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I just had a fascinating discussion with my friend who has lived in Switzerland for the past 6 years. On a whim, I asked her how health care worked there, because I had no idea, and assumed it was probably some kind of single-payer, universal system.
I was wrong. It is universal, but not single-payer. A brief overview of how it works:
The government has outlined guidelines of "basic health care" that they then require everyone living in the country to pay for coverage for. They also, and this is *key*, require all insurance companies to give that basic coverage to anyone who pays for it, with one set of premiums (kids and adults have different prices, and you can choose different deductibles, etc.). No variation is allowed for high-risk or pre-existing conditions, etc. Employers are not involved.
All employers *do* provide what they call "accident insurance" (no exemptions for "small" companies, etc., from what I can gather), which, to my understanding, covers, well, accidents. Which is an interesting split, since we tend to lump "anything that'll put me in the hospital" under the same heading, here. If you're unemployed or self-employed, you're required to carry your own accident insurance in addition to health insurance. There are programs to help unemployed and/or others who can't afford it pay their premiums.
From my quick investigation online, for about $90/month, an adult individual can get their basic coverage.
Where it gets interesting for the insurance companies is in providing "extras" above and beyond the mandated "basic" coverage. My friend pays a little per month for the ability to get a private room if she's in the hospital, for instance.
In practice, how it work seems to be better for doctors, as well. Since everyone in the country knows the "basic care" guidelines, there's much less hassle with whether an insurance company will pay for something or not, and there *seems* to be less paperwork, too. My friend says how it's worked for them so far is:
1) they go to their doctor
2) he sends them a bill, which they have 30 days to pay
3) they send a copy of the bill to their insurance company (note they're not filling out forms, just forwarding the bill)
4) The insurance company deposits the amount that was covered (the bill minus any copays/deductible) directly into their bank account. She says this usually happens about 2 weeks after the mail the bill to them.
My understanding is that if you don't get yourself insurance, if+when it's found out that you aren't covered, you get a plan assigned to you, and it may not be the cheapest or the one that fits your needs best, and you get back-billed for it.
I thought that this was a very interesting compromise between what we have now in the US, and a single-payer system. My friend found me this article from a couple year ago that compares the Swiss system to the way things are in Massachusetts:
http://www.heritage.org/Research/HealthCare/wm1037.cfm
I was wrong. It is universal, but not single-payer. A brief overview of how it works:
The government has outlined guidelines of "basic health care" that they then require everyone living in the country to pay for coverage for. They also, and this is *key*, require all insurance companies to give that basic coverage to anyone who pays for it, with one set of premiums (kids and adults have different prices, and you can choose different deductibles, etc.). No variation is allowed for high-risk or pre-existing conditions, etc. Employers are not involved.
All employers *do* provide what they call "accident insurance" (no exemptions for "small" companies, etc., from what I can gather), which, to my understanding, covers, well, accidents. Which is an interesting split, since we tend to lump "anything that'll put me in the hospital" under the same heading, here. If you're unemployed or self-employed, you're required to carry your own accident insurance in addition to health insurance. There are programs to help unemployed and/or others who can't afford it pay their premiums.
From my quick investigation online, for about $90/month, an adult individual can get their basic coverage.
Where it gets interesting for the insurance companies is in providing "extras" above and beyond the mandated "basic" coverage. My friend pays a little per month for the ability to get a private room if she's in the hospital, for instance.
In practice, how it work seems to be better for doctors, as well. Since everyone in the country knows the "basic care" guidelines, there's much less hassle with whether an insurance company will pay for something or not, and there *seems* to be less paperwork, too. My friend says how it's worked for them so far is:
1) they go to their doctor
2) he sends them a bill, which they have 30 days to pay
3) they send a copy of the bill to their insurance company (note they're not filling out forms, just forwarding the bill)
4) The insurance company deposits the amount that was covered (the bill minus any copays/deductible) directly into their bank account. She says this usually happens about 2 weeks after the mail the bill to them.
My understanding is that if you don't get yourself insurance, if+when it's found out that you aren't covered, you get a plan assigned to you, and it may not be the cheapest or the one that fits your needs best, and you get back-billed for it.
I thought that this was a very interesting compromise between what we have now in the US, and a single-payer system. My friend found me this article from a couple year ago that compares the Swiss system to the way things are in Massachusetts:
http://www.heritage.org/Research/HealthCare/wm1037.cfm
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