Health care system of Switzerland
In Switzerland, the cantons are largely responsible for overseeing healthcare provision (e.g. hospitals, advanced medicine, the authorisation to practice health professions, and prevention). The Swiss federal government is responsible for the compulsory health insurance scheme, control of communicable diseases, as well as medically assisted reproduction and transplants. The whole healthcare system is geared toward the general goals of keeping the system competitive across cantonal lines, promoting general public health and reducing costs while encouraging individual responsibility.
The Swiss healthcare system is a combination of public, subsidised private and totally private systems:
- public: e. g. the University Hospital of Geneva (HUG) with 2,350 beds, 8,300 staff and 50,000 patients per year;
- subsidised private: the home care services to which one may have recourse in case of a difficult pregnancy, after childbirth, illness, accident, handicap or old age;
- totally private: doctors in private practice and in private clinics.
Everyone who lives in Switzerland has to take out basic health insurance with a provider of their choosing. The monthly premium depends on where the person lives in Switzerland, their gender and the annual deductible sum they have chosen. For adults, the deductible can range from CHF 300 to CHF 2,500. The insured person has full freedom of choice among the recognised healthcare providers competent to treat their condition (in his region) on the understanding that the costs are covered by the insurance up to the level of the official tariff.
Health expenditure accounts for 11.7% of Swiss GDP. Spending rose to CHF 71.2 billion in 2014 compared with CHF 51.7 billion in 2004. Per capita health expenditure in Switzerland is the second highest among OECD countries after the United States. Rising health care costs are due to an ageing population, medical advances and rising public demand for medical services. A series of measures have been introduced to curb health costs in Switzerland. These include the promotion of managed-care models, a new hospital funding regime with a set price for each service provided, as well as an ‘eHealth’ strategy.
In Switzerland, there were 4.6 hospital beds per 1,000 inhabitants in 2014, compared with 7.6 in Austria, 8.2 in Germany and 6.2 in France. Over the last few years a number of cantons have restructured their hospital network, grouping certain specialist areas in one location or closing under-utilised facilities. According to the OECD, there were 17,4 carer per thousand inhabitants in Switzerland in 2013, including professional nurses and associate professional nurses. The density of practising physicians is 4 per thousand population. In the 2015 Euro health consumer index survey Switzerland was placed second, and described as an excellent, although expensive, healthcare system.
Bundesamt für Gesundheit BAG:
OECD, Health at a Glance Europe 2016, S. 160