Healthcare in Switzerland: World’s Best System?

The Swiss are healthy. This, we can say. Many statistics say so; among them, one tells us that Switzerland has one of the highest life expectancies in the world at almost 84 years which is four years above the OECD average age of 80 years.

Higher life expectancy is usually associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors). Since Switzerland checks all the boxes for the latter standards, it’s no wonder the Swiss healthcare system is good. In addition, Switzerland’s efficient healthcare communication networks, facilitating seamless coordination between healthcare providers and patients, contribute significantly to its acclaimed healthcare system

How is your health?

As OECD reports, when the Swiss were asked “How is your health in general?” almost 78% of people in Switzerland reported being in good health, more than the average of 69%.

Swiss Healthcare Fast Facts

Insurance is compulsory

Understanding the whole health insurance system in Switzerland is not necessary, but what is crucial is to know that health insurance coverage is mandatory for any person residing in Switzerland for more than three months. If you work in Switzerland, however, you must get insured immediately.

It’s governed by law

This basic universal coverage of health insurance is governed by a federal law called LAMal and comprises the same benefits for all insurers, but the monthly premiums vary a lot according to insurance model and age. This law aims to ensure high-quality health care for everyone, subsidise those who cannot afford it and control costs.

What basic insurance covers

The terms of basic coverage are set by law, therefore basic insurance always includes medical treatment in the event of illness and accident, the most common ailments (including diabetes), pre-existing conditions, most inpatient and outpatient treatment, as well as hospitalization in the general ward of a public hospital in one’s canton of residence.

In most cases, home visits by doctors, nurses, or specialists are also covered by insurance. Additionally, coverage extends to prescribed services, like physiotherapy, nursing care, occupational therapy, speech therapy, and nutritional counseling. As for the dentist, the public health system doesn’t usually extend to them.

You are free to choose your own insurance company

In Switzerland, there are more than 60 government-approved non-profit insurance providers that provide the basic mandatory coverage set by the government. Insurance premiums vary according to the provider, type, and depend on the policyholder’s place of residence.

Deductibles, coinsurance, out-of-pocket spendings

Although you’re able to choose which provider and plan you want, plans in Switzerland impose relatively high cost-sharing, including deductibles and coinsurance. ‘The policyholder will have to pay the set deductible before the insurance kicks in. After the deductible, the individual will pay a coinsurance of 10% of the costs exceeding the deductible. There’s a maximum set on the coinsurance of 700 Fr. per year. Each insurance plan also usually sets an annual maximum out-of-pocket amount.’

Compulsory insurance applies to all foreigners, even EU nationals

Health insurance has to be taken no matter what your nationality is; it is also compulsory if you are from an EU or EFTA state but work in Switzerland without residing here. As for people who live in a neighbouring country and come to Switzerland to work (cross-border commuters), they can choose whether to take out health insurance in their own country or Switzerland.

What if I miss the 3-month deadline? Are there any penalties?

Well, kind of.

If you miss the three-month deadline to get yourself insured, the government will assign you a plan without asking you wich premium you want. Oftentimes, they will charge higher premiums than you’d like to pay.

Maternity coverage is excellent

Maternity coverage in Switzerland includes prenatal care, all delivery-related costs, a week-long post-delivery hospital stay where mothers learn baby-care skills. There are also post-natal housecalls by a qualified midwife.

Private or public health insurance?

People usually look for private supplemental insurance to cover things not under the basic insurance plan- outpatient services like orthodontic or osteopathic treatment, for example.

Premium plans allow you to go to private hospitals, which means you might be able to get a single room or get treated by senior, more experienced doctors. However, the law in Switzerland ensures that even if you don’t choose private insurance, you’ll still be well taken care of.

Swiss healthcare system flaws

The Swiss system does have a few flaws, however:

Out-of-pocket expenses

Out-of-pocket expenses for the Swiss are considered exceptionally high by European standards.

Increasing premiums

MHI premiums are increasing more quickly than Swiss incomes, and low- and middle-income households end up contributing a greater share of their income to the financing of health care than high-income households.

High health spending

Switzerland’s level of health spending is high compared to most European countries (most of which have single-payer systems). The Swiss currently spend 7,317 USD/per capita on health care, according to data from OECD.

Basic insurance does not cover all medical expenses

You are charged 10% of the costs. This can rise to 20% at the pharmacy if you choose a branded drug when a cheaper generic alternative is available. Above a certain level of annual expenses (CHF 7,000 for adults and CHF 3,500 for children), the 10% contribution does not apply. Therefore, afterward, you do not have to pay at all.

However, there are some exceptions as to who is not required to pay and for treatments that are not covered.

Overall, I think we can all agree that the Swiss healthcare system is pretty good and worth every penny Franc.