Swiss Health Care Thrives Without Public Option - NYT »
Posted By deathray 1 month, 3 weeks ago in Health & FitnessZURICH — Like every other country in Europe, Switzerland guarantees health care for all its citizens. But the system here does not remotely resemble the model of bureaucratic, socialized medicine often cited by opponents of universal coverage in the United States.
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deathray
Hm...summarizing a life...Investment banker, sailor, unintentional gourmet cook. Ex US Naval officer, also Foreign Service. Split my time between NYC and Miami Beach ...
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deathray1 month, 3 weeks ago
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fta:
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"By many measures, the Swiss are healthier than Americans, and surveys indicate that Swiss people are generally happy with their system. Switzerland, moreover, provides high-quality care at costs well below what the United States spends per person. Swiss insurance companies offer the mandatory basic plan on a not-for-profit basis, although they are permitted to earn a profit on supplemental plans.
And yet, as a potential model for the United States, the Swiss health care system involves some important trade-offs that American consumers, insurers and health care providers might find hard to swallow.
The Swiss government does not “ration care” — that populist bogeyman in the American debate — but it does keep down overall spending by regulating drug prices and fees for lab tests and medical devices. It also requires patients to share some costs — at a higher level than in the United States — so they have an incentive to avoid unnecessary treatments. And some doctors grumble that cost controls are making it harder these days for a physician to make a franc.
The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 percent of personal income, and about 35 to 40 percent of households get some form of subsidy. In some cases, employers contribute part of the insurance premium, but, unlike in the United States, they do not receive a tax break for it. (All the health care proposals in Congress would provide a subsidy to moderate-income Americans.)
Unlike the United States, where the Medicare program for the elderly costs taxpayers about $500 billion a year, Switzerland has no special break for older Swiss people beyond the general subsidy."
the difference is that in Switzerland insurance is a regulated industry like power, with cost controls and the equivalent of a public service commission to regulate rate changes. this would change the business model quite raically, and likely offend both the free marketeers and those who want less government interference in their health care.-
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tadair9191 month, 3 weeks ago
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Following the recent death of Senator Kennedy, universal health care supporters have been pushing even harder for the passage of government run health care, as a monument to Teddy's commitment to the program.
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This seems to overlook the fact that Senator Kennedy, under his private healthcare plan, had over $100,000 worth of treatment for his terminal glial blastoma. In the UK, a person of his age would not have qualified for such treatment - it exceeds the $45,000 limit.
Perhaps, this is why less money is spent on health care in the UK. Because they simply deny more expensive procedures. In other words, maybe spending more money on health care isn't such a bad thing, since the money spent is also function of what is available to buy on the market. -
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hyperbola1 month, 3 weeks ago
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Well, having been served by the Swiss system for a few years of my life, I can assure you that it works far better than our system.
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It also guarantees coverage to anyone who hits an emergency. Whilst I was working there I ended up (in the absence at the moment of the Swiss professor with whom I worked) having to deal with a Indian post-doc who had both visa problems and a newly discovered brain tumor. The system looked after him.
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deathray1 month, 3 weeks ago
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more fta:
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"While many patients seem content, the burdens fall more heavily on doctors, especially general practitioners and pediatricians.
Dr. Gerlinde Schurter, Mrs. Burgstaller’s physician, says she feels squeezed by government regulators and insurance companies that have fought to hold down costs — most recently with a 15 percent cut in lab fees that forced her five-member group to lay off its principal technician.
Dr. Schurter also fears a so-called blue letter, a warning from an insurance company that she is prescribing too many drugs or expensive procedures.
If doctors cannot justify their treatments, they can be forced to repay insurers for a portion of the medical services prescribed. And while prescriptions are covered, the government has insisted that consumers fork over a 20 percent co-payment if they want brand-name drugs, rather than 10 percent for generics.
Similarly, the government health office also lowered reimbursements across the board for medical devices in 2006.
These are among the reasons health care costs consume 10.8 percent of gross domestic product in Switzerland, compared with 16 percent in the United States, the highest level of spending among industrial countries, according to the Organization for Economic Cooperation and Development. "
i doubt the pharma industry, the ama, the medical labs, and the testing equipment manufacturers. imaging firms would also likely be affected. -
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deathray1 month, 3 weeks ago
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finally, some comments about peace of mind and the tradeoffs in the swiss system, also fta:
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"Despite pressure on general practitioners, hospital physicians like Edouard Battegay at the University of Zurich say universal coverage also lowers costs by reducing emergency room visits.
Indeed, his E.R. is as quiet and efficient as a Swiss watch, and he still expresses amazement at what he saw when he worked briefly in Seattle.
“I’ve seen things in the U.S. that I’ve never seen here; it was a state of disaster,” he said. “Chronic disease management is better here. If you don’t treat hypertension, you treat strokes. Not treating patients is expensive.”
And even Dr. Schurter — who says her income has been flat for the last five years — praises the virtues of the Swiss system for patients struck by catastrophe.
When her daughter was found to have leukemia seven years ago, “I never worried for a second how and if she’d get treatment and if it would be paid for,” she said. “All was granted as naturally as the air we breathe.” "-
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tadair9191 month, 3 weeks ago
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Thomas Jefferson realized that local governments are the ones that govern best. Your city council is infinitely more likely to be responsive to you and your neighbors, over the federal government. Wouldn't you agree?
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You may not know this but Switzerland only has 7.6 million people in it. This is a bit smaller than Virginia!
So, if anything this is a sign that if anybody should be running a successful mix of socialized and private health care programs, then it would have the highest chances of working in the local level -- not the out-of-touch and inaffectual federal government.
Mind you, the Swiss system does not function phenominally. It is merly a less horible malfunction than the US one.
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Charlson1 month, 3 weeks ago
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Georgia501 month, 3 weeks ago
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Agreed.
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One-size-fits-all works for neither government nor private health insurance or health care. We need a basic plan, with extra supplemental plans for:
1. young couples who want kids
2. people who engage in high-risk activities (parachute jumping, race driving, scuba diving, etc.)
3. those documented to engage in high-risk lifestyles (smoking, homosexual activity, drug use, excessive tats, etc.)
4. obesity (a rider at the very least if you are x% over medical weight)
5. trauma and accidental
...and so forth.
Those who can navigate life down the middle and avoid added risk get the lowest rates and the cheapest ride.
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lfergie8121 month, 3 weeks ago
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I've seen cases where treatment was denied until the patient died. One person sets himself up to overrule the doctor and decide what is necessary and what isn't.
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Our insurance company once tried to overrule our doctor and change medication on the spouse. I told them that they were practicing medicine without seeing the patient and I wanted a signed statement that they would accept responsibility for her if she had problems with the replacement medication. Needless to say, they sent the medication our doctor prescribed.
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lfergie8121 month, 3 weeks ago
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There is no doubt that a health plan is need here in the USA and there is no doubt that it can be accomplished if the Republicans would cooperate and get serious with working out a solution that everyone can agree with. Well, 60% anyway. Without a "public option" plan, the government would have to set the fees that the insurance companies can charge and reduce their "profit margin" to a reasonable level. As in Switzerland, drug prices would also have to be regulated to keep down medical cost.
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Now I know there will be those that argue that we have too much government and regulating the medical industry will be "big brother" watching you but anyone that is not bias can remember all the regulation that the Conservatives fought to have removed over the last 30 years and the problems they have created. If you don't read this article.
http://www.governmentisgood.com/articles.php?aid=1... -
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deathray1 month, 3 weeks ago
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another issue is that this is a national plan in switzerland, although the cantons have considerable leeway, and the tenth amendment folks who want to limit commerce clause invocation would likely have a problem with this...i guess it depends whether or not health care becomes a priority for them or not.
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tadair9191 month, 3 weeks ago
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When I mention Hawaii and Massachusetts I am told these are just anecdotal stories.
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Associated Press: "Hawaii Ends Universal Child Health Care 7 Months After Start" October 18, 2008
“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I don’t believe that was the intent of the program.”
New York Times: "In Massachusetts, Universal Coverage Strains Care"
Dr. Atkinson, 45, said [h]er insurance reimbursements often do not cover her costs, she said.
“I calculated that every time I have a Medicaid patient, it’s like handing them a $20 bill when they leave,” she said. “I never went into medicine to get rich, but I never expected to feel as disrespected as I feel.
WSJ: "Socialized Health Care Makes Massachusetts Insurance Most Expensive in Nation - Rationing Being Considered"
"Now they tell us. What really whipped along RomneyCare were claims that health care would be less expensive if everyone were covered. But reducing costs while increasing access are irreconcilable issues."
Nothing to see here, folks. See Switzerland. I said see Switzerland!-
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deathray1 month, 3 weeks ago
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that's why proof of income to qualify for the subsidy should be required, just like medicaid.
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romneycare is not socialized medicine; if anything, it's more like an insurance exchage than anything else.
switzerland's doctors seem to have the same complaints apparently as those in massachusetts. they just seem to deal with it differently. -
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lfergie8121 month, 3 weeks ago
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"“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I don’t believe that was the intent of the program.”"
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FTA:"Swiss private insurers are required to offer coverage to all citizens, regardless of age or medical history. And those people, in turn, are obligated to buy health insurance."
"The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 percent of personal income, and about 35 to 40 percent of households get some form of subsidy."
"WSJ: "Socialized Health Care Makes Massachusetts Insurance Most Expensive in Nation - Rationing Being Considered"
Ignorance is bliss. People need to learn the difference between "socialized health care" and what we have. Under socialized health care, the government owns and operates medical facilities such as the Veteran Hospitals under the proposed health care plan being proposed by congress, the medical facilities and doctors will work for themselves. The health care plan proposed by congress has no provisions to own and operate the hospitals and employ the doctors as England does. More recently, the Republicans have used the term more broadly to any publicly funded system. In other words, they are trying to change the meaning of socialized medicine to include any public funded program and put the socialism tag on anything they don't like. -
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pokydoke1 month, 3 weeks ago
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Health insurance is not socialized here in Mass. We are all required to have health insurance. those that can not get it at work because the shop is too small or they are either unemployed or self employed can get insurance from a pool..Mass offers health insurance subsidies to those that are on the unemployment roles which is why the health insurance is costing the state so much money. Actual health care costs are going down but Insurance costs are going up, further justification to remove the insurance companies from the health care industry.
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tadair9191 month, 3 weeks ago
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I tried posting this earlier, but propeller absorbed it into the abyss. I will try and repost bloggers comments from switzerland below:
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"There is no such thing as the "European model". Europe has a lot of different countries with a lot of different healthcare systems. Now they all have their problems I guess, but some seem work better than others. The only system I know well enough to comment about is the Swiss system, as I live in Switzerland. We have kind of a mixed system, with both public and private elements. The quality of healthcare is good but the costs are high." --Cedric -
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tadair9191 month, 3 weeks ago
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"The Swiss healthcare system changed dramatically in 1996, when the so-called Krankenversicherungsgesetz ("health insurance act") came into effect.
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The law made the following changes:
* Every Swiss citizen needs to have basic health insurance, called Grundversicherung ("baseinsurance").
* The government regulates what has to be covered by this basic insurance. Insurers can't remove or even add anything.
* Insurers are not allowed to make money off of the basic insurance, they are not allowed to charge different rates to different people or age groups and they are not allowed to refuse anyone.
There are a lot more things of course, but I think these are the three most important points.
Now, ever since the law came into effect, we have had problems with rising costs in our healthcare system. The costs rise only slowly (at least slower than in other countries) but still faster than people's incomes can keep up. I see two main reasons for this. First, because the cost for everyone is the same, people spend more and more money on healthcare and don't check prices. Second, because politicians keep adding more and more things to the "basic insurance" because of pressure from special interest groups. Originally, the basic insurance was supposed to only cover the most basic things, but nowadays it covers practically everything you could think of.
Another problem arising from the fact that insurers can't charge different people different rates is that there is no penalty for having an unhealthy lifestyle. In a free market system, people who for example smoke a lot or drink alot would pay more because they have a higher risk of becoming sick in the future. But not in Switzerland! However the government knows that this is a problem. So in order to "fix" the problem they created, they have heavily increased taxes on cigarettes and alcohol up to the point where we see increases in crime rates because people are smuggling in goods across the border."
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tadair9191 month, 3 weeks ago
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"And of course, because the government dictates what my insurance has to cover, I can't even choose what medical treatments I want to pay for! Only recently for example the decision was made to include so-called "Alternative Medicine" (like homeopathy) in the basic insurance. Now, I don't care if someone believes in homeopathy. That is none of my business. It's just that personally I don't believe in it and that means I don't want to pay for it let alone subsidize it's practice. But just as I don't want to pay for Alternative Medicine I don't except anyone to pay for Science-Based Medicine it they don't want to do so.
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Now politicians know that something is wrong with our system and that at some point people simply aren't going to be able to afford to pay for their healthcare anymore if costs keep rising. The problem is that no party has been able to gain enough support for their ideas yet. Even smaller changes are resisted by the Swiss people, which have to vote on the laws. Pretty much any law that had anything to do with healthcare reform in the past years have been voted down. And of course, the left always blames it on "big pharma" or some other bs. For some reason they never think it's their own fault...
Now, with all that having been said I think our healthcare system is still a lot less crazy than those in other European countries like France, Germany, Britain, Italy or Austria. Hospitals and doctors are luckily still mostly free to "do their thing", and since people have to pay a small percentage of their medical bills themselves at least some people are starting to wake up and beginning compare prices. It's still a long shot, but at the end of the day I'd rather live here in Switzerland than in France."
--Posted: August 29, 2009 7:01 PM -
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NoWayMan1 month, 3 weeks ago
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lfergie8121 month, 3 weeks ago
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"the cons and their Big Insurance benefactors would never go for a system that regulated."
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Exactly why they won't set down and come to a compromise solution. Bis insurance is paying off congresspeople with big money. Both Republicans and Democrats. Of course there's the anti-Obama factor too. -
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slate1 month, 3 weeks ago
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Radiofreeeuropa1 month, 3 weeks ago
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I'm convinced all but 2 Republicans are wholly owned subsidiaries of Pharma and Insurance. A fair amount of Dems as well. Baucus to be certain. The US sadly will never do anything other than line the coffers of a few mega-industries unless bribe money is taken out of the political equation. Who will ever do that? The bribers??? The Bribees? Never.
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Unless citizens absolutely demand that influence through money be banned entirely in politics we'll get exactly what we deserve. Nothing. -
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beavith11 month, 3 weeks ago
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i'm not a reform opponent, per se.
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i'm an opponent of dumb reform, no matter if a certain political wing of our country is trying to get a stampede going for a monstrous plan with zero real feedback.
sell me that better mousetrap. not some sort of rube goldberg contraption because this current plan is a recipe for disaster.
asking for heavy subsidization and regulation imposed any gov't implies that it can't stand on its own. whether you're a supporter of big gov't or not, that alone, should be setting off alarm bells to you.-
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lfergie8121 month, 3 weeks ago
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"sell me that better mousetrap. not some sort of rube goldberg contraption because this current plan is a recipe for disaster. "
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How the hell would you know? You hear that on FOX News? The plan hasn't even finalized yet and you call it a disaster. ROFLMAO -
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