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Two tiers of medicine in Switzerland?

8. September 2016 0 Comments

About 80% of the Swiss population has, besides their basic health insurance, also a supplemental insurance. This covers a more extensive range of scenarios than the basic coverage (illness, accident and maternity). Is the difference in percentage an indicator of a two tier system in Switzerland? And are supplemental insurances even necessary?

In a comparison with other European countries, Switzerland succeeds with above-average primary health care.

Two skiers crash together on a Swiss ski slope. Both are badly insured and are transported into the closest hospital by trained relief units to conduct the necessary surgical procedures. One of the patients is operated on by the chief physician himself and he spends the next couple of days after the surgery in a spacious private room; the other patient has to settle with a medical assistant and a shared room. The reason; he does not have a private supplemental insurance.

This situation and generally the possibility to insure oneself additionally signalises a two tiered system in Switzerland.  Willy Oggier, a Swiss health economist even claims that the two tiered medical system always existed and that it will continue to do so. The question however is, what is the standard level of coverage for people in the second tier (Benz, 2013). In Switzerland, 20% of people do not have the supplemental insurance; either because they cannot afford the insurance or choose not to pay. These people make up the second tier. On average these people pay around 60 CHF less on health insurance per month. However, if these people require certain treatments they may be left with large costs which they are required to cover personally.

In a comparison with other European countries, Switzerland succeeds with above-average primary health care and positions itself on the second place behind only the Netherlands in the “Euro Health Consumer Index 2015”. The sectors of the primary health insurance that were investigated are patients’ rights and information, waiting time, results, extent of provided service and access to pharmaceuticals. The Swiss “second-rate insured” are therefore provided with excellent quality and along with Belgium have the shortest waiting times in the whole of Europe (Björnberg, 2016).

 

The Euro Health Consumer Index 2015

diagramm(2)

Silver medal for Switzerland in the Euro Health Consumer Index 2015 for their excellent primary health care in the sectors patients’ rights and information, waiting time, results, extent of provided service and access to pharmaceuticals.

 

The extensive primary health insurance is however very costly. According to the OECD numbers from the year 2000, Switzerland invested proportionately the third most resources into the health of their inhabitants of all the OECD countries, after the USA and France (Bundesamt für Statistik, 2011).

Due to the above average, high quality premium health insurance the supplemental insurance is not an obligation. However, it is advisable for a person to invest in the supplemental insurance as it provides a variety of benefits including an emphasis on alternative cures.

kassenpatient-wartezimmer

Waiting room for patients with no supplemental insurance? 
At least not in Switzerland.

The ambulant supplemental insurance covers; glasses, visual aid, gym, emergencies abroad, different methods of natural healing and cures. A comparison between a family of four in three different towns in the cantons Bern, Luzern and Zurich would show the costs of the supplemental insurance ranges between 270 and 425 CHF, depending on the insurance company and location. If the family would not have the supplemental insurance and one family member would suffer from visual problems, the family would have to cover the costs themselves. Yet, glasses with visual lenses can easily cost around 400 CHF. A family covered by the supplemental health insurance would not have to pay the full amount themselves.

Another example would be the dental supplemental insurance for around 15 CHF per month, which covers the majority of the costs. Moreover, it also includes other offers such as roentgen, correction of teeth, general therapy and has many additional benefits. The treatment of a dental disease can easily cost 400 to 600 CHF; in this case a dental supplemental insurance is cost-efficient.

Cost advantages through demand-oriented supplemental insurances

Therefore, the insured person can reduce costs with a conscious demand-orientated product decision. As the supplemental insurance covers such a wide variety of extra treatments the benefit is greater than the financial outlay. A person with supplementary insurance receives countless potential treatments for a small increase in cost. Additionally, only two thirds of insurance fees paid by citizens are used for the obligatory basic insurance (Anivo, 2016). The other third automatically funds the supplemental insurance. Essentially those who only have basic insurance automatically assist to fund the supplementary insurance. Those funds will be then used for prevention-discounts in favour of the people covered by supplemental insurance.

Due to the fact that the client has the option to take out additional supplemental health insurance, qualitative differences in treatment will always remain. However, supplemental insurances can also be financially beneficial in the long run for the less wealthy population.

Not only the insured people benefit from preventive measures but also the insurance company. The client stays healthier and fit and the insurance company decreases their total costs; due to the fact that the costs from the prevention measures are substantially less than the costs of a potential medical treatment in case of a disease. In 2005 the Swiss health insurance companies spend overall roughly CHF 1.13 billions on prevention measures and this trend is likely to increase (Bundesamt für Gesundheit, 2007).

This goes to the extent that some insurance companies have started to reward their clients for a healthy lifestyle. New technologies like “Fitbit” bracelets and “Runtastic” Apps help to represent the rhythm of movement, the diet and the rhythm of sleep and help to illustrate their lifestyle. Those who lead a healthy lifestyle, and can prove they do so, are rewarded by the insurance company. In 2015, the insurance company CSS started a pilot scheme to this effect (Frankfurter Allgemeine, 2016) (Zeit online GmbH, 2014).

Due to the fact that the client has the option to take out additional supplemental health insurance, qualitative differences in treatment will always remain. However, supplemental insurances can also be financially beneficial in the long run for the less wealthy population.

You can find out easily at Anivo.ch, which supplemental insurance corresponds the best to your standards and has a fair price. Due to the straightforward insurance comparison you can compare within a few minutes the benefits of different Suisse health insurance companies and demand non-binding offers. FINMA qualified insurance experts are always available via phone, chat or email to discuss your personal situation and answer any question regarding your offer. Finally, you can conclude your desired insurance comfortable online.

 


References

  1. Anivo, (2016). ANIVO – Online versichert. Persönlich beraten. [online] Anivo.ch. Available at: https://www.anivo.ch/?platform=anivo-         health#/responsive_health_request [Accessed on 4 Jul. 2016].
  2. Benz, D. (2013). Spitäler: «Zweiklassenmedizin hat es schon immer gegeben»-Beobachter. [online] Beobachter. Available at: http://www.beobachter.ch/geld-sicherheit/krankenkasse/artikel/spitaeler_zweiklassenmedizin-hat-es-schon-immer-gegeben/ [Accessed on 1 Jul. 2016].
  3. Björnberg, A. (2016). Euro Health Consumer Index 2015 Report. 1st ed. [ebook]Health Consumer Powerhouse Ltd. Available at: http://www.healthpowerhouse.com/files/EHCI_2015/EHCI_2015_report.pdf [Accessed on 1 Jul. 2016].
  4. Bundesamt für Gesundheit, (2007). Prävention und Gesundheitsförderung in der Schweiz. Liebefeld: Bundesamt für Gesundheit.
  5. Bundesamt für Statistik BFS, (2011). Kosten und Finanzierung des Gesundheitswesens. Neuchâtel: Bundesamt für Statistik BFS.
  6. Frankfurter Allgemeine, (2016). Versicherer General: Joggen für die geringe Versicherungsprämie. [online] FAZ.NET. Available at: http://www.faz.net/aktuell/finanzen/meine-finanzen/versichern-und-schuetzen/versicherer-generali-fuehrt-vitality-tarife-in-deutschland-ein-14299998.html [Accessed on 1 Jul. 2016].
  7. Zeit Online GmbH, (2014). Krankenversicherung: General will Fitnessdaten von Kunden sammeln. [online] Zeit online. Available at: http://www.zeit.de/digital/2014-11/versicherung-generali-fitness-daten-sammeln [Accessed on 1 Jul. 2016].

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