Swiss Health Care

Here’s a fun topic.  It comes to mind not due to the political war currently raging in the US but because a few weeks ago I injured myself again playing basketball, this time breaking a finger.  Before beginning, I should note that I like the system here.  It’s not perfect and it’s expensive but it works and it’s fair.   That last part is important and is a bit personal for me.  Several years ago, prior to ACA, my oldest daughter was living in New York and went uncovered for a short time.  For me this was extremely unsettling.  She worked as a camp counselor for a private social work organization and even basic catastrophic coverage would have cost her twenty percent of her barely minimum wage gross pay.  She solved the problem by registering part time at the local community college, thus qualifying for the less expensive student insurance.  Most people aren’t as clever as she is and simply go naked.  This shouldn’t happen and it doesn’t here.   

Clearly, a blog like this is inadequate to discuss this topic in any depth so I’ll limit this post to just a few observations.  An obvious starting point when discussing health care is cost.   I hesitate to compare what we pay here with what we paid in the US because we’ve been away so long but it’s safe to say that both systems are expensive.  The US and Switzerland are ranked one and two worldwide respectively in percent of GDP spent on health care but they’re not neck and neck.  Switzerland is positioned at the top of a large cluster of western countries while the US has its head, shoulders and entire torso ahead of the pack.  The US is the Usain Bolt of health care spending.    So, what does the average Swiss health care consumer get for all that money?  Well, one clear benefit is high quality care and access to the most advanced technologies possible.   And it’s important to say that in this case, “average consumer” means all consumers.  It’s not that two-thirds of the population gets great coverage while the other third goes uncovered.  Another benefit is convenience.  There is simply no waiting and the hospitals and clinics are ubiquitous.  I had my broken finger attended to within thirty minutes of presenting myself, without an appointment, at a clinic located a five minute bike ride from my home.    In January, I needed an MRI for a suspected lung embolism and my waiting time was determined only by how quickly I could get myself to the clinic (not long).  Another advantage is that the insurance companies are surprisingly responsive and the paperwork is pretty limited.  We’ve had three providers here and all were much easier to deal with than any of those I dealt with in the US were.  One feature I don’t understand but won’t complain about is that your employer’s insurance covers accidents, whether or not they’re work related (for instance all of my basketball injuries).   This means that accident claims are not subject to deductibles.  Really, the only disadvantage of the Swiss system is the high cost but there are a number of amusing idiosyncrasies that merit mention.  For instance, ibuprofen is a prescription drug here and costs about a dollar a pill.  All of our Swiss friends stock up at the CVS when vacationing in the US.  And it’s not just OTC pain relievers.  You  pretty much have to visit the pharmacy for everything that you put in your mouth or spread on your skin (toothpaste and soap being notable exceptions).   Another funny characteristic is the general reluctance to use antibiotics, which makes sense from the creation of resistant super bugs perspective but these drugs do have a place in modern medicine.  I have a work colleague whose young son went through a progression of homeopathic treatments that included placing an onion slice under his pillow before she was asked if it would be okay if they tried an antibiotic.   Another common practice here (I’ll not comment whether it’s a pro or con) is that they seem to allow you to stay in the hospital as long as you want.  My son had a friend who stayed a week after having his tonsils removed.  A few years back, my second daughter broke her collarbone.  We’ll never know how long they would have allowed her to stay as we practically broke her out to go hiking after two nights.   In the end, as I said, I like the system here and while it didn't make my top 10 list it's yet another reason to live here.