Health insurance system in Switzerland

The system is fine. I don‘t see an issue. Health care is already expensive enough.

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No I don’t agree.

I also agree with others that it doesn’t make sense to have an obligatory health insurance and let private for profit companies handle it. It was supposed to decrease cost of health care, instead we have this circus with tons of insurance companies having tons of insurance models and tons of people changing insurance every year to have a cheaper insurance or, worse, people ending up for some reason locked with an expensive insurance. My opinion is that there should be one state company managing obligatory medical insurance per canton.

I know that it is a highly politicized topic and its discussion may escalate, but so far the discussion is not more heated than a regular discussion in this forum. I don’t want to heat it up, but I also don’t want to give a silent consent to the current system.

When the time will come, I will vote correspondingly.


It already has been voted on and has been refused (only one structure for mandatory insurance).

But in essence I agree with your statement, the current insurance system is not efficient. Just think about all the marketing CHF every november, plus the amount of CEOs you have to pay.

Hell no. It would be twice as expensive as any state company would be half as efficient.

I beg to differ.

And this is in Purchase Power Adjusted dollars, so Switzerland is the second most expensive country. France, having a similar system but with the mandatory part covered by a state organisation, is much cheaper per head (having its problem too, I won’t disregard that), and complementary private insurance. Still it is the top country of the WHO healtcare ranking.

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If you find a study, I would be interested, unfortunately it seems that in Switzerland there is no proper analysis of the effect of health care policies (which would be actually easier than in other centralised countries since you have cantons with different policies).

Can you provide some evidence for that claim instead of the Ron Swanson’eque libertarian talking point.

Not sure if this is the right metric.

Comparing normalized and purchase power adjusted costs per head and checking that the quality is at least equal is not the right metric for measuring the efficiency of a system ?

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No because the quality is just laughable compared to Switzerland. How long do you need to wait for a MRI appointment in France or Germany? 3 Months. How long in Switzerland? You get one the very next day. It doesn‘t account for such things, or hospital density etc.

I don‘t want to get too political. But there are structural reasons why the EU is doomed and why Switzerland is doing so well. One main reason is the „Staatsquote“. The more the goverment does what private companies could be doing, the more disastrous the longterm effects. France is already at a 60% quota and this can never be fixed, it can only get worse from here on.

Not according to the WHO.
MRI in France took me less than a week for a non urgent check. I guess for urgent checks you will get it right away (I remember I had to wait at my appointment because some accident victim came in).
And it is also a sign of efficiency when you allocate ressources properly. Not every MRI needs to be done in a day.

Where is your source ?

From my experience, the tasks from the state and private are pretty much the same in France and Switzerland. Furthermore in France you see a lot of outsourcing of state infrastructure (Public Private Partnerships, highways, sewer systems operated by private companies like Veolia/Suez etc.) which in Switzerland would be a no go. Quick disclaimer : efficiency never went well there.
Actually the energy system in Switzerland is the least liberalized in Europe and it is holding up pretty good compared to the liberalized one in Germany (and partially in France), partially because of it because utility companies can think long term. On the other hand you see a lack of professionalism, especially in smaller utilities.

And just a remark, if the EU will be doomed, Switzerland will be as well (who do you think Switzerland is doing most business with ?)

EDIT: just to be clear, I am not saying that there are no problems in France, the EU, etc. I just want to be clear that problems are much more complicated than opposing private to public. Do I have the ultimate solution, certainly not. Comparing what other countries and looking what they do differently makes sense.


@Dr.PI : This has started to discuss the policy itself instead of mustachian consequences. People already start to get emotional. Also all this is very far away from the original question.

The thread should probably be locked and the off-topic talk completely purged.

I would not say emotional, but yes it is off-topic. My bad for feeding it and sorry about that.

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For now I make a decision that we can discuss the health insurance policy (current Swiss system vs. state insurance companies or other alternatives). It does have an effect on people’s health and financial standing. Of course as long as the argument remains civilized.

The only practical personal finance optimisation angle I can see on this is to change Canton or become a frontalier.

In Geneva we have one of the highest tax burdens and 19% of the taxes go on Health. I assume it may be lower in other cantons

In Canton of Vaud the premium is a bit cheaper, but not for a lot in comparison to Geneva. However, you can have more help (« subside ») from the state of Vaud than Geneva.

For instance, in Geneva I could have 100 CHF of subside per month when I was a student. In Vaud I could have between 160 CHF and 300 CHF of subside…

This is my current view, I would say that a federal mandatory insurance should be better, but it will not take thé specificities of each Canton.

Private insurance will made their business with their complementary insurance which is already the case.

Yes, this is another aspect of the current system that I find questionable. So, state budget supports premia paid to private insurance companies. So much for the free market!

In a more neutral tone, there are so many regulations for companies involved in obligatory health insurance business that I don’t see how you can have a reasonable competition there.

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The issue is transparency.
Any doctor can bill everyday 150% of his time and nobody can control/object this. This overbiling is further cascaded down to insurances and eventually end-patients.
Personal example: before south Asia tip decided to get some vaccines. I got 4 vaccines, wife got only 2 out of those 4 (same arzthaus albeit different doctor) despite asking same service. Now guess who’s consultation time (no conditions to make it different) and bill was almost 2x higher…

Compulsory health insurers are non-profit. Insurers can only make profits with private insurances on top. See Key points in brief

There are still insurance admin/management costs that may be higher with the current model. I don’t know whether a single insurer model would be cheaper overall.

Other parts of healthcare are profit-oriented, of course, but to a certain degree this is the case everywhere (at least for some pharma). Maybe there are parts where stricter regulations or nationalization would help. I don’t know.