Swiss Health Care – Just The Facts

 “What are the facts? Again and again and again — what are the facts? Shun wishful thinking, ignore divine revelation, forget what “the stars foretell,” avoid opinion, care not what the neighbors think, never mind the unguessable “verdict of history” — what are the facts, and to how many decimal places? You pilot always into an unknown future; facts are your single clue. Get the facts!”  – Robert Heinlein, The Notebooks of Lazarus Long, from Time Enough for Love

Who knew that Swiss folks were notorious for so much more than being extremely punctual chocolate-loving yodelers?

Turns out that the Swiss healthcare system is an almost utopian mix of public support and private insurance.  There’s enough free market notions to set Tea Party wing-nut ideologues panting with excitement – insurance is tied to the individual, for example, and not to the employer.  On the other hand, the government coerces mandates a minimum level of individual insurance, the system is wholly funded by taxes, and coverage is universal.  As such, it gladdens the heart of  many a fascist liberal pinko.

Not a Swiss Doctor ...

Not a Swiss Doctor …

The numbers tell the story, don’t they?

Just the Facts

A life expectancy of 80.5 years for men and 84.7 years for women (best in the world) and  infant mortality rate of 3.6 per 1,000 (8 per 1,000 in the U.S.).  Healthcare costs in Switzerland are 11.4% of Gross Domestic Product, GDP.  Compares favorably with Germany and France at 11.6%, and certainly with the U.S. sitting at 17.6% in 2010.

And who would quibble with those facts, reminded that they are Wikipedia-strong.  Carved in virtual stone, as it were.  Some more:

In 2014, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are the following:

  • CHF 396.12 (PPP-adjusted US$ 243) for an adult (age 26+)
  • CHF 363.55 (PPP-adjusted $ 223) for a young adult (age 19–25)
  • CHF 91.52 (PPP-adjusted $ 56.14) for a child (age 0–18)

This is the bare minimum, mind you.  Additional bunion-removing insurance adds just a smidge more.

So, if you gotta get sick, the facts tell us that Switzerland is just a groovy place in to be ill.  Even that bastion of the free market, Forbes magazine, seems to think so.  Problem is,  it works swell only if you’re Swiss and live in Switzerland.

Just as the Danes are satisfied with their own particular mix of private and public (90% approval), the Swedes think their health care system is just lagom  (tack så mycket), while the Germans will keep theirs and with ruthless pragmatism charge everyone else who is not German.  Swedes are not amused by this Teutonic trickery:

But the recent case of Johanna, a Swedish woman residing in Germany who was left with 130,000 kronor ($18,500) in medical bills after she gave birth prematurely while visiting family in Sweden, shows that the system doesn’t always work, especially for mobile Europeans who divide their time between more than one EU country.

As for the Canadians, they don’t think much of the Europeans. They got their own set of facts:

  • 7.61 death rate in Canada, versus 10.25 in Denmark, and even lower than the Brits, who are dropping off at the equally alarming rate of 10.05.
  • 9.7% of GDP spent on healthcare. Suck it, France!
  • 17% percentage of health care dollars spent on bureaucracy administration, versus 31% in the United Status.  Take that, Yanks!

Canadians like their system just fine. Keep yer mitts offa it.

Not happy with healtcare

Not happy with healthcare

In the land of the free and home of the brave, no one seems to be happy.  This porridge is too hot, and this one’s too cold.  But, when medical insurance federal laws are written by insurance company insiders themselves, that’s the bed you get to lie in (“Political Entrepreneurship, or:  How I Learned to Stop Worrying and Love Obamacare, Part II“)

Health Care:  an Arm and a Leg

It sure costs a bundle for healthcare in the U.S. Why exactly?

The arcane mysteries of Google’s algorythm provides some clues:

Query: why does America spend so much on healthcare?

Answer #1:  Why Does the U.S. Overspend on Health Care? One Simple Reason, by Daily Finance.

There may have been a champagne bottle or two popped at Daily Finance when this page hit #1 on Google for this keyphrase.  In any event, sure glad it’s only ONE simple reason.  Broad hint:  we’re living longer, and end-of-life care costs heaps and bunches.

Answer #2:  ”Why Does U.S. Health Care Cost So Much? The Hidden-in-plain-sight Answer“   This article is a little, check that, a LOT more scholarly, because it’s written by an actual, white-coat-and-stethoscope doctor, but with an obviously different conclusion.

The reason that health care costs 17% of GDP, is that we don’t live in Switzerland:

The explanation is, in fact, clear, but is seldom pointed out, even by critics such as ourselves. It is a consequence of the fact that the United States is not only the only country that finances health care through market-driven private insurance, but we are also the only country that allows prices to be set through the private marketplace.

Maybe Americans should just eat more chocolate and Swiss Cheese.

 

 

That’s it for today, thanks for dropping in and visiting for a spell. If reading about health care is your thing, don’t neglect Part 1 of the Obamacare series. Otherwise, a simple subscription by Email may alert to another article on matters health-related. And if you’d like to play nurse and doctor with a significant other, recommend a stethoscope and other accoutrements. See right.

All photo credit for the Shona Witch Doctor goes to Hans Hillewaert

Second photo is of New Orleans Flint Goodrich Hospital in 1941, from the Works Progress Adminstration archives.
This post was featured in the Carnival of Wealth, Innumeracy Division, over at Control Your Cash.  And, prominently dumped on over at Financial Uproar (much obliged).

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Comments

  1. From the beginning of your post I was going to mention that France may have a higher GDP % dedicated to healthcare because Switzerland is more compact and dense while France needs to provide doctors and hospitals in remote countryside, which happens to have lots of old people who need doctors. But the same should apply to Canada yet they spend less.
    Regarding the EU, you need to get a free European health card before you travel or move to another EU country and present it when admitted at the hospital, you will be charged what you would have been at home, and your home social security will compensate the foreign one. Even that woman who gave birth can claim expenses when she gets back. I even got Guatemalan dental treatment reimbursed by social security!
    Pauline recently posted..How to stay inspired as a freelance writer

    • Hi Pauline / Glad you pointed out the EU story, as the link to the Swedish site was busted. As it stands, there’s a wrinkle to the whole reimbursement deal:

      But because she was pregnant when she moved to Germany, health authorities there said she had a “pre-existing condition” and thus wasn’t covered by Germany’s public health insurance system.

      Aside from that, I’d probably wager that the cost sharing scheme probably works OK.

      And I must say, the phrase “Guatemalan dental treatment” sounds a little frightening just taken on its own. :-)

  2. My wife and I (US citizens) moved to Canada in 2009 in part because of the availability of affordable, guaranteed health insurance. The choice paid off for us big time last year when I had major health challenges. We’re not hankering to move back to the U.S., but it’s not an option until we’re eligible for Medicare.

    The Swiss model sounds intriguing; I’ll have to read up on it. Every system can of course be improved, and perhaps Canada could borrow a few good ideas from the Swiss.

    As for the U.S., no real change is possible until the electorate decides–and elect politicians who agree–that profit-making capitalism is not the best model for health insurance and health care. There now I’ve started a fight. :-)
    Kurt @ Money Counselor recently posted..E*Trade Refunds Transfer Fees!

    • Hey Kurt, sounds like good planning paid off. Profit-making capitalism gets its share of thrown brickbats, especially when it comes to healthcare.

      Maybe it’s time to go back to what’s worked just fine in the past, voluntary association and mutual assistance.

  3. Heh! I’d say “ain’t it the truth” but the whole lash-up just leaves one’s head spinning.

    Along those lines, the other day I met a new client, an American banker involved in development in an Asian country — very interesting fellow. He spends part of the year in the US and part in this other country. Six or eight years ago he had a cancer treated — put it in remission, but he has to go back to the Mayo every so often for some kind of test. Recently he went on Medicare; the Mayo will not accept Medicare assignment, which means not that they won’t take what Medicare pays but that they don’t accept direct payment from Medicare, the result being that the patient gets a very clear view of what’s being billed and paid.

    These tests were costing his old insurance company $1800 a hit. Comes Medicare, he shufflers through the volumes of paper they send and sees that the Mayo received $450 for the most recent test.

    He figure the bill didn’t get paid, so he calls the Mayo’s billing department and asks what he owes. “Nothing,” he’s told.”Medicare paid for it.”

    “But,” says he, “You were charging my insurance $1800. How come it’s now $450?”

    “That’s the correct amount,” sez the billing clerk. “That’s what we agreed to charge Medicare for this procedure.”

    uh huh…. Is there any question why insurance premiums are so outrageous in this country?
    Funny about Money recently posted..Cash vs. Credit Redux…already!

    • It is to head-spin, to be sure.

      That’s a good story, FaM. The takeaway depends on what kind of ears one hears that with, and what the facts are perceived to be.

      Here’s a fact: this banker-man was not paying for the test directly. In both instances, there’s an intermediary. It’s not the “free market” versus “socialized”, it’s just “bigness”.

      This week I had a free-market example where an intermediary added little value, and “bigness” got in the way. In my day job, I was trying to buy, let’s say apples (it was actually an obscure industrial product) from Acme Apples Inc. I was providing some feedback to the Acme sales guy, and told him how damn difficult it was to buy apples from them direct. We had to buy through a distributor in our state. Once again, for the nth time, this company was informed that their distributor sucked. Indifferent customer service, higher costs, longer delivery, and therefore, little additional value in our minds. We could buy “apples” from Dutch or Mexican suppliers, and were in fact doing so. We are also thinking of doing a global blanket deal for “apples” for the coming year, on behalf of all our global affiliates. We would invite several large apple suppliers to bid. But probably not Acme Apples, because their distributor sucked. All this was delivered to the Acme sales guy, who listened attentively, and promised to relay the message on up the chain of command back to HQ in I-forget-what-large-city. But nothing would be done. The sales guy was potentially impacted by our decisions, but seemingly powerless to act. This company is just too big to react quickly to customer feedback.

      Some might say that if Mayo had to compete directly with MD Anderson or Cedars Sinai for this cancer-ridden banker, costs would be more transparent. Maybe, I don’t know.

      Others might also say that if there were one single large customer setting prices, things would also be more transparent. Again, maybe.

      Bigness. When systems are scaled up to the point of absurd complexity, they cease to work effectively.

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  1. […] a hearty welcome back, after what I’m assuming was a six month bender. He took a look at heath care systems around the world, and tried to figure out why citizens of Switzerland have better care than […]

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