By Letter to the Editor on March 3, 2020.
Americans like talking about Switzerland’s private health system, where it seems everyone is blissfully buying private insurance and getting great health care. But does Switzerland’s health insurance scheme really run like a fine Swiss watch?
The Swiss government guarantees health care for all of its citizens by regulating the private insurance industry; markedly different from a country like the U.S. where health insurers operate with impunity, resulting in millions of under-insured Americans, many with no health coverage at all.
Not surprisingly, Switzerland has one of the most expensive health-care industries in the world, and the costs keep rising. Swiss people are on the hook for hefty insurance premiums, including up-front, out-of-pocket expenses like high deductibles and co-payments, along with some stiff penalties if you forget to pay. Unlike the U.S., there are no employer-based health plans to soften the blow. Everybody pays the same rates, rich or poor, leaving moderate- to low-income Swiss, in spite of state subsidies, submerged by their insurance costs.
Like other countries that lean on private health insurers, the Swiss have discovered that keeping the lid on spiralling costs, risk selection and profit gets complicated as the insurance marketplace becomes powerful enough to manipulate the system.