Health System
The Swiss Health System
is a combination of the public and private sectors.
private health insurance operates in a highly regulated market.
Health providers such as doctors and hospitals belong to the private sector but operate under the State's supervision.
On the other hand, care is entrusted to the cantons, while the law regulates certain aspects at the federal level.
That is why this fragmented and baffling system is among the world's most expensive.
Patients pay Huge Sums
In Switzerland, every citizen is obliged to purchase basic Health System insurance coverage, and every citizen must pay monthly premiums to the health insurance fund of his choice.
Thus, there is strong competition between insurance companies and premiums vary by company and canton. Modest earners benefit from deductibles in an external link provided to them by the canton in which they live.
Health System insurance is required to guarantee anyone, whether sick or old. Contractual freedom is applied only when it comes to special supplementary insurance.
Patients must contribute a minimum cost of 300 francs per year. But they can also choose to pay Franchise higher annual self-contributions - up to 2,500 francs - which reduces the value of their monthly premiums.
This means that a patient who chooses high self-contributions must pay for medical expenses and the price of medicines up to CFAF 2,500 per year. Health System insurance starts to cover its expenses only after the patient has exceeded this threshold.
This is not the end of payments:
- even after exceeding annual self-contribution, the patient also pays 10% for each health service, and 20% of the price of some medicines until the amount reaches 700 francs per year.
- Upon admission to the hospital, the patient pays a contribution of 15 francs per day.
Hospital funding many actors
However, there is a lack of funding and the state must co-finance hospitals External association:
- for the treatment of stable cases in hospitals, the cantons bear 55% of the costs, while Health System insurance cover 45% of them.
- For medical consultations that do not have to stay in the hospital, insurance companies are guaranteed to pay the full costs 100%.
- This is why the cantons shorten the length of hospitalization as much as possible.
- It raises a tendency to The tendency to prefer "treatment without long stay in the hospital" is highly controversial.
- we talk about "bloody discharge" when the patient is returned home very early.
The cantons work with designated hospitals
- the cantons can send their invoices to the primary insurance company and receive public assistance.
- In contrast, these hospitals must secure health care for the entire population (authorization of effectiveness).
- The cantons also establish specialized treatment and medicine centres to ensure that hospitals do not provide all medical services, which allows planning for "hospital treatment as needed", which also contributes to cost-cutting.
Doctors under supervision
Health System insurance (basic insurance) should compensate only effective and economic services External link.
These services are determined by legal rules and lists. In the event of a disagreement, the court makes the final decision.
The prices that doctors and other medical providers are allowed to apply are clearly detailed. They are determined either under collective agreements approved by the State.
Health System insurance and service providers, by law or by a public authority. For medical consultations, Tarmed has an external link pricing.
For hospital-based treatment, SwissDRGP is applied.
In the context of the so-called effectiveness audit, Health System insurance monitors independent doctors.
Any doctor who highlights in the statistics - that is, his prescriptions and costs are higher than those practised by other doctors - must expect action against him.
In this case, he has to pay the costs. This policy aims to avoid over-pricing.
For independent doctors such as family doctors, dermatologists and gynaecologists, this situation causes them significant risks to their work as they can be claimed for millions of francs.
Switzerland depends on foreign countries
The deterrent effect of the risks to health work has a significant impact on the number of people working in the country.
The country faces a particularly serious shortage of family doctors, midwives and nurses.
Thus, Switzerland relies on foreign employees, which is particularly problematic with regard to the level of education.
There are also two factors that reinforce the severe shortage of health workers:
- The "number limit" and the freezing of new clinics.
- In areas such as human medicine, dentistry, veterinary medicine and "keropractic" handcrafts, Swiss universities impose admission restrictions.
The Federal Government's controversial action, "Freezing new medical clinics", first imposed temporary restrictions in 2002 on the registration of new doctors in Switzerland.
The policy aims to reduce the increase in health costs (the higher the intensity of doctors, the higher the cost of health care). The current freeze will expire in 2022.
Parliament and the Government are currently discussing an alternative plan.
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