Switzerland invites you. A Public-Private Health Plan? Experiences of the Swiss Universal Health Coverage - Privately Managed

On Friday, November 6, the Embassy of Switzerland, Representative Tammy Baldwin (D-Wisconsin) and AARP hosted a discussion regarding the Swiss health care system with Dr. Thomas Zeltner, Secretary of State for Health of Switzerland, who has held office for the last 19 years. Dr. Zeltner chaired the discussion as health care policy leaders addressed the solutions offered by the Swiss universal health care system, which is supported by private competition and is state regulated.

Dr. Zeltner was joined by Regina Herzlinger, Professor at Harvard Business School, Harvard University; Sarah Thomas, Director of the Public Policy Institute (PPI) Health Team, AARP; and Brian Biles, MD, MPH, Professor in the Department of Health Policy at George Washington University.

Dr. Zeltner presented an overview of the Swiss health care system from access to coverage to costs. Swiss citizens are legally required to have private basic health coverage. Swiss insurance companies offer a set mandatory plan on a not-for-profit basis but are permitted to earn a profit on supplemental plans. He reminded the audience that citizens have free choice of physicians; few health inequalities; and, high customer satisfaction. Costs being a common challenge for all countries, Dr. Zeltner said, "The Swiss Federal and Cantonal governments finance 22% of health care costs, while the U.S. finances 46%. We have found success in the combination of private competition with state regulation." Cost control measures include financial reforms; electronic health records; managed care; and the promotion of preventative health care.

Regina Herzlinger, a health care policy expert, who has done comparative studies with the Swiss health system said, "The Swiss health insurance system shows that we can provide universal coverage at a price people are willing to pay without a public plan, long waiting lists, and rationing of care to the sick." She also revealed that the Swiss insurance administrative costs are between 4% to 9.6%.

Sarah Thomas stated that the AARP assessed several foreign health schemes. The Swiss model included two major issues for elderly people: universal coverage and no age-discrimination. Brian Biles noted that several important elements of the Swiss health care system are to be found in the draft for a new American Health Bill. Individual health insurance plans should become possible, a certain competition between health insurance companies should improve quality and lower costs (increases). Success has been noted in Switzerland by the fact that there are virtually no uninsured residents. In addition, each canton (state) has a safety net in place for those with a low income. The Swiss combination of a public mandate privately managed has been successful in the delivery of effective and timely health care, prevention service and long-term care.

This event was part of the U.S.-wide program ThinkSwiss—Brainstorm the Future. As a leading country in science, research and technology, Switzerland is working with its American counterparts to address key global topics. For more information, please visit  ThinkSwiss.org.