Government turns down national health scheme Swissinfo
NZZ Online
December 10, 2005
The cabinet has come out against a proposal to set up a national health insurance scheme, saying that it would not help to reduce spiraling health costs.
The proposal, which was launched by the centre-left Social Democrats, wants to set up a single non-profit insurance system based on an individual’s income.
The plan is still expected to be put to a nationwide vote next year.
The interior ministry said on Friday that the cabinet would rather stick with the status quo, where more than 100 private insurers compete against each other.
The government believes that a system which relies on different insurers – where people can switch companies without any restrictions – offers better perspectives than a state-run monopoly.
It adds that competition slows rising costs and presents a wealth of choice.
The government rejects the proposed structure of a single health scheme.
Suggestions that premiums could be paid according to a person’s income as part of a national health scheme were also rejected.
http://www.nzz.ch/2005/12/10/eng/article6303166.html
Comment: Advocates of consumer-directed health care (CDHC) in the United States have used the Swiss example of competition between private health plans as being close to a model that we should emulate, but there are serious problems with their system.
Global health care costs in Switzerland are very high, exceeded only by the costs in the United States. CDHC advocates admire the very high out-of-pocket health-care spending in Switzerland, much higher than most OECD nations, since that theoretically makes the Swiss more value-oriented health-care shoppers. Contrary to their view, having higher access costs (cost sharing) has not been effective in controlling health-care spending. Also, Switzerland’s system is quite inequitable since it is one of the most regressively funded systems of OECD nations.
In spite of its deficiencies, Switzerland’s system functions much more effectively than ours, but it is not because of the impact of CDHC. Switzerland’s insurance industry is very tightly regulated, causing it to have more features in common with a single payer system than does our fragmented system here in the United States. It is not market competition but rather government oversight that has made their system more effective.
Although their regulatory environment reduces some of their administrative waste, they could achieve greater efficiencies by switching to a single, non-profit insurance system as proposed by the Social Democrats. With a single system, funding could be made much more equitable, and the ineffectual and detrimental out-of-pocket cost sharing could be eliminated. As a monopsony, the single payer insurer could address the real causes of high health-care spending, such as non-beneficial high-tech excesses.
Will the Swiss support a change to a single-payer system? That depends on whether they have enough solidarity to support a more egalitarian system. Just don’t look to the United States; we won’t even spring for a crutch for Tiny Tim.