Friday, August 1, 2008

The Swiss Approach

One of the things George C. Halvorson stresses in Health Care Reform Now! is that we should look at the systems in place around the world that provide universal care. Not with the idea of adopting a foreign system outright, but rather in order to see what elements we might be able to adopt in order to create a truly American system responsive to our particular needs as a nation. That element of his approach came to mind for me early this morning while listening to NPR with my wife this morning over coffee.

This morning, they aired a program which delved into the way the Swiss system works, and it seems to me that there are a lot of things to consider in their way of administering health care.

Via NPR:

At first glance, Switzerland's health care system looks like it could be the perfect political compromise for the United States.

As Republicans would prefer, individuals — not employers or the government — choose from a broad array of health plans, sold by private insurance companies.

And as Democrats urge, everyone in Switzerland has health coverage (it's required by law), with the government providing generous subsidies for those who couldn't otherwise afford it.

NPR goes beyond that first glance and delves into the system in detail. One of their findings is important but hardly shocking: rising costs are a major issue. While Switzerland's 7.5 million people are very happy with the system as it stands they are not immune to the rising costs that are such an important issue during our own health care debate.

There are many things about their system that are appealing, and the public satisfaction level is unparalleled in the United States. One of the ways in which the Swiss operate (pardon the pun) is that insurers are not permitted to make a profit on basic health plans.
Where Swiss health insurers can and do make profits, however, is on supplemental coverage. This is for things like dentistry, alternative medicine (which is popular in Switzerland), and semiprivate or private hospital rooms. For 30 francs per month, Cecile and her husband have a supplementary policy that covers, "for example, all kinds of prevention, not-on-the-list medication, help at home, glasses, transport, alternative medicine. That's a good one," she says.
Jue Rovner's article for NPR is well worth the read. She speaks with a family that has lived both here in the US and in Switerland and are able to make direct comparisons between the two systems. One thing I found really interesting was the difference in mindset she reveals between the way the Swiss and Americans view the idea of social safety nets such as universal care. Cecile Crettol-Rappaz, one of the women interviewed, states it pretty succinctly:
"You are so used to having this individualistic way of thinking, and that's why you don't have these social [safety] nets. You still have this pioneer mentality where everyone has to take care of themselves."
All in all this is great source material for the debate. I wonder how much attention it will get over the next four months or so.

SOURCE: "In Switzerland, A Health Care Model For America?" 07/31/08
photo courtesy of Fr Antunes, used under its Creative Commons license

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