Cost of Health Insurance


#1

Only the health insurance is that expensive, but that’s a government sanctioned robbery and not a free choice. Everything else should be much much cheaper unless you’re real swiss and insure again every event you can imagine


10y fixed vs libor
#2

3 health insurances, 2 cars, life insurance, household, travel and liability. It all adds up. I’ll keep life insurance until my investments reach 1/2 of the mortgage amount. The household needs some serious trimming, as I’m indeed over insured, although as of now my claims and premiums paid pretty much even out.


#3

That’s an interesting topic for me. Maybe even worth its separate thread. Why do you say that health insurance is a robbery? Do you suggest it should be voluntary? Then what would we do with the people who didn’t get insured and got sick? Treat them and send them the bill? Let them die?

BTW So in Switzerland the cheapest all-inclusive insurance costs like 400 CHF per month, and that’s regardless of your income. For comparison, in Poland it costs 9% of your salary (*after ZUS). So if your salary is 5000 CHF (that’s a lot), you will pay as much as in Switzerland for a really crappy health insurance!

Even better, if you’re not employed but still wanna be insured, you will pay based on average Polish salary (currently 1300 CHF). But after 10 years it goes to 200%! 250 CHF for an unemployed person. That’s why in Poland people seek fake employment for minimal wage, just to be insured.

What I hate in Swiss healthcare system is that you don’t know the prices of procedures up front. You can’t compare and take the cheapest option. They will send you the bill two months after your visit. In Poland you can check the prices on the website.


#4

Yes.

If it was voluntary, it would be moral, more efficient and cheaper, ceteris paribus.

Polish health care is a full case of the inefficiency and corrupting force of the socialistic pathology.

In Poland registered unemployed is insured.

That’s true. It’s a big source of inefficiency in the Swiss system. It’s similar to US in this manner and leads to rising prices.


#5

@Julianek. :slight_smile:


#6

For us mustachians and for other wealthy/healthy people, the abolition of compulsory health insurance would be beneficial, because the free market rate would be lower. But this leads to a lot of risks. Like, if an uninsured person would get cancer, nobody would insure them at that point. Without any savings, this person would be forced to die. Or if you would treat this person and charge them with the bill, the cost could be a few hundred thousand francs. How is a person without savings going to repay this? And if the treatment fails and they die, who pays the bill?

The insurance company could enforce genetical tests to evaluate the risk of you getting sick and base the premiums on that. This could lead to some people having to pay a higher premium from their birth. These are some serious moral dilemmas.

You’re right, I forgot about that. But I’m talking about a retired mustachian, for example. Or a stay at home wife/husband. If you register as unemployed, you are looking for a job, and you need to fulfil some requirements, right? I don’t think you can stay unemployed for 10 years, can you?


#7

If an unisured person get sick and die, we all have to pay with taxes or some hidden tax in the krankenkasse costs. If an uninsured person get sick, he will go to an ER. That again will cost more than normal checkups (see USA).
The system here is ok-ish. Full of inefficiencies but somehow it works (for now).
The problem are people that don’t use their options (go to a pharmacy first), they don’t trust their doctor (if my doctor does not prescribe me a pill for my sore, he’s probably an idiot). The doctor are a problem as well (let’s buy the new xray machine available at any price. The patients will pay it. Who cares that I can share it with the other 1000 doctors in the village). The trasparency is also a problem, no one knows what happens. In the Philippines I’ve seen an efficient way to cut costs. If your doctor ask you to get a blood exam, he’ll tell you which exam to do and you go to a laboratory to do it. You will see how much it will cost, the doctor save time and the laboratories will have to fight between eachothers for clients.

I could go down the chain of people involved in the health care system and point to every single problem there. There are problems at all levels. The one where we concentrate is unfortunately theoretically not the problem. The Krankenkassen just move money around they are not the problem. They are the problem if we start talking about Hospitals owned by them, “frenemy” relations with doctors and hospitals (“we don’t sue us since it’s not our money at the end of the day”) and so on.

Compulsory health care should not be removed. You can remove part of it, sure.

One “funny” question, just to throw gas on fire. Is there a difference between health insurance between men and women like for Car insurances? :smile:


10y fixed vs libor
#8

Well have you been at a swiss doctor? The system is expensive and inefficient despite you paying many thousands a year just for basic coverage. Some 10-20 minutes of doctor time will set you back a couple hundred franks and you’ll pay many times over a free market price for medicines and expendables, and you ain’t gonna wanna hear how much an ambulance ride or a hospital stay would cost. There’s no incentives to cut costs and be efficient, doctors and hospitals are basically free to charge as much as they can get away with. It’s not as bad as in US but the system’s converging into that state. ma0’ right though it’s mostly not the insurers fault, they’re at the mercy of doctors/hospitals and ultimately the government is responsible and has to to sort out this mess… As a small time investor however there’s nothing you can do about it, you probably don’t even have a right to vote so just swim along…

It is possible to have an efficient and accessible universal health care system - look at UK.


#9

Thanks for the clarification, @hedgehog. I agree that the costs of medical procedures here in Switzerland are very high, but my question was more related to the fact, that if we abolish compulsory insurance, it will open up a bunch of new problems.

A follow-up question: when we reach FIRE, it would be nice to have a health insurance that’s recognized worldwide. Do you know if such insurances exist, did any of you study the topic? For example, if I retire in Poland, what alternative do I have to getting insured at NFZ? (national healthcare fund). And I’m talking about the same coverage of the inurance. Not only small visits, but also surgeries etc.


#10

www.swisscare.com comes to mind as a general health insurance. It might get expensive, expecially if you include USA.

An interesting question for FIRE is how much could the insurance cost in 10-20-30 years. Should we axpect it to double?

On a side note, Health insurance is not only premium + 700chf max. You should add the hidden costs. For example Hospital’s meals (or something like that, not sure how they are called. It’s not covered). Ambulance transportations can sometimes not be counted. For some rare illness you might have to pay more as well.


#11

Thanks! I checked your link and it’s a nice comparison website. There are many insurance companies. I put some input criteria and it displayed me rates between 100 and 200 USD with an annual max cost of 500k-1000k. That’s not bad. I wonder how it goes when you get older. Can they just say: hey, we don’t want to insure you any more, or you pay MUCH more now. So many questions…


#12

ooh. They’ve changed. It used to be a (re)insurance company. It’s a secret gem for students coming from abroad. Imagine paying 60chf per month (with 1000chf deductible) instead of the usual 250…


#13

I agree that the current health insurance system is a robbery.

I still think that a mandatory health insurance is a good thing but not in the current state. First, for me, it should be state-managed insurance (but we already voted on that and it failed :cry:). But the main problem is that it already insure too many things. The basic health insurance should not insure about getting a cold and going to the doctor for this. This kind of thing (and the people who exploit this) is what is driving up the prices. For me, mandatory health insurance should only cover accidents and serious illness. A cold or a strained ankle should never be insured by the base health insurance.


#14

I don’t agree. What we miss is more free market, not less.

Agree. But in a way this should not be a problem in Switzerland. The people with 2500 CHF franchise will avoid going to doctor if it’s not serious. I know I do it. But somehow this 20 min visit costs 120-180 CHF.


#15

I agree with that and here’s a good article explaining why we need more free market (and another one).

Yes, I think 2500 CHF franchise is a brilliant thing. Otherwise, the premiums would be even higher, I wish I could push it even higher than that limit.

In any case, I think the Swiss system is the best in Europe, but it still sucks compared to normal, honest, transparent free-market services.


#16

That would be disaster. It would push taxes unbelievably high and Switzerland would lose its competitiveness vis-a-vis EU countries.

Yes, I agree. I think the default policy should be to maximise the franchise, and the current limit of 2500 is way too low. In state-founded insurance, you’d have every single bit financed by the state, because people would vote for that - people are dumb and believe that when the state pays for something, then it’s free and somebody else covers the cost, so they ask for more and more, and more.


#17

In Poland people often get employed on 1/16 work time equivalent to get insurance. Maybe in Switzerland on FIRE, it’s enough to open a consulting business and pay your own insurance?


#18

Please don’t. Rather look at Singapore, they have the best efficiency per $ spend and they’re usually best in health-care rankings.


#19

I think it would be mostly beneficial to the poor, because the health insurance would got much cheaper and it wouldn’t be such a problem for most poor to get it (as the problem currently exists in US for example). Voluntary uninsured person takes risk and he has to face the consequences of their recklessness - just like people who do base-jumping or any other risky activity, they take the risk, they need to face the consequences. Involuntary uninsured person should get help from charity and (as a last resort) commune.

That would increase efficiency. It would get cheaper for most of the people, except those who have potentially higher risk of getting sick. That’s they whole point of insurance of any risk, not only health care risk. Alternatively, you could go to insurer that doesn’t do the tests, but charge you more - you’d have free choice.


#20

If we start to talk about genetic tests we could also start blocking the frontiers and not allowin certain people in switzerland or maybe stop helping disabled/old people and so on… I think it’s bullshit.

If you want to spy on people to understand unhealthy habits (smoking ?) you might feel going in the right way, but what happens if they start to check if you eat too much fat and not enough veggies? Or worse they believe you must eat a certain amout of sugar per day?

I think there isn’t an easy solution. Somebody is trying to find it, see Singapore. Right now in Singapore if you go early to a Mc Donald you might find old people (>70) serving you since they have to work again in order to be accepted in the social system. They are adapting to the new system.

Maybe there should be different level of health insurance:
Level 1: You might die: all covered from the most basic insurance: heart attacks, and so on. Also some regular checkup should be covered (right now they are not!)
Level 2. Healing after level 1 problems. This is not compulsory and can be made of several comfort levels
Level 3. Other problems?
Level 4. Omeopatic, chinese and so on
Physiotherapy? I have no idea where to put it, but so many people use it. It should be paid by your employer’s insurance though. Or something else if it’s your fault.
All this might be a dumb idea I had 2 minutes ago. I am not sure. :slight_smile:

The only thing I’m sure is that there are many many people that exploit the system. And I’m not talking about people, I’m talking about doctors & co. When you have a physiotherapy that costs 1000chf per session, you start to think that there are some nasty stuff going on.

Anyway, I’d like to remind to all of you that there are other people that have crazier wages. Think about lawyers or worse notary. They ask you 2k++ just to sign a paper that say that you are really you.

Also let’s not talk about dentists, that don’t consider themselves doctors (try to get an insurance for your teeth…)

end dumb rant.