Switzerland is a high-income country in Central Europe. Its population in 2022 was 8.7 million people and life expectancy in 2021 was 84 years. In 2021, In 2021, Switzerland’s current health expenditure (CHE) was 11.8% of GDP in 2021, and its CHE was $10 897 per capita [2]. In 2020, public expenditure accounted for only 35.7% while private expenditure accounted for 64.3%; and out-of-pocked spending accounted for 22% of CHE (2020).
The following extract is from the “Country overview” for Switzerland published by the European Observatory on Health Systems and Policies.
Switzerland ensures access to health care through a system of mandatory health insurance (MHI), which has been compulsory for every resident since 1996. The Swiss health system is highly decentralized. The federal level defines the legal framework for managed competition in the statutory health system and supervises developments at lower levels of the system.
Cantonal governments are responsible for the provision of health care and for the implementation of federal policies. Several coordination bodies exist to improve the collaboration of cantons amongst each other and with the federal government. Popular initiatives and referenda play a prominent role in influencing health policy-making, both at the local and the national level. Certain reforms of the health care system entail a positive referendum by the Swiss population.
MHI is offered by competing non-profit insurers overseen by the Federal Office of Public Health. It covers most general practitioner and specialist services, home care services, physiotherapy (if prescribed) and some preventive measures, as well as several pharmaceuticals and medical devices. Hospital services are also financed by MHI, although vastly subsidized by the cantons. Routine dental care (except for children) is excluded from public coverage.
Financial flows are split between different government levels and social insurance schemes. Resources are collected mostly through taxes and MHI premiums, with a substantial part allocated to the various social insurance schemes, in particular to subsidize MHI premiums for lower-income households.
The following extract from the Federal Office of Public Health of Switzerland describes how compulsory health insurance is arranged in Switzerland.
Around 60 authorised non-profit insurers offer compulsory health insurance (basic insurance) and optional daily allowance insurance. …
Compulsory health insurance is financed by policyholders’ contributions (premiums) and co-payments (deductible, retention fee, contribution to the costs of a hospital stay) and federal and cantonal funding (premium subsidies).
The premiums charged by an insurer must cover its costs (return on capital can be taken into account when calculating the cost of premiums). Premiums are not dependent on income and vary according to the insurer, place of residence and type of insurance selected (optional deductible, restricted choice of providers).
People on a low income, children and young adults in education/training often receive premium subsidies. Entitlement to subsidies is determined by the cantons. …
Providers can be compensated for their services in two ways:
- By policyholders, whose costs are in turn reimbursed by their insurer (tiers garant system, e.g. for physicians’ bills)
- By insurers, if it has been agreed with the providers.
The Federal Quality Commission plays a key role in improving the quality of health services.
