ a b c Schwartz, Nelson D. (October 1, 2009). "Swiss health care thrives without public option". The New York Times. p. A1.
- ^ Reinhardt, Uwe (September 8, 2004). "The Swiss health system: regulated competition without managed care". JAMA. 292 (10): 1227–1231.
- ^ Federal Office of Public Health (September 29, 2009). "Average compulsory basic health insurance premiums by canton for 2009/2010 (with accident insurance)". Federal Office of Public Health.