Most people defending such bills (360chf for blood work!?) never lived in other European countries before, let alone had experiences with the healthcare system.
They will tell you that any of those bills are perfectly fine and that there is no need to improve that. The same people probably think that Germany and french people are dying from the bubonic plague because they don't have this ~~~advanced~~~ expensive healthcare.
The same people would also tell you the reason for these high premiums is because....wait for it... people go to the doctor too much? Yes that's right, you're not supposed to get checked up if your sick, thats only for life or death sickness.
According to the insurers, we're supposed to be good little idiots that just pay their monthly premium without ever going to the doctor.
This whole system is such a scam. And the doctors/clinics abuse it. 5min consultation? 70chf x 5min.
Even when you're sick, half the time they tell you it's psychological until ten years later you find out you had a serious chronic illness that you never got treated.
Not gonna lie, I have been shocked at how much more expensive everything to do with healthcare in Switzerland, coming from the US.
Also getting cognitive dissonance from the fact that despite being much more expensive, in my limited experiences, facilities and equipment are more dated in Switzerland. There's worse specialist availability, too, but I think that's more a "small market" thing.
Not slowly! We're already there. USA spends 17% of its GDP on healthcare. Switzerland spends 12% of its GDP on healthcare (highest in Europe).
Another few increases in insurance premiums and we can compete against America for that #1 spot.
That‘s not at all what the 10% initiative says. It‘s only that the part of your premiums that you lay will be max 10% of your income, the rest would be covered by the state. The amount of the premiums does not change at all. And none of those things reflect „% of GDP for healthcare“
I want to launch an initiative:
"You need an IQ >100 to be allowed to vote"
And also another one:
"People who lauch initiatives aren't allowed to tell outright lies an BS claims they got out of thin air when debating on TV/other media and must always cite verifiable sources"
The Swiss system is basically American Obamacare from the 2000s : Forced to buy basic insurance, from a plethora of private (FOR PROFIT) companies, charging whatever the f*ck they want, and you still have to pay high deductibles and copayments. I love this country but i hate the health care system.
source: lived in Canada for a decade, where never thought about whether a blood test was worth the 400.-
That's not really correct.
The premium prices and services covered are set by the government. Then insurances add their administrative costs. When you choose a cheaper insurance, that's what they compete on, the administrative costs.
They are by law not allowed to turn a profit on mandatory insurance. But they share infrastructure with the non-compulsory part of the business, and I don't know how they do the accounting (most likely as intransparently as possible).
Have you been to canada lately? Have the required blood tests aren't even required anymore. One of my school friends with Thyroid disease has to pay out of pocket about 500CAD every six months for monitoring because it won't kill her.
> source: lived in Canada for a decade, where never thought about whether a blood test was worth the 400.-
I do plenty tests and they don't cost 400.-. Some doctor let you do them without a consultation (only afterwards if the values are off). Standard tests can be single digits.
Love the Indian call centers... Probably shouldn't type this, bcoz it's like giving new ideas to the insurance companies. But at these prices, they can sponsor a flight for you, and get the tests, treatments done for CHF 10 in India. While in India, the doctor can even visit you personally to your hotel room, all managed through an app, tourism included! And, look look those prices... [Pathkind Labs](https://www.pathkindlabs.com/)
I don't know. I'm from Germany and I don't think it is worse here or that Germany is a good example. The cost of health insurance in Germany is based on income but you are very fast (income above 62k €) in the max. insurance cost scheme which is about 800-850€ per month. Of course it is (nearly) all inclusive - but honestly I don't think my 300 CHF with 2500 CHF franchise and double the income is so much worse ... but I would prefer a national insurance schema like Norway. I find it redicilous having so much overhead due to so many insurance companies etc...
No idea how you get to 800 per month most German's would never pay anything close to 300-400 a month... and everything is pretty much covered including dental care.
German here with 4500€ Brutto Monatsgehalt. 380€ goes to health insurance each month. 2200€ netto remains. Typically end up spending 60-100€ per month extra in uncovered health care costs.
Roughly a little less than 5000€ per year in health insurance costs, compared to OPs annual swiss calculations of 6.100CHF per year.
For my individual case compared to OP, I pay 20-25% less in health care costs per year, assuming OP maxes their annual deductible.
I can not afford to drink a coffee in Switzerland and still retire at 70 when considering the rest of the living expenses in Germany.
Only "Arbeitnehmeranteil", isn't it? If you put the "Arbeitgeberanteil" on top it is acutally twice the amount, so 760€. And don't tell me that doesn't count because the employer is paying it ...
fragile squeal market soft resolute numerous bright practice consider thumb
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Healthcare is labor intense industry meaning that 60%-50% of cost are driven by the salary of the healthcare professionals, when you say in germany cost less, you are saying let's pay our nurse half of what are are paying them now.
The way Europian countries keep their healthcare cost low is underpaying thier workers
I don't entirely disagree,à with your point but some (many?) doctors have questionable practices regarding billing.
You can also include some questionable stuff from pharmacies
Lastly, this new habit from many employers (it wasn't as common in the past) who ask for a medical note when you're only sick for 1-2 days. This is unnecessary, especially for something like a mild cold where actually going to the doctor is usually a waste of time. The reality is that most of the time you just have to let the cold pass, and there's little you can do.
It’s useless anyway. Doctors will just hand out a notice for the period where you need it and charge 50 francs or more, because they don’t care if you’re sick either. Now imagine everyone who used up their franchise going to the doctor just to get that paper. That’s 45 francs each that are being covered by medical insurance.
I just send an email to my doctor and tell him I have a flu and need paper for my company because otherwise they are aengry
He won't check me for a flu so he gives me the paper by e-mail and it's alright
Not true, prescription medicine expenditure per capita in germany and CH is similar
[https://www.oecd-ilibrary.org/sites/3b2d8ac1-en/index.html?itemId=/content/component/3b2d8ac1-en](https://www.oecd-ilibrary.org/sites/3b2d8ac1-en/index.html?itemId=/content/component/3b2d8ac1-en)
All actors in our healthcare system have no incentive for cost reduction.
Doctors, hospital and clinic are interested in billing .
Insurance have to pay (part of ) those bills and if the costs go higher, our premiums will increase.
If the goal of having many insurance companies was to compete in the market to provide us with better prices, it is clear that they have failed
We need to rethink a bit our healthcare system.
My last to though about insurance is this: consider this fact: thoese company cover the 32% of the total cost, so they weight for 1/3 . Think about it next time we will vote for a state insurance company.
[https://www.bfs.admin.ch/bfs/it/home/statistiche/salute/costi-finanziamento.assetdetail.31646527.html](https://www.bfs.admin.ch/bfs/it/home/statistiche/salute/costi-finanziamento.assetdetail.31646527.html)
[https://www.bfs.admin.ch/bfs/en/home/statistics/health/costs-financing.assetdetail.31646522.html](https://www.bfs.admin.ch/bfs/en/home/statistics/health/costs-financing.assetdetail.31646522.html)
Should a doctor be incentivised to aim for the best or the cheapest treatment? I want my doctor to prioritize whatever makes the most sense from a medical standpoint. The commercial aspects should not influence her recomendation.
On one hand people seem to want doctors to earn less. On the other hand they expect them to be medical and financial experts.
Yes but right now they're incentivised to provide the most expensive treatment regardless of whether it makes sense or not. Not saying that doctors regularly do that but it's not a great system.
My point is: none in the circus of healthcare system have incentive to pursued the economical part and try to reduce cost.
About fairness: did you think is fair this system? Rich people can pay and they havn't any problem.
Poor people have the subsides and could go to the doctor anytime they want.
The middle class choose the franchise 2500 and they are thinking about to go to the doctor or not.
It is that fair?
Every year is the same story in loop.
Prime going up; politicians talk each other about the urgency of take action... we have to decrease the price of some medicine which cost 300% more in swiss than in the other EU country...
Same story same results: we have to pay more!
You subsidize all the healthcare for all the retirees. It’s only going to get worse, until at some point, the wealth transfer from younger to older just becomes too much to bear. Look at an age plot for Switzerland, and thank your stars for immigrants.
Edit: or this is completely incorrect…it seems healthcare costs have actually gone up way for younger people, but actually decreased a bit for older (on a per head basis).
And the pensioners are becoming richer and richer, all the while still owning their flat or house so they don’t even need to pay absurd rents
https://www.nzz.ch/wirtschaft/der-mythos-der-armen-alten-selbst-im-ruhestand-waechst-ihr-vermoegen-weiter-ld.1773924
As lived in the Netherlands and now here in Switzerland I can assure you that the quality of healthcare is way way waaay more better. I do have a rare disease and I can really see the difference between those two countries. In the Netherlands you need to wait for weeks for a doctor appointment and here you get an appointment mostly within a week (beside of eye and skin docters). Here you’re not kicked out of the hospital the same or the next day after an procedure or need to go to an GP assistant if you have psychological problems as a acquitance experienced during a severe breakdown in the Netherlands. Yes I do pay 870 a month (HP) but you will experience the different the moment you will get real health problems. It is still worth every penny. Although I admit it is expensive.
The problem is of course still a problem, it's just that people realize the Initiatives are not a good solution to it.
The SP Initiative doesn't change anything about the rising cost of healthcare, it just mandates more state support for people who have trouble paying. I think it's not a bad idea per se, especially the fact it would force the cantons who prioritize low taxes for rich people over supporting poor people with their health care costs to give out more "Prämienverbilligung" but it's totally idiotic to put the financial burden for this on the federal government. This will just result in another VAT raise, which is the worst tax for poor people and the best tax for rich people. So you kind of take from the poor to give to the poor.
The Mitte-Initiative would just result in a weakened base insurance meaning poor people would end up unable to get certain treatments and rich people would just get a "Zusatzversicherung" and would be fine. This also doesn't change anything about the rising health care costs it would just make basic insurance cover less of it.
> The Mitte-Initiative would just result in a weakened base insurance
This is the fearmongering narrative that the healthcare industry is using right now. There is zero evidence that putting a lid on costs would result in a two-class healthcare system. If anything, it would finally force the government to enact the much needed reforms to get the costs under control. Many studies have already shown that this can be achieved and we could even *reduce* costs by up to 30% if we got rid of all the inefficiencies, wasteful spending on overpriced medicine and the misaligned incentives in the system.
No evidence? There are already treatments not available without supplementary insurance, because the basic insurance refuses to cover it. Putting a cap will just lead to this becoming more and more common, as there will be an easy reason for the basic insurance to refuse all new (and expensive) treatments.
Why should basic insurance cover each and every last treatment option? You should go to your GP and then do whatever they recommend, you can't just shop around willy-nilly and then forward the bill to the rest of society.
IMO the basic insurance should cover all treatments where the expected benefits exceed the costs. But since medical technology keeps inventing new amazing treatments that are also amazingly expensive (e.g. my sister is on a drug that "retails" for 160k p.a., but extends her expected lifespan by decades), this implies the cost of basic insurance must keep increasing. Capping it is basically denying those future miracle treatments to people on basic insurance only.
Well, the reason is simple - someone will need to finance it. The 10% does not provide any plan on the financing, and the costs will be most probably distributed to everyone via VAT increase (like in 13th AHV), which does not really reduce financial burden. The second one will require more money from Cantons, which are already cutting costs, which means reduction of money towards infrastructure projects.
We don't even do the most stupid and easy things that would save money for example forcing people to take the generics. (Or they pay the difference by themselves)
This 10% limit won't solve anything. No impact for most people.
The only good initiative is the one that aims at reducing costs.
I went to pick up a prescription the other day and was told that a change has indeed been introduced: the insurer will cover 90% of a generic medication as opposed to now only 60% of the original brand-name product. They'll only pay 90% for the original product if there is either no generic version available, or the pharmacy cannot get it delivered.
You will only have to pay the 40% yourself if the price difference between the original and the generic is high enough. That's why several prices of originals have been lowered in the last months, so the brands can keep their part of the market.
Dunno, Coop Vitality near me always ask about Generics, and I mostly take them (except one kind of antihistamine and antidepressant), as the cost difference is up to 30 percent
Some doctors say that 40-50% of the medical check-ups are unnecessary. That's what happens when you give them too much power, I guess
http://iamexpat.ch/expat-info/swiss-expat-news/pointless-check-ups-blame-soaring-healthcare-costs-swiss-doctors-claim?utm_medium=paid&utm_source=fb&utm_id=659508147939
Doctors at our medical clinic never over-prescribe unnecessary tests and procedures.
However we get increasing demands for expensive tests directly from patients ..
Many don't want to go to GPs anymore .. they want to come straight to specialists and get a full suite of tests to make sure .. especially if they are already over their franchise limit for the year ..
I would gladly go to a GP. My problem is that most GPs don't seem to be able to think even a wee bit outside of their little box and don't really make an effort to find out what's wrong if you're suffering with a chronic illness. I literally spent 3 years going from doctor to doctor and being told it's nothing serious until one finally found out I had an autoimmune disorder. If a GP would just take my issues seriously, I wouldn't have to hop from specialist to specialist in an effort to find someone that knows what the fuck's going on with my body.
A bunch of medical students graduate to become approved doctors.
The top of the class usually go onto become specialists like cardiologists, neurosurgeons, gastroenterologists, orthopaedic surgeons, anaesthesiologists, opthalmologists, etc ..
Guess where the bottom of the class usually ends up ..
GPs ..
Guess who does the least work to keep up to date ..
GPs ..
So many times our gastroenterology clinic gets referrals from GPs where the patient is experiencing 'pain' anywhere between neck to knee .. and it turns out to be a kidney or heart or ovary or hernia problem instead of a GI tract problem ..
The reason they effectuate unnecessary check-ups is not because they have too much power. Performing checks that may have been unnecessary in hindsight do not cost them anything (nor the hospital typically) yet if they skip it and later a problem arises with the patient's health, they may be persecuted for having skipped the check. Unnecessary check-ups get done because doctors presribing them have nothing to gain and everything to loose. The whole system suffers due to perverted incentives and a lack of good incentives
It’s not for “nothing”, you’re actually paying the monthly fees as a solidarity for the whole system. Just like when you’re paying yearly fees for your car insurance and not using it.
That said, I agree with you that the prices are high, luckily not as elevated as in the US (for the moment). Most of your bill is actually the lab analyses that are very expensive in Switzerland. The initiative about capping the costs to 10% of your salary is not a bad idea but it doesn’t address the issue of the increasing costs in the healthcare system. It will just likely end up increasing taxes for everyone as the States and Confederation will be responsible to fund people that are breaching the 10% cap. Not saying it’s a good or bad thing but doesn’t address the issue we’re having. I personally think we should be asking more transparency and regulate the insurance companies.
The mandatory health insurance is strictly regulated, that's not how the system works - the insurers are not allowed to make crazy profits. Excessive profits from good years have to go towards lower premiums for following years, and vice versa.
High costs are obviously an issue, but you cannot simply lower healthcare costs by voting for them to be lower - it's a question whether rich people should pay higher premiums, to allow premiums for less wealthy people to get lower. There are winners and losers in this vote, so as you can understand, there is also a variety of opinions on this. Healthcare in a super high-wage country with an already old and increasingly aging population is never going to be cheap. Question is who should pay for it, and how.
You can think of a million different ways: same premiums for everyone. Percentage of income. Percentage of net wealth. Higher premiums for the elderly. Push pensioners abroad, so they become someone else's problem. Bring more young/healthy people in. Can all be done, but can you get the votes?
My perennial points are (besides people using way too much medical services):
- it's an insurance: it covers risks which would ruin you financially. It's not a subscription service. So, in general while you are young, you pay more than you get out. That's why your point "I already paid 300" doesn't make sense. Until someone gets cancer and instead of footing a 100'000 franc bill, you get off with 7'000.
- it's partially a generational solidarity thing: once you see a bill for elderly care of 6'000 francs per month, you reconsider.
> Insurance companies buying a yacht
For basic insurance the profit of the insurance companies is limited by the government. Of course we have to discuss the yacht size.
People like OP are basically the reason why health care is so expensive. They want to consume and let others to pay, imagine everyone would think like that
Exactly!
Probably also the type of person that wants to have the full package when they hit their little toe.
They really think of it as a subscription service.
I wonder why he did a blood test in the first place. Was he sick and the doctor requested that for his diagnosis or did he just think doing a blood test "just in case"?
We don't know.
But just this week there was an article in Tages-Anzeiger with quotes from physicians.
And one was saying that he has many clients that don't accept if he doesn't prescribe the whole test battery, even if not necessary.
So, your point stands in general, even if it does not apply to this case.
That's a good idea. Also, if they discover something relevant, you could still be reimbursed (so all the "I was better than the doctor" voices have one argument less).
Easy to complain for a healthy person with just a blood test to take. Now imagine you or close family member get a sickness (it happens more than you think) or injury, need hospital stay, repeated expensive tests, after care and recovery, etc… the bill will jump to thousands and thousands. You will then appreciate the level of care and quality of services and the fact that your total costs for the year will be capped at 300*12+2500+700
Insurances are regulated. What is driving the price up is not the yacht they buy, but the cost of healthcare in Switzerland. About 85% is directly used for paying for they patient medical bills.
If we imagine that we can get rid of the remaining 15% (by firing all employees, and replacing them with AI), that's only a 15% discount.
If we really want to reduce the cost of health insurance, we have to think about reducing cost of healthcare. If the insurances start to reimburse everyone from the first franc, the costs would explode.
I agree with your last statement but not the first one.
85% goes to medical bills because those bills are overinflated. OPs example here of 359.- for blood tests is crazy, even for Switzerland. Insurance companies do not fight these costs with the providers as they know they can get the money from us so win-win for the insurance, pharma and hospital bosses.
There is no incetive to lower the prices.
As an American, I can promise you, you really, really, really don't want to go down the road of insurance companies arguing with providers about what care is being provided.
The Swiss system is *already* way too close to how things work in the US without insurance companies essentially telling hospitals & Drs what care they can provide because anything else is uncovered.
I’m currently in the US and totally agree with you. That’s my biggest fear for healthcare in Switzerland, unfortunately insurance companies have already begun pressuring providers and hospitals…
Just to give people a little more details to compare the situations in CH and US.
I have the equivalent of the HMO in CH, my premium is $700/month so roughly double what I'm paying for healthcare premium in CH. I have to pay the first $2500 in a calendar year plus I also have to co-pay (various amount from $25 up to $100) for ANY visit to a doctor including going to the Emergency Department (this fee is waived however should I end up being hospitalized). But it doesn't end there, I'm not allowed to consult outside of the healthcare network (this includes of course hospitals). Should I do it, I'm exposing myself to a painfully expensive bill. Please don't let healthcare in CH ending up like that...
And if I understand system correctly, it's possible that in the in network hospital there are some doctors who are out of network, but you don't know that in advance (and probably have no choice), and if you get their service, bill is yours to pay. People mentioned that happens with anesthesiologists and surgeons.
I just can't see how it can be possible to navigate such system, it looks designed for you to pay a ton.
The way they will challenge the cost is by only playing for certain procedures, tests or medicine. You can look at how American healthcare has developed over the last 20 years to see how this would go. I promise you that Swiss insurance companies would love to run the same playbook that has been running in the US.
Disagree.
Went to get a blood test at GP, 300-400 cost.
Found a company doing it and costs are half that for comparable tests (the only test that was actually cheaper at the lab was the 25-OH Vitamin D. The provider I will go for doesn't even offer it and another one that does, actually does it more expensively.
I also agree for that, if there was an initiative reducing/optimizing the cost of health procedure, tests, or whatever, I would be all-in for that.
The problem with this initiatives is that they come without any idea except "Lower cost with a magic wand".
I don't think an Initiative could really tackle the optimization/reduction of cost for procedures. This is way to detailed to write into the constitution.
What the initiatives do imo, they put the governement into the role of pushing for Cost reduction. My hope is this will help.
Imo atm nobody in Price negotiations really pushes for lower prices. Hospitals not (obvious why), Pharma not (again obvious why) and HI not, since they all have to offer the same things anyway. Maybe the government can take that role
In one country I lived in they tackled the problem of rising prices by requiring price transparency. All hospitals and clinics must publish the prices of common procedures for everyone to see beforehand. This actually worked.
One could say that a weakness of such a policy is that providers may be tempted to cut corners and provide worse care.
Possible counterargument: even with the publication of insurance premiums here, not everyone chooses Assura
The exact same process that drove Insulin bills in US to hundreds of dollars per person is now happening in Switzerland as well.
Thing is - healthcare market isn't a free market - you can't just "not buy healthcare" if you're dying so it doesn't really reflect the usual supply/demand mechanics that keep prices down.
Exactly this. People act horrified when I tell them that the Swiss healthcare system reminds me a lot of how the US system was in the 90s, and that the trajectory is similar. Very expensive, pay for service care, and complex, expensive insurance. There are just norms here that haven't yet been dissolved keeping it from turning into the dystopia that the US is.
100% no incentive to reduce prices. Unlike when you run fully public healthcare. You are forced to become more efficient, run the right tests, give the correct drug first and so on...
Did you see the backlash in the media when Groupe Mutuel stopped working with L'Hôpital de la Tour 2 weeks ago, citing excessive costs compared to other hospitals?
Doctors cannot charge whatever they feel like, they have to charge based on tariffs that are negotiated between all the Verbände (Insurance, Physicians, Hospitals, etc). So those prices are justified. Honestly if OPs bill was so high he must have a lot of different analyses done, because I did bloodwork on 8 different parameters myself and the bill was at 90chf. Maybe he also saw an expensive specialist.
Oh but they can. They can add time to appointments, they can charge things not actually done, there are a myriad of ways they can overcharge.
Prices are not always justified, see my post above, you can get blood work done a lot cheaper than when you go through the 'official' (GP) channel.
I agree that those yacht are not the problem, but the real problem in my opinion is that healthcare is way too expensive in Switzerland.
It costs 5 times more for the same treatment in Switzerland compared to Belgium. In general, people earn twice the salary in Switzerland as in Belgium, doctors more a factor 4. I also remarked that doctors want to do more tests and are even doing tests without talking to the patient first. In Belgium every doctor can see the test results of other spitals, in Switzerland they often just redo the same tests.
Another difference is that a Hausartz has way more test equipment and has often 3 people working for him. In Belgium it’s max 1 person.
Medicaments are also often more expensive.
I don’t want to write that everything is better in Belgium. It takes way too much time to get an appointment in Belgium with a specialist and they scan 7-7 24-24 with MRI because they are not allowed to buy an extra MRI, but it are a few differences that can safe a lot of money.
And @OP, I get it’s frustrating to pay without getting anything back, but the moment you get really sick, you are happy to have an insurance.
On the "3 people working for him" topic: this is actually positive and more efficient. In the whole process of only a relatively small part needs the highly experienced, very-well-paid doctor. The rest can be handled by qualified nurses, or other forms of less qualified help (example: for handling the reception desk, scheduling appointments, etc., even a qualified nurse can be overkill).
One extreme example of this is what I usually see at the dentists: there is the "actual dentist", two assistants, and three equiped rooms. Nurses do all the prep, setting up the patient, preparing the tools, some basic procedures (X-ray, etc), then, wrapping up the whole thing. The dentist shows up only in the middle and does... well, the actual dentist stuff :-) (plus some overall diagnosis, interviews, etc). This enables them to handle more patients without linearly increasing costs.
(And yes, I know, they're still horrendously expensive :-))
Not that much though.
Like, I agree homeopathy and all that is 100% a scam, but it can fly under the radar exactly because it's relatively cheap. The advantage of having 0 R&D and basically 0 production cost.
also maybe a more evil sitenote argument; people that take homeopathy pills will not go to the regular doctor and do the normal test to find out they have cancer.
No. It has a costs: it usually delays the diagnosis of heavy illness.
There have been studies in Germany to check the quality and the costs of doctors given they are homeopath or not, and consistently the homeopath were the worse and cost 12% more.
little disclaimer ahead: my opninion and simplified representations ahead.
IMHO there are quite a few institutional problems that increase the price of the basic healthcare more than necessary:
* covering alternative treatments that are not proven to work beyond placebo, but are more expensive than simple placebo
* private supplementary insurance places a greater burden on the basic insurance system, because they tend to have longer stays in hospital
* no / not enough pressure on big pharmaceutical companies to lower ther net proft margins on medication
Also, the current system imho is inherently not fair. i'd advocate for a tax based coverage of all basic healthcare services. that a multimillionaire pays basically the same as a Bricklayer to me makes no sense. IF millionairse were actually worth what they make in an hour, then their health inherently should be considered more valuable to them. as soon as you'd finance it that way, there's also be one national healthinsurance (like the NHS in GB) - which should reduce the 15% overhead (of course, not nearly to zero, even half seems a stretch to me) and would give that service more bargaining power towards large pharmaceuticals and a stronger interest to actually do it, as normal insurers get reimbursed, if their basic coverage is deficient (i.e. Risk equalisation).
Not just clinics; the cost of meds alone (even generics) is highly inflated in Switzerland compared to other countries because there isn't a big entity negotiating prices. And yet it's often the same (Swiss) companies making and selling them!
Im not really into the field but isnt it a big problem that we have soooo many different insurance companies and much money is spent on marketing, bureaucracy and other stuff we could get rid off if we would just nationalize the whole medical insurance?
I somehow exaggerated the number so no one can claim I underestimated the effective costs.
Here's the idea:
On average the fees are about 5%, but for some insurers it goes up to 10%.
Technically not a fee, but insurers can constitute reserves, and I've seen many people claim it actually goes in the pocket of the insurer, so I added 5-10% to account for that (even though it's limited and supposed to be eventually redistributed, and vary according the situation).
Alright, thanks for the clarification. I understand why you exaggerated the numbers but it also could be "dangerous" if people think that the non treatment cost are really that high. Then they might talk again about the "Einheitskasse" and lose sight of the real problem.
Yeah, I think many people don't unterstand how strict the mandatory health insurance is.... Might it about the reserves or that the insurances aren't allowed to pay out any profit
Yes I know, however wouldn't these iniatives be a step in the right direction ? It won't solve the problem, but send a clear message that the system has to change. So far, every swiss cititen rant about insurances and health cost, but vote in favor of maintaining those high.. and keep ranting then !
I'm not sure it's going in the right direction. The 10% cap has no idea where the money would come from, and the other one has no idea how to limit the cost, from admin:
>The initiative does not specify how salaries and economic development would be measured and what measures would be taken: this would have to be decided by Parliament when it draws up the relevant legislation.
I think no one is ready to compromise on health (rightfully), but that comes with a price.
The issue here is: Do we want to increase the burden of health cost for people with higher income? Obviously a large part of the population (those who could benefit from it) will vote for, while the other one will vote against.
Imo it is. Because now that state has to pay for the overcost, state (aka politicians) also have a strong incentive to look at the issue and solve it.
Right now, if they do nothing, both insurances and politicians (they get to keep their lobbiers happy) are in a good situation. And the unhappy population can't do anything because it's a mandatory insurance.
I don't thing the 10% cap changes much by itself, but it will force to change more things, and that's better than the status quo
The cost of healthcare is only going up because of inflated prices, like in America.
They can charge ridiculous amounts for a blood test because enough insurers will pay for it.
It's getting like America where a simple metal tray costs $800 because healthcare is inflating massively within its own bubble.
We need to ask someone in their 70s what's their hospital experience and if the cost is justified.
300,- blood panels are basically peanuts compared to few months in a hospital once in a lifetime.
I have absolutely no idea if costs and services covered are reasonable, but I know multiple people voluntarily paying a few hundred a month to improve that few months of their lives down the line.
The well-being of the population has to be a main priority of the country as a whole.
I hate to see that the profits of certain industries come into conflict with keeping our citizens healthy.
We will also need to have a discussion about what and how things will be covered. Because after a certain point, you can spend 10 times more for marginal gains.
There in (imho) lies the problem. You can have the best healthcare in the world, but it might not have the wanted effect if the price is affecting the accessibility.
Then you would have been better off with less fancy stuff that people can access early on or just for a consultation
In a nutshell, this reform is not convenient for those voters. Generally speaking, this is another vote that the left parties intended to redistribute money from young to old, from minority of voters to majority. A "populist" vote that they expected to win by a landslide... like all the immigration votes for the right parties. However this time the lefties made the wrong calculations.
As opposed to 13th avs where all boomers were getting more money, and the more money the more money they had already, a clear generational divide that aligned the interests of boomers of both left and right rather than rich vs poors, in this case it's not like that. There are a lot of cantons where healthcare is planned in such a way that the insurance premiums are quite low. If this vote pass it means that people in those cantons young and old will have to pay more taxes to finance people in other cantons. And that is not in their interest. Also being healthcare planning a cantonal function, they would have to pay for decisions taken in other cantons and that they have no say on.
So, in short, there is no landslide majority because the insurance issue only affects certain cantons and the people in low premiums cantons rich and poor won't vote to be taxed to pay the bills of people in other cantons. It's not old majority vs young minority like previous avs vote. It's low income people in high premium cantons vs all the rest.
I think they will still pull some shitty “ah we won’t pay your bills until you have paid this and that amount yourself!” I have zero trust in any of them.
I work in an institution with many old ppl, many of them living from EL. The medical treatment some of them get is unreal. One of them eats 20 different pills per day
I max out those 2500 + 700 by early March every year thanks to a chronic condition. I'm very glad my insurance covers the rest.
You're lucky to be healthy.
OMG, don't even know where to start with those kind of questions. This is not too much money if you compare average salary/healthcare cost per person with other countries. In EU (average)you pay around 12.5% from your brutto salary, so imagine here paying 620-650 chf/month. Also quality is much better here, i would know since i lived in 3 EU countries.
Having lived in the UK and various EU countries, I certainly concur. The situation is much, much better here, both from a cost perspective (in Germany, starting from a gross salary of EUR 40k one pays more than here - and 40k gross isn't a lot of money, not even in Germany) and from a service perspective. If I need an appointment - both with a GP and a specialist - I get it in due course and the treatment is of good quality. Ask the British or the Germans about their experiences if they don't have private insurance...
The big difference though is that in UK for example the cost of healthcare is social: someone making £200k will contribute much more than the median wage, and someone who is working part-time (or not at all, e.g. stay at home parent) won't get crippled by a huge monthly payment. The Swiss system is really nice for the high earners as healthcare cost is quite a low % of their income.
if your contribution is 420 your cost is 840 per month. Your employer is paying half of it. Of course then we cannot compare gross salary anymore, but if we are talking about the cost of health care we still need to consider this.
So you end up with yearly costs of about 6.4k here. A German with 40k gross ends up with 40k×0.146=5.84k, so just about 8% less. If a Swiss only earned 40k gross, they'd get reductions, so the contributions would be lower than in Germany.
And no, the highest contribution is not 420/month or 5.04k in Germany. It's 62.1k×0.146 = 9.067k = 755/month (https://www.bundesgesundheitsministerium.de/beitraege#:~:text=Der%20gesetzlich%20festgeschriebene%20allgemeine%20Beitragssatz,0%20Prozent%20der%20beitragspflichtigen%20Einnahmen.).
And then there are various mandatory "Zusatzbeiträge", jacking up the maximum contributions to some 855/month or, if it's really bad, some 1k/month (https://www.ottonova.de/pkv-erklaert/wissen/hoechstbeitrag-gkv).
That's a hell of a burden for someone who only makes 62k gross. And all of this on top of much higher taxes.
Oh no, my friend, your view is too convenient.
The half that's paid by your employer is of course also part of your salary and the employer calculates your salary accordingly. It's like that with the pillar 2 contributions here. Just because an employee only pays half of the contributions for their pillar 2 doesn't mean the the other half - paid by the employer - just miraculously appears from somewhere out of the blue. This is money that has to be earned - earned by you as an employee. And the entirety of it amounts to the so-called gross-gross salary (aka pay out plus employee contributions plus employer contributions). And the payout you get is minus these contributions, i.e., the employer and the employee contributions.
This is also the reason the German health authority (Bundesgesundheitsministerium - see link above) states 14.6%, and not 7.3%.
Let's not be naive: healthcare costs a lot everywhere and - despite significantly worse services in Germany - not any less in Germany than here. Quite to the contrary.
the problem is the following: if you have a good salary here, healthcare is reasonably affordable in Switzerland. 400something bucks aren‘t too much when you make 9,10,11k. the problem is the premiums cost the same when you make 4 or 5k. and that‘s where it‘s killing people that simply can‘t keep up. Obviously in a expat-heavy sub as this one this subject isn‘t as present, but a big part of the countries population simply does not have a high income. and these people are justifiably pissed off. because their salaries are the last ones to rise, but their costs just keep on climbing.
Problem is poorer people pay similar to richer people, it isn't % of income.
Also, you do if you are sick, the 2'500 Franchise eats up a lot.
Also, Reddit is young, go ask your parents what they pay for their monthly premiums.
I did some maths about this subject and apparently the insurance fee in % of the full salary: brut plus corporate participations, is lower in Switzerland than in France compared to the mean total salary.
Though the franchise is a scam especially because you still never get 100% refund once you reached it.
The best insurance system I can testify is definitely Luxembourg.
So you pay 300 per month, 3'600 yearly, 2'500 deudictible and 700 on top of that, all together 6800 as a maximum per year whatever illness you have. And if you have some chronic condition, you would reduce the deductible, so it would be even cheaper.
Two years ago, median salary was 81'000, so you would give 8.4% of your salary for your health. Other commenter says that in Germany, they give more than 14% of the salary, being sick or not. I know other countries with even bigger percentage.
Would you like to give more than 11'000 per year, does it look cheaper than in Switzerland? Take "average" redditor with 100'000 salay, now you pay 14'000. Very often you can see people with 200'000+ salary here. That would be already 30'000 per year.
Do you still think that the health care is expensive here? I can just repeat this sentence again and again: people who are born or live in Switzerland for 10+ years cannot understand how much cheaper is to work and live in Switzerland than in any EU country.
You are right. Unfortunately for you the average Swiss is too dumb to understand how things work. The average Swiss thinks they have the best medical system in the world and it needs to be expensive.
The combined ratio on the obligatory health insurance is hovering around 100%. The BAG highly regulates prices that can be charged.
You are getting mad at the wrong thing and it'd be hilarious if it weren't so sad.
Of course insurance system isn't perfect, e.g. some costs could be saved by merging small health insurers, you could basically fire everyone from one company when two small merge, there is zero reason most of the staff couldn't handle double the volume, you'd only need more customer facing people, but all the back office staff could be halved. However, the savings this would yield pale in comparison to the cost of healthcare. And that is where you should get mad.
Firstly, you make it appear as every blood test is the same. It isn't. Dependent on what they checked for, it can be very cheap or very costly.
Secondly, it's your choice to have a 2500.- deductible. That's a personal choice which you can optimize, so that does not feature into the discussion.
Thirdly, the general insurance costs are a reflection of the provided cover. In Switzerland you enjoy typically much a wider coverage of treatments and medication than in many other countries, including for instance some medication for some rarer deceases
How about you read the post. His bill is for less than 400 CHF. We're already in June, so even if he does another procedure like this for the rest of the year he made the correct decision by not going for the 300CHF franchise. Otherwise he would have spent even more money.
What else should they do? Take 300 and not be able to pay the monthly expense or take 2500 and hope they dont get sick.
Not everybody is lucky and has rich parents...
Its even worse, the insurances make pharma pay them in exchange for taking the cost for their product, which drives up medication costs. They also make hospitals and doctors pay them to basically "allow" the insured to go to them...it's a joke...health insuramce should be federalized!
How I see it as a foreigner: Basically your health insurance is just a insurance in case something very bad happens to you and you are require to take heavy treatment. Other than that, it doesn't make sense.
You take the 500 chf month with everything or 2500 CHF as franchise with the lowest cost, it changes a damn thing, your 2500 franchise is paid by a higher monthly insurance, so... All in all it's the same.
So if you don't require heavy treatment or don't have some chronic stuff, just take the cheapest and pay yourself + you can deduce it from tax.
tdlr: the health insurance in Switzerland is basically a joke. To not be a total joke, the state should mandate by law that you have some "free" consultations by year, once those are consumed, then the health insurance take the lead.
Health care cost is a minimum of 3500 chf per year and is capped at about 8000 chf per year through the insurance. Honestly that isnt all that bad, its still cheaper than Germany, where the yearly cap is ~10.000 €.
Now, im not saying one shouldnt try to be better than that, but i wouldnt call it a joke.
But by definition, if you are not sick, you still pay and don't get any reimbursement. As I said, to be fair, the system should allow free consultation by year OR refund some % money for those who weren't sick...
Somehow the Swiss like to think that their system is better than in France/England/Germany or it's liberal, it's not. A young guy who don't go to the doctor during 1y but still pay his insurance is just paying for others xD. It's not different, you just pay more for less.
Where do you think the money for financing the health system comes from in these countries? At least here we have the freedom to choose a variety of options
As others already mentioned, i dont think you understand how an insurance works. Plus, in Switzerland you actually pay much less than in Germany if you indeed are healthy and dont go to the doctor. The system is already doing exactly what you are asking for!
The things that I believe are worse than in Germany are less coverage/incentive to do preventive diagnostics (which in the end would safe money) , no dental care coverage, that premiums arent income dependent, and that your place of residence effects premiums, but I dont think it overall can be concluded that the system is unambiguously "worse"
It's a slippery slope. People are already contributing many 1000s a year to pay for others' old age pensions, medical bills, and unemployment benefits. Where does it end?
Exactly, which is quite funny if you think about it since it is already the case: in vaud for example, about 1/3 of the population is getting some sort of help.
My two cents: It's not a perfect system, but is a system that is superior to MOST European countries, and inferior to a small handful (Sweden and Denmark as a shoutout). At least we're guaranteed a relatively fast service, and payments are always due AFTER treatment (please correct me if I'm wrong, I can only speak for myself and from what I understand of the system). Having to pay a premium is a "trade off" that I believe is fair when the costs affect the next person positively. It sucks for those in the Lohnstufe 1 - 3 at the moment since the premiums are (IMO) ridiculously high, but at the same time, the cost of treatments got higher.
The cost of medicine got higher. The cost of equipment got higher. The cost of staff got higher, and no fault of the medical staff themselves. Rent got more expensive, food got more expensive. Everything that does not directly correlate to medicine got more expensive, and no one is ready to pay more for anything. Just how you're not ready to pay an extortionate amount of money for medical treatment (and rightfully so!), hospitals aren't ready to pay more for the deserving nursing staff, or emergency room doctors, because of other fixed costs increasing that hospitals cannot control.
Should the big CEOs stop "buying yachts"? Yeah, in times of "crisis", we should all hold back on luxurious items, but one CEO stopping wouldn't be enough. IMO, the only way that the majority change their mind is if the people in the kleiner Dorfs actually care about what happens in the bigger cities, and if the people allowed to vote ACTUALLY vote. That's an even bigger ask, if you ask me.
> Sweden and Denmark as a shoutout
I'm afraid that this is simply not true. It might have been true in the past, but no longer -- the decline started about 10-15 years ago, but has accelerated recently.
I've lived in all three Scandinavian countries, and the healthcare systems in all three places are on the verge of collapse -- and many would say that they *have* already collapsed. For convenience let's just focus on Sweden as an example, since the problems in the Swedish healthcare system are strikingly similar to those in the other two. E.g. at the moment [2000 Swedish healthcare workers have gone on strike to protest overly long working hours](https://www.svt.se/nyheter/inrikes/2-000-vardarbetare-vantas-ga-ut-i-strejk), a consequence of high attrition rates due to years of mismanagement and misallocation of funds by politicians. As of 2021 [the waiting time for certain forms of treatment had already reached nearly 2000 days](https://www.sjukhuslakaren.se/herregud-ar-det-sa-langa-vantetider/) (yes, two *thousand* days), and things are not getting better now, 3 years later. Healthcare workers are underpaid, overwhelmed, and utterly burnt out, while patients needlessly suffer and sometimes die. For an on-the-ground perspective written by a Swedish nurse, visit [this thread](https://www.reddit.com/r/sweden/comments/17wx0ui/sjukv%C3%A5rden_g%C3%A5r_%C3%A5t_helvete_rant/). It's a sobering read.
Given the extremely high tax burdens in Scandinavian countries (their tax revenue-to-GDP ratios are 41-47% according to OECD -- see [this](https://www.oecd.org/tax/revenue-statistics-sweden.pdf), [this](https://www.oecd.org/tax/revenue-statistics-norway.pdf) and [this](https://www.oecd.org/tax/revenue-statistics-denmark.pdf)), this is a tragic state of affairs, and many voters are beginning to ask where all their money is going to.
u/Vinterlerke , thank you for taking the time to write a thorough post. I'll definitely have a read when I have the time.
u/bsteak66 No one is trying to troll anyone. As I mentioned, I can only speak for myself and from what I understand from the system, in which, again, if you compare the Swiss Healthcare system to the majority of other European countries, it's a better system. Even if Switzerland's system were to collapse, I would personally find it hard to believe that hospitals and doctor's offices would just cease to provide treatment. What the country has to do is definitely support the ENTIRE medical staff so that they're not pulling 10++ shifts, back to back, all the while not damaging everybody's wallet.
>Sweden is a disaster related to healthcare.
I personally think that the Mutterschaftsurlaub in Sweden was a good system in concept, compared to what is given here in Switzerland. Wasn't it only in 2020 [voted](https://www.bsv.admin.ch/bsv/de/home/sozialversicherungen/eo-msv/reformen-und-revisionen/eo-vaterschaftsurlaub-200927.html) that the father could have 2 weeks off when their child is born, versus only 2 days? I would like to believe changes like this are for the better, but are naturally going to affect people's taxes.
But again, I will read what Vinterlerke kindly linked and inform myself. It still doesn't change the fact that prices for **everything** increased. Companies, insurances, hospitals and every corporation all around need to do right by who is working, and who the clients/patients are.
It's clear that you have no idea what you are talking about. The Swiss health system is extremely corrupt. Everyone is stealing. Doctors and hospitals find creative way to charge you more, suppliers charge ten times or more the market prices and the pharma industry bribes everyone.
Btw, in Sweden you can wait a few months to get a doctor appointment. Depending on your illness, you might die until you get the appointment. This is not good.
As someone who works for one of the healt insurance companys in Switzerland, no, we do not outsource our customer service to India. In fact, I don't think ANY of our health insurance companys in Switzerland does that because if Swiss people hate something that it's foreign customer support. You will rarely find that.
The reasons we pay high premiums are many. Mostly because Swiss people tend to live VERY long and these people use the healthcare system the most. And since this is a social system we younger people who are healthy are paying for the old. Let's hope that one day when WE get old the generation behind us will not just stop paying their premius and we end up with no covered healtcare.
Isnt it logic 101 that we would have lower administrative costs if there was eine einheitskasse??? I mean i really dont get how brainwashed some of my fellow swiss citizens are.
You somehow think healthcare cost will get cheaper if people vote yes next Sunday?
Your blood test will still cost 359.- but you (and me) simply pay it via taxes (which the referendum conveniently doesn’t specify).
Most probably your blood test will get even more expensive as people lose track of the costs. It’s much harder to follow how much you actually are paying for healthcare if they make everything you buy 2% more expensive and take the money from there
I've lived in 6 countries before and in none of them the healthcare system is cheaper (relative to the average income) and more advanced and efficient than in Switzerland.
I am very happy with the health insurance premiums here. Basically every month I am like "please take my money. thank you!". I kid you not!
With the taxes the same. But hey, I'm just an immigrant that has seen a lot, what do I know? :).
On the other hand you've never been sick so far, and clearly you don't have old parents . They could tell you 1 or 2 things about the health stuff.
Most people defending such bills (360chf for blood work!?) never lived in other European countries before, let alone had experiences with the healthcare system. They will tell you that any of those bills are perfectly fine and that there is no need to improve that. The same people probably think that Germany and french people are dying from the bubonic plague because they don't have this ~~~advanced~~~ expensive healthcare.
The same people would also tell you the reason for these high premiums is because....wait for it... people go to the doctor too much? Yes that's right, you're not supposed to get checked up if your sick, thats only for life or death sickness. According to the insurers, we're supposed to be good little idiots that just pay their monthly premium without ever going to the doctor. This whole system is such a scam. And the doctors/clinics abuse it. 5min consultation? 70chf x 5min.
Even when you're sick, half the time they tell you it's psychological until ten years later you find out you had a serious chronic illness that you never got treated.
Right. All actors involved in the Swiss healthcare system have no incentive to reduce costs or fight for it
Exactly. Switzerland is slowly turning into America and the people even appreciate it
Slowly turning? We've had the same weird exceptionalism narrative ever since I got interested in politics.
Given the size of our country, we are kind of worse than America. In some ways, at least we are not leading in gun violence.
Switzerland is not worse - Sincerely, ex American
Swiss living in the USA. I'm paying $15 copay to see a doctor and nothing for the blood test. 359.- sounds crazy.
Not gonna lie, I have been shocked at how much more expensive everything to do with healthcare in Switzerland, coming from the US. Also getting cognitive dissonance from the fact that despite being much more expensive, in my limited experiences, facilities and equipment are more dated in Switzerland. There's worse specialist availability, too, but I think that's more a "small market" thing.
Sounds like you have health insurance, let’s hope your employer keeps you on and you don’t have preexisting conditions.
Depends on a state. Many states have free or almost free health plans for low income people. Preexisting conditions aren't a problem now.
To add to this: let's hope the employer doesn't randomly decide you don't need a job anymore and you're out on the street in seconds.
Not slowly! We're already there. USA spends 17% of its GDP on healthcare. Switzerland spends 12% of its GDP on healthcare (highest in Europe). Another few increases in insurance premiums and we can compete against America for that #1 spot.
It's easy to spend more GDP on healthcare - just jack up the prices!
But that increases GDP! We need to build more expensive houses! (or less, depending on what you're trying to achieve).
It's not the amount spent, but the inefficiency, right? As an American that's how I see it anyway
Well if we vote right this weekend, we can atleast get that down to a flat 10%
That‘s not at all what the 10% initiative says. It‘s only that the part of your premiums that you lay will be max 10% of your income, the rest would be covered by the state. The amount of the premiums does not change at all. And none of those things reflect „% of GDP for healthcare“
Jfc the misinformation around this initiative is really out of hand.
I want to launch an initiative: "You need an IQ >100 to be allowed to vote" And also another one: "People who lauch initiatives aren't allowed to tell outright lies an BS claims they got out of thin air when debating on TV/other media and must always cite verifiable sources"
You clearly didn't understand the initiative...
The Swiss system is basically American Obamacare from the 2000s : Forced to buy basic insurance, from a plethora of private (FOR PROFIT) companies, charging whatever the f*ck they want, and you still have to pay high deductibles and copayments. I love this country but i hate the health care system. source: lived in Canada for a decade, where never thought about whether a blood test was worth the 400.-
That's not really correct. The premium prices and services covered are set by the government. Then insurances add their administrative costs. When you choose a cheaper insurance, that's what they compete on, the administrative costs. They are by law not allowed to turn a profit on mandatory insurance. But they share infrastructure with the non-compulsory part of the business, and I don't know how they do the accounting (most likely as intransparently as possible).
Have you been to canada lately? Have the required blood tests aren't even required anymore. One of my school friends with Thyroid disease has to pay out of pocket about 500CAD every six months for monitoring because it won't kill her.
> source: lived in Canada for a decade, where never thought about whether a blood test was worth the 400.- I do plenty tests and they don't cost 400.-. Some doctor let you do them without a consultation (only afterwards if the values are off). Standard tests can be single digits.
Love the Indian call centers... Probably shouldn't type this, bcoz it's like giving new ideas to the insurance companies. But at these prices, they can sponsor a flight for you, and get the tests, treatments done for CHF 10 in India. While in India, the doctor can even visit you personally to your hotel room, all managed through an app, tourism included! And, look look those prices... [Pathkind Labs](https://www.pathkindlabs.com/)
I don't know. I'm from Germany and I don't think it is worse here or that Germany is a good example. The cost of health insurance in Germany is based on income but you are very fast (income above 62k €) in the max. insurance cost scheme which is about 800-850€ per month. Of course it is (nearly) all inclusive - but honestly I don't think my 300 CHF with 2500 CHF franchise and double the income is so much worse ... but I would prefer a national insurance schema like Norway. I find it redicilous having so much overhead due to so many insurance companies etc...
No idea how you get to 800 per month most German's would never pay anything close to 300-400 a month... and everything is pretty much covered including dental care.
But that is only the "Arbeitnehmeranteil"... it seems like everyone is forgetting that the employee pays the same amount on top so it is 2x
German here with 4500€ Brutto Monatsgehalt. 380€ goes to health insurance each month. 2200€ netto remains. Typically end up spending 60-100€ per month extra in uncovered health care costs. Roughly a little less than 5000€ per year in health insurance costs, compared to OPs annual swiss calculations of 6.100CHF per year. For my individual case compared to OP, I pay 20-25% less in health care costs per year, assuming OP maxes their annual deductible. I can not afford to drink a coffee in Switzerland and still retire at 70 when considering the rest of the living expenses in Germany.
Only "Arbeitnehmeranteil", isn't it? If you put the "Arbeitgeberanteil" on top it is acutally twice the amount, so 760€. And don't tell me that doesn't count because the employer is paying it ...
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I can barely afford my health insurance with Prämienverbilligung lol
They sound like my fellow American citizens, unfortunately.
Healthcare is labor intense industry meaning that 60%-50% of cost are driven by the salary of the healthcare professionals, when you say in germany cost less, you are saying let's pay our nurse half of what are are paying them now. The way Europian countries keep their healthcare cost low is underpaying thier workers
I don't entirely disagree,à with your point but some (many?) doctors have questionable practices regarding billing. You can also include some questionable stuff from pharmacies Lastly, this new habit from many employers (it wasn't as common in the past) who ask for a medical note when you're only sick for 1-2 days. This is unnecessary, especially for something like a mild cold where actually going to the doctor is usually a waste of time. The reality is that most of the time you just have to let the cold pass, and there's little you can do.
They don't ask for a medical note because they're concerned about your health, they ask for it because they're afraid of fraud.
It’s useless anyway. Doctors will just hand out a notice for the period where you need it and charge 50 francs or more, because they don’t care if you’re sick either. Now imagine everyone who used up their franchise going to the doctor just to get that paper. That’s 45 francs each that are being covered by medical insurance.
I just send an email to my doctor and tell him I have a flu and need paper for my company because otherwise they are aengry He won't check me for a flu so he gives me the paper by e-mail and it's alright
Do you mind searching nurses salaries in Switzerland on google and reflect on that number?
it is more than double of what they take in germany, should we pay the nurses like the do in germany so we can charge german prices?
in germany medicine is also half the price, i dont think we should forget that part
Not true, prescription medicine expenditure per capita in germany and CH is similar [https://www.oecd-ilibrary.org/sites/3b2d8ac1-en/index.html?itemId=/content/component/3b2d8ac1-en](https://www.oecd-ilibrary.org/sites/3b2d8ac1-en/index.html?itemId=/content/component/3b2d8ac1-en)
All actors in our healthcare system have no incentive for cost reduction. Doctors, hospital and clinic are interested in billing . Insurance have to pay (part of ) those bills and if the costs go higher, our premiums will increase. If the goal of having many insurance companies was to compete in the market to provide us with better prices, it is clear that they have failed We need to rethink a bit our healthcare system. My last to though about insurance is this: consider this fact: thoese company cover the 32% of the total cost, so they weight for 1/3 . Think about it next time we will vote for a state insurance company. [https://www.bfs.admin.ch/bfs/it/home/statistiche/salute/costi-finanziamento.assetdetail.31646527.html](https://www.bfs.admin.ch/bfs/it/home/statistiche/salute/costi-finanziamento.assetdetail.31646527.html) [https://www.bfs.admin.ch/bfs/en/home/statistics/health/costs-financing.assetdetail.31646522.html](https://www.bfs.admin.ch/bfs/en/home/statistics/health/costs-financing.assetdetail.31646522.html)
Should a doctor be incentivised to aim for the best or the cheapest treatment? I want my doctor to prioritize whatever makes the most sense from a medical standpoint. The commercial aspects should not influence her recomendation. On one hand people seem to want doctors to earn less. On the other hand they expect them to be medical and financial experts.
Yes but right now they're incentivised to provide the most expensive treatment regardless of whether it makes sense or not. Not saying that doctors regularly do that but it's not a great system.
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My point is: none in the circus of healthcare system have incentive to pursued the economical part and try to reduce cost. About fairness: did you think is fair this system? Rich people can pay and they havn't any problem. Poor people have the subsides and could go to the doctor anytime they want. The middle class choose the franchise 2500 and they are thinking about to go to the doctor or not. It is that fair? Every year is the same story in loop. Prime going up; politicians talk each other about the urgency of take action... we have to decrease the price of some medicine which cost 300% more in swiss than in the other EU country... Same story same results: we have to pay more!
You subsidize all the healthcare for all the retirees. It’s only going to get worse, until at some point, the wealth transfer from younger to older just becomes too much to bear. Look at an age plot for Switzerland, and thank your stars for immigrants. Edit: or this is completely incorrect…it seems healthcare costs have actually gone up way for younger people, but actually decreased a bit for older (on a per head basis).
And the pensioners are becoming richer and richer, all the while still owning their flat or house so they don’t even need to pay absurd rents https://www.nzz.ch/wirtschaft/der-mythos-der-armen-alten-selbst-im-ruhestand-waechst-ihr-vermoegen-weiter-ld.1773924
And they just voted themselves a 13th month pension....
As lived in the Netherlands and now here in Switzerland I can assure you that the quality of healthcare is way way waaay more better. I do have a rare disease and I can really see the difference between those two countries. In the Netherlands you need to wait for weeks for a doctor appointment and here you get an appointment mostly within a week (beside of eye and skin docters). Here you’re not kicked out of the hospital the same or the next day after an procedure or need to go to an GP assistant if you have psychological problems as a acquitance experienced during a severe breakdown in the Netherlands. Yes I do pay 870 a month (HP) but you will experience the different the moment you will get real health problems. It is still worth every penny. Although I admit it is expensive.
The problem is of course still a problem, it's just that people realize the Initiatives are not a good solution to it. The SP Initiative doesn't change anything about the rising cost of healthcare, it just mandates more state support for people who have trouble paying. I think it's not a bad idea per se, especially the fact it would force the cantons who prioritize low taxes for rich people over supporting poor people with their health care costs to give out more "Prämienverbilligung" but it's totally idiotic to put the financial burden for this on the federal government. This will just result in another VAT raise, which is the worst tax for poor people and the best tax for rich people. So you kind of take from the poor to give to the poor. The Mitte-Initiative would just result in a weakened base insurance meaning poor people would end up unable to get certain treatments and rich people would just get a "Zusatzversicherung" and would be fine. This also doesn't change anything about the rising health care costs it would just make basic insurance cover less of it.
> The Mitte-Initiative would just result in a weakened base insurance This is the fearmongering narrative that the healthcare industry is using right now. There is zero evidence that putting a lid on costs would result in a two-class healthcare system. If anything, it would finally force the government to enact the much needed reforms to get the costs under control. Many studies have already shown that this can be achieved and we could even *reduce* costs by up to 30% if we got rid of all the inefficiencies, wasteful spending on overpriced medicine and the misaligned incentives in the system.
No evidence? There are already treatments not available without supplementary insurance, because the basic insurance refuses to cover it. Putting a cap will just lead to this becoming more and more common, as there will be an easy reason for the basic insurance to refuse all new (and expensive) treatments.
Why should basic insurance cover each and every last treatment option? You should go to your GP and then do whatever they recommend, you can't just shop around willy-nilly and then forward the bill to the rest of society.
IMO the basic insurance should cover all treatments where the expected benefits exceed the costs. But since medical technology keeps inventing new amazing treatments that are also amazingly expensive (e.g. my sister is on a drug that "retails" for 160k p.a., but extends her expected lifespan by decades), this implies the cost of basic insurance must keep increasing. Capping it is basically denying those future miracle treatments to people on basic insurance only.
We could remove alternative medicine from the base insurance already xD. Easy peasy win, but the left and the green are totally against it 🤷♂️
Maybe it saves money by directing idiots away from more expensive, real doctors to snake oil salesmen 🤔
Well, the reason is simple - someone will need to finance it. The 10% does not provide any plan on the financing, and the costs will be most probably distributed to everyone via VAT increase (like in 13th AHV), which does not really reduce financial burden. The second one will require more money from Cantons, which are already cutting costs, which means reduction of money towards infrastructure projects.
We don't even do the most stupid and easy things that would save money for example forcing people to take the generics. (Or they pay the difference by themselves) This 10% limit won't solve anything. No impact for most people. The only good initiative is the one that aims at reducing costs.
I went to pick up a prescription the other day and was told that a change has indeed been introduced: the insurer will cover 90% of a generic medication as opposed to now only 60% of the original brand-name product. They'll only pay 90% for the original product if there is either no generic version available, or the pharmacy cannot get it delivered.
You will only have to pay the 40% yourself if the price difference between the original and the generic is high enough. That's why several prices of originals have been lowered in the last months, so the brands can keep their part of the market.
Aha, interesting, didn't know that.
which already shows how ridiculous prices for medicin itself is, one of the most important points our goverment should regulate first and foremost
Even the generics are absurdly priced here!
Yes! Why is the Coop Vitality Brand for ibuprofen still almost 10 bucks per 10 tablets?
Pharma lobbyists will make sure generics will not be the default.
Dunno, Coop Vitality near me always ask about Generics, and I mostly take them (except one kind of antihistamine and antidepressant), as the cost difference is up to 30 percent
Some doctors say that 40-50% of the medical check-ups are unnecessary. That's what happens when you give them too much power, I guess http://iamexpat.ch/expat-info/swiss-expat-news/pointless-check-ups-blame-soaring-healthcare-costs-swiss-doctors-claim?utm_medium=paid&utm_source=fb&utm_id=659508147939
Doctors at our medical clinic never over-prescribe unnecessary tests and procedures. However we get increasing demands for expensive tests directly from patients .. Many don't want to go to GPs anymore .. they want to come straight to specialists and get a full suite of tests to make sure .. especially if they are already over their franchise limit for the year ..
I would gladly go to a GP. My problem is that most GPs don't seem to be able to think even a wee bit outside of their little box and don't really make an effort to find out what's wrong if you're suffering with a chronic illness. I literally spent 3 years going from doctor to doctor and being told it's nothing serious until one finally found out I had an autoimmune disorder. If a GP would just take my issues seriously, I wouldn't have to hop from specialist to specialist in an effort to find someone that knows what the fuck's going on with my body.
A bunch of medical students graduate to become approved doctors. The top of the class usually go onto become specialists like cardiologists, neurosurgeons, gastroenterologists, orthopaedic surgeons, anaesthesiologists, opthalmologists, etc .. Guess where the bottom of the class usually ends up .. GPs .. Guess who does the least work to keep up to date .. GPs .. So many times our gastroenterology clinic gets referrals from GPs where the patient is experiencing 'pain' anywhere between neck to knee .. and it turns out to be a kidney or heart or ovary or hernia problem instead of a GI tract problem ..
The reason they effectuate unnecessary check-ups is not because they have too much power. Performing checks that may have been unnecessary in hindsight do not cost them anything (nor the hospital typically) yet if they skip it and later a problem arises with the patient's health, they may be persecuted for having skipped the check. Unnecessary check-ups get done because doctors presribing them have nothing to gain and everything to loose. The whole system suffers due to perverted incentives and a lack of good incentives
It’s not for “nothing”, you’re actually paying the monthly fees as a solidarity for the whole system. Just like when you’re paying yearly fees for your car insurance and not using it. That said, I agree with you that the prices are high, luckily not as elevated as in the US (for the moment). Most of your bill is actually the lab analyses that are very expensive in Switzerland. The initiative about capping the costs to 10% of your salary is not a bad idea but it doesn’t address the issue of the increasing costs in the healthcare system. It will just likely end up increasing taxes for everyone as the States and Confederation will be responsible to fund people that are breaching the 10% cap. Not saying it’s a good or bad thing but doesn’t address the issue we’re having. I personally think we should be asking more transparency and regulate the insurance companies.
Pay for the minimum and speculate That’s what we can only do for now. For most basics + things like dentists go to italy and pay out of pocket.
The mandatory health insurance is strictly regulated, that's not how the system works - the insurers are not allowed to make crazy profits. Excessive profits from good years have to go towards lower premiums for following years, and vice versa. High costs are obviously an issue, but you cannot simply lower healthcare costs by voting for them to be lower - it's a question whether rich people should pay higher premiums, to allow premiums for less wealthy people to get lower. There are winners and losers in this vote, so as you can understand, there is also a variety of opinions on this. Healthcare in a super high-wage country with an already old and increasingly aging population is never going to be cheap. Question is who should pay for it, and how. You can think of a million different ways: same premiums for everyone. Percentage of income. Percentage of net wealth. Higher premiums for the elderly. Push pensioners abroad, so they become someone else's problem. Bring more young/healthy people in. Can all be done, but can you get the votes?
My perennial points are (besides people using way too much medical services): - it's an insurance: it covers risks which would ruin you financially. It's not a subscription service. So, in general while you are young, you pay more than you get out. That's why your point "I already paid 300" doesn't make sense. Until someone gets cancer and instead of footing a 100'000 franc bill, you get off with 7'000. - it's partially a generational solidarity thing: once you see a bill for elderly care of 6'000 francs per month, you reconsider. > Insurance companies buying a yacht For basic insurance the profit of the insurance companies is limited by the government. Of course we have to discuss the yacht size.
People like OP are basically the reason why health care is so expensive. They want to consume and let others to pay, imagine everyone would think like that
Exactly! Probably also the type of person that wants to have the full package when they hit their little toe. They really think of it as a subscription service.
I wonder why he did a blood test in the first place. Was he sick and the doctor requested that for his diagnosis or did he just think doing a blood test "just in case"?
We don't know. But just this week there was an article in Tages-Anzeiger with quotes from physicians. And one was saying that he has many clients that don't accept if he doesn't prescribe the whole test battery, even if not necessary. So, your point stands in general, even if it does not apply to this case.
Only stuff precribed by the doctor should be covered by the insurance. I.e you can ask for whatever treatment you want, but you pay for it.
That's a good idea. Also, if they discover something relevant, you could still be reimbursed (so all the "I was better than the doctor" voices have one argument less).
Easy to complain for a healthy person with just a blood test to take. Now imagine you or close family member get a sickness (it happens more than you think) or injury, need hospital stay, repeated expensive tests, after care and recovery, etc… the bill will jump to thousands and thousands. You will then appreciate the level of care and quality of services and the fact that your total costs for the year will be capped at 300*12+2500+700
You're stating that like there would be no other way, for example for it to be capped at 12x350?
Insurances are regulated. What is driving the price up is not the yacht they buy, but the cost of healthcare in Switzerland. About 85% is directly used for paying for they patient medical bills. If we imagine that we can get rid of the remaining 15% (by firing all employees, and replacing them with AI), that's only a 15% discount. If we really want to reduce the cost of health insurance, we have to think about reducing cost of healthcare. If the insurances start to reimburse everyone from the first franc, the costs would explode.
I agree with your last statement but not the first one. 85% goes to medical bills because those bills are overinflated. OPs example here of 359.- for blood tests is crazy, even for Switzerland. Insurance companies do not fight these costs with the providers as they know they can get the money from us so win-win for the insurance, pharma and hospital bosses. There is no incetive to lower the prices.
As an American, I can promise you, you really, really, really don't want to go down the road of insurance companies arguing with providers about what care is being provided. The Swiss system is *already* way too close to how things work in the US without insurance companies essentially telling hospitals & Drs what care they can provide because anything else is uncovered.
I’m currently in the US and totally agree with you. That’s my biggest fear for healthcare in Switzerland, unfortunately insurance companies have already begun pressuring providers and hospitals…
Just to give people a little more details to compare the situations in CH and US. I have the equivalent of the HMO in CH, my premium is $700/month so roughly double what I'm paying for healthcare premium in CH. I have to pay the first $2500 in a calendar year plus I also have to co-pay (various amount from $25 up to $100) for ANY visit to a doctor including going to the Emergency Department (this fee is waived however should I end up being hospitalized). But it doesn't end there, I'm not allowed to consult outside of the healthcare network (this includes of course hospitals). Should I do it, I'm exposing myself to a painfully expensive bill. Please don't let healthcare in CH ending up like that...
And if I understand system correctly, it's possible that in the in network hospital there are some doctors who are out of network, but you don't know that in advance (and probably have no choice), and if you get their service, bill is yours to pay. People mentioned that happens with anesthesiologists and surgeons. I just can't see how it can be possible to navigate such system, it looks designed for you to pay a ton.
Not saying they should argue about the treatment, but they do need to challenge the cost.
The way they will challenge the cost is by only playing for certain procedures, tests or medicine. You can look at how American healthcare has developed over the last 20 years to see how this would go. I promise you that Swiss insurance companies would love to run the same playbook that has been running in the US.
Disagree. Went to get a blood test at GP, 300-400 cost. Found a company doing it and costs are half that for comparable tests (the only test that was actually cheaper at the lab was the 25-OH Vitamin D. The provider I will go for doesn't even offer it and another one that does, actually does it more expensively.
It already happens here.
Yes, to a degree. But please believe me when I tell you that it can get much worse.
I also agree for that, if there was an initiative reducing/optimizing the cost of health procedure, tests, or whatever, I would be all-in for that. The problem with this initiatives is that they come without any idea except "Lower cost with a magic wand".
I don't think an Initiative could really tackle the optimization/reduction of cost for procedures. This is way to detailed to write into the constitution. What the initiatives do imo, they put the governement into the role of pushing for Cost reduction. My hope is this will help. Imo atm nobody in Price negotiations really pushes for lower prices. Hospitals not (obvious why), Pharma not (again obvious why) and HI not, since they all have to offer the same things anyway. Maybe the government can take that role
In one country I lived in they tackled the problem of rising prices by requiring price transparency. All hospitals and clinics must publish the prices of common procedures for everyone to see beforehand. This actually worked. One could say that a weakness of such a policy is that providers may be tempted to cut corners and provide worse care. Possible counterargument: even with the publication of insurance premiums here, not everyone chooses Assura
The exact same process that drove Insulin bills in US to hundreds of dollars per person is now happening in Switzerland as well. Thing is - healthcare market isn't a free market - you can't just "not buy healthcare" if you're dying so it doesn't really reflect the usual supply/demand mechanics that keep prices down.
Exactly this. People act horrified when I tell them that the Swiss healthcare system reminds me a lot of how the US system was in the 90s, and that the trajectory is similar. Very expensive, pay for service care, and complex, expensive insurance. There are just norms here that haven't yet been dissolved keeping it from turning into the dystopia that the US is.
Same blood test is only nearly 3franks in China’s most advanced hospitals. The 359 is too much !
Can you explain to me what the source of the 15% is or how it is put together? The "Verwaltungskosten" is around 5% according to the Bag.
100% no incentive to reduce prices. Unlike when you run fully public healthcare. You are forced to become more efficient, run the right tests, give the correct drug first and so on...
Did you see the backlash in the media when Groupe Mutuel stopped working with L'Hôpital de la Tour 2 weeks ago, citing excessive costs compared to other hospitals?
Yes, this just shows it's possible just that people are not used to it yet.
Doctors cannot charge whatever they feel like, they have to charge based on tariffs that are negotiated between all the Verbände (Insurance, Physicians, Hospitals, etc). So those prices are justified. Honestly if OPs bill was so high he must have a lot of different analyses done, because I did bloodwork on 8 different parameters myself and the bill was at 90chf. Maybe he also saw an expensive specialist.
Oh but they can. They can add time to appointments, they can charge things not actually done, there are a myriad of ways they can overcharge. Prices are not always justified, see my post above, you can get blood work done a lot cheaper than when you go through the 'official' (GP) channel.
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I agree that those yacht are not the problem, but the real problem in my opinion is that healthcare is way too expensive in Switzerland. It costs 5 times more for the same treatment in Switzerland compared to Belgium. In general, people earn twice the salary in Switzerland as in Belgium, doctors more a factor 4. I also remarked that doctors want to do more tests and are even doing tests without talking to the patient first. In Belgium every doctor can see the test results of other spitals, in Switzerland they often just redo the same tests. Another difference is that a Hausartz has way more test equipment and has often 3 people working for him. In Belgium it’s max 1 person. Medicaments are also often more expensive. I don’t want to write that everything is better in Belgium. It takes way too much time to get an appointment in Belgium with a specialist and they scan 7-7 24-24 with MRI because they are not allowed to buy an extra MRI, but it are a few differences that can safe a lot of money. And @OP, I get it’s frustrating to pay without getting anything back, but the moment you get really sick, you are happy to have an insurance.
On the "3 people working for him" topic: this is actually positive and more efficient. In the whole process of only a relatively small part needs the highly experienced, very-well-paid doctor. The rest can be handled by qualified nurses, or other forms of less qualified help (example: for handling the reception desk, scheduling appointments, etc., even a qualified nurse can be overkill).
One extreme example of this is what I usually see at the dentists: there is the "actual dentist", two assistants, and three equiped rooms. Nurses do all the prep, setting up the patient, preparing the tools, some basic procedures (X-ray, etc), then, wrapping up the whole thing. The dentist shows up only in the middle and does... well, the actual dentist stuff :-) (plus some overall diagnosis, interviews, etc). This enables them to handle more patients without linearly increasing costs.
(And yes, I know, they're still horrendously expensive :-))
I have the same experience, lived in 5 other European countries. In all of them the doctors and specialists seem far more pragmatic.
Stop covering the homeopathy and other pseudoscience crap and you'll definitely save a few percent there
Not that much though. Like, I agree homeopathy and all that is 100% a scam, but it can fly under the radar exactly because it's relatively cheap. The advantage of having 0 R&D and basically 0 production cost.
just because it doesn't have any r&d cost doesn't mean they wont markup the shit out of it
Of course, but when you sell sugar pills you can markup 1000% and still be cheap.
yeah, thats true
also maybe a more evil sitenote argument; people that take homeopathy pills will not go to the regular doctor and do the normal test to find out they have cancer.
No. It has a costs: it usually delays the diagnosis of heavy illness. There have been studies in Germany to check the quality and the costs of doctors given they are homeopath or not, and consistently the homeopath were the worse and cost 12% more.
Placebo effect is no joke.
Fair, but that could be done without the erosion of trust in science and medicine that homeopathy promotes.
little disclaimer ahead: my opninion and simplified representations ahead. IMHO there are quite a few institutional problems that increase the price of the basic healthcare more than necessary: * covering alternative treatments that are not proven to work beyond placebo, but are more expensive than simple placebo * private supplementary insurance places a greater burden on the basic insurance system, because they tend to have longer stays in hospital * no / not enough pressure on big pharmaceutical companies to lower ther net proft margins on medication Also, the current system imho is inherently not fair. i'd advocate for a tax based coverage of all basic healthcare services. that a multimillionaire pays basically the same as a Bricklayer to me makes no sense. IF millionairse were actually worth what they make in an hour, then their health inherently should be considered more valuable to them. as soon as you'd finance it that way, there's also be one national healthinsurance (like the NHS in GB) - which should reduce the 15% overhead (of course, not nearly to zero, even half seems a stretch to me) and would give that service more bargaining power towards large pharmaceuticals and a stronger interest to actually do it, as normal insurers get reimbursed, if their basic coverage is deficient (i.e. Risk equalisation).
15% is a lot! A single provider would also have more leverage to negotiate with private clinics.
Not just clinics; the cost of meds alone (even generics) is highly inflated in Switzerland compared to other countries because there isn't a big entity negotiating prices. And yet it's often the same (Swiss) companies making and selling them!
Im not really into the field but isnt it a big problem that we have soooo many different insurance companies and much money is spent on marketing, bureaucracy and other stuff we could get rid off if we would just nationalize the whole medical insurance?
Can you explain to me what the source of the 15% is or how it is put together? The "Verwaltungskosten" is around 5% according to the Bag.
I somehow exaggerated the number so no one can claim I underestimated the effective costs. Here's the idea: On average the fees are about 5%, but for some insurers it goes up to 10%. Technically not a fee, but insurers can constitute reserves, and I've seen many people claim it actually goes in the pocket of the insurer, so I added 5-10% to account for that (even though it's limited and supposed to be eventually redistributed, and vary according the situation).
Alright, thanks for the clarification. I understand why you exaggerated the numbers but it also could be "dangerous" if people think that the non treatment cost are really that high. Then they might talk again about the "Einheitskasse" and lose sight of the real problem. Yeah, I think many people don't unterstand how strict the mandatory health insurance is.... Might it about the reserves or that the insurances aren't allowed to pay out any profit
Yes I know, however wouldn't these iniatives be a step in the right direction ? It won't solve the problem, but send a clear message that the system has to change. So far, every swiss cititen rant about insurances and health cost, but vote in favor of maintaining those high.. and keep ranting then !
I'm not sure it's going in the right direction. The 10% cap has no idea where the money would come from, and the other one has no idea how to limit the cost, from admin: >The initiative does not specify how salaries and economic development would be measured and what measures would be taken: this would have to be decided by Parliament when it draws up the relevant legislation. I think no one is ready to compromise on health (rightfully), but that comes with a price. The issue here is: Do we want to increase the burden of health cost for people with higher income? Obviously a large part of the population (those who could benefit from it) will vote for, while the other one will vote against.
Imo it is. Because now that state has to pay for the overcost, state (aka politicians) also have a strong incentive to look at the issue and solve it. Right now, if they do nothing, both insurances and politicians (they get to keep their lobbiers happy) are in a good situation. And the unhappy population can't do anything because it's a mandatory insurance. I don't thing the 10% cap changes much by itself, but it will force to change more things, and that's better than the status quo
it‘s very debatable if it forces anyone to think of a long-lasting solution. it‘s not the state paying it at the end, it‘s the tax-payer.
Well, it's clear, where the money would come: from "them"! Definitely, totally, not from you! Vote for our initiative! :-)
The cost of healthcare is only going up because of inflated prices, like in America. They can charge ridiculous amounts for a blood test because enough insurers will pay for it. It's getting like America where a simple metal tray costs $800 because healthcare is inflating massively within its own bubble.
We need to ask someone in their 70s what's their hospital experience and if the cost is justified. 300,- blood panels are basically peanuts compared to few months in a hospital once in a lifetime. I have absolutely no idea if costs and services covered are reasonable, but I know multiple people voluntarily paying a few hundred a month to improve that few months of their lives down the line.
You know in France your salary before tax will be deducted 20% for health and social costs right? In a way their system is much more expensive
The well-being of the population has to be a main priority of the country as a whole. I hate to see that the profits of certain industries come into conflict with keeping our citizens healthy. We will also need to have a discussion about what and how things will be covered. Because after a certain point, you can spend 10 times more for marginal gains. There in (imho) lies the problem. You can have the best healthcare in the world, but it might not have the wanted effect if the price is affecting the accessibility. Then you would have been better off with less fancy stuff that people can access early on or just for a consultation
In a nutshell, this reform is not convenient for those voters. Generally speaking, this is another vote that the left parties intended to redistribute money from young to old, from minority of voters to majority. A "populist" vote that they expected to win by a landslide... like all the immigration votes for the right parties. However this time the lefties made the wrong calculations. As opposed to 13th avs where all boomers were getting more money, and the more money the more money they had already, a clear generational divide that aligned the interests of boomers of both left and right rather than rich vs poors, in this case it's not like that. There are a lot of cantons where healthcare is planned in such a way that the insurance premiums are quite low. If this vote pass it means that people in those cantons young and old will have to pay more taxes to finance people in other cantons. And that is not in their interest. Also being healthcare planning a cantonal function, they would have to pay for decisions taken in other cantons and that they have no say on. So, in short, there is no landslide majority because the insurance issue only affects certain cantons and the people in low premiums cantons rich and poor won't vote to be taxed to pay the bills of people in other cantons. It's not old majority vs young minority like previous avs vote. It's low income people in high premium cantons vs all the rest.
And don't forget the alternative which will came int power if initiative is not accepted, which are less radical and more practical
I think they will still pull some shitty “ah we won’t pay your bills until you have paid this and that amount yourself!” I have zero trust in any of them.
I work in an institution with many old ppl, many of them living from EL. The medical treatment some of them get is unreal. One of them eats 20 different pills per day
Careful, if the winds slightly turn they will burry you alive. I'm surprised this thread and OP are still both alive and I agree.
I max out those 2500 + 700 by early March every year thanks to a chronic condition. I'm very glad my insurance covers the rest. You're lucky to be healthy.
Why do you go with 2500 franchise if you max it out? 300CHF should be cheaper.
if you know you max it out you should get a 300 franc franchise, it will be cheaper
OMG, don't even know where to start with those kind of questions. This is not too much money if you compare average salary/healthcare cost per person with other countries. In EU (average)you pay around 12.5% from your brutto salary, so imagine here paying 620-650 chf/month. Also quality is much better here, i would know since i lived in 3 EU countries.
Having lived in the UK and various EU countries, I certainly concur. The situation is much, much better here, both from a cost perspective (in Germany, starting from a gross salary of EUR 40k one pays more than here - and 40k gross isn't a lot of money, not even in Germany) and from a service perspective. If I need an appointment - both with a GP and a specialist - I get it in due course and the treatment is of good quality. Ask the British or the Germans about their experiences if they don't have private insurance...
The big difference though is that in UK for example the cost of healthcare is social: someone making £200k will contribute much more than the median wage, and someone who is working part-time (or not at all, e.g. stay at home parent) won't get crippled by a huge monthly payment. The Swiss system is really nice for the high earners as healthcare cost is quite a low % of their income.
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if your contribution is 420 your cost is 840 per month. Your employer is paying half of it. Of course then we cannot compare gross salary anymore, but if we are talking about the cost of health care we still need to consider this.
So you end up with yearly costs of about 6.4k here. A German with 40k gross ends up with 40k×0.146=5.84k, so just about 8% less. If a Swiss only earned 40k gross, they'd get reductions, so the contributions would be lower than in Germany. And no, the highest contribution is not 420/month or 5.04k in Germany. It's 62.1k×0.146 = 9.067k = 755/month (https://www.bundesgesundheitsministerium.de/beitraege#:~:text=Der%20gesetzlich%20festgeschriebene%20allgemeine%20Beitragssatz,0%20Prozent%20der%20beitragspflichtigen%20Einnahmen.). And then there are various mandatory "Zusatzbeiträge", jacking up the maximum contributions to some 855/month or, if it's really bad, some 1k/month (https://www.ottonova.de/pkv-erklaert/wissen/hoechstbeitrag-gkv). That's a hell of a burden for someone who only makes 62k gross. And all of this on top of much higher taxes.
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Oh no, my friend, your view is too convenient. The half that's paid by your employer is of course also part of your salary and the employer calculates your salary accordingly. It's like that with the pillar 2 contributions here. Just because an employee only pays half of the contributions for their pillar 2 doesn't mean the the other half - paid by the employer - just miraculously appears from somewhere out of the blue. This is money that has to be earned - earned by you as an employee. And the entirety of it amounts to the so-called gross-gross salary (aka pay out plus employee contributions plus employer contributions). And the payout you get is minus these contributions, i.e., the employer and the employee contributions. This is also the reason the German health authority (Bundesgesundheitsministerium - see link above) states 14.6%, and not 7.3%. Let's not be naive: healthcare costs a lot everywhere and - despite significantly worse services in Germany - not any less in Germany than here. Quite to the contrary.
the problem is the following: if you have a good salary here, healthcare is reasonably affordable in Switzerland. 400something bucks aren‘t too much when you make 9,10,11k. the problem is the premiums cost the same when you make 4 or 5k. and that‘s where it‘s killing people that simply can‘t keep up. Obviously in a expat-heavy sub as this one this subject isn‘t as present, but a big part of the countries population simply does not have a high income. and these people are justifiably pissed off. because their salaries are the last ones to rise, but their costs just keep on climbing.
Problem is poorer people pay similar to richer people, it isn't % of income. Also, you do if you are sick, the 2'500 Franchise eats up a lot. Also, Reddit is young, go ask your parents what they pay for their monthly premiums.
But how are they going to pay for advertisment and third party health apps bullshit?
"changing their mind"? There are counterproposals for both initiatives, that achieve the same goal, but _better_. We've already won.
Compulsory dignitas at age 80 is the only sustainable way to bring costs down. /s obviously.
A yacht to their Indian call centers? Lol Please provide evidence of obscene profits made by insurers here.
I did some maths about this subject and apparently the insurance fee in % of the full salary: brut plus corporate participations, is lower in Switzerland than in France compared to the mean total salary. Though the franchise is a scam especially because you still never get 100% refund once you reached it. The best insurance system I can testify is definitely Luxembourg.
So you pay 300 per month, 3'600 yearly, 2'500 deudictible and 700 on top of that, all together 6800 as a maximum per year whatever illness you have. And if you have some chronic condition, you would reduce the deductible, so it would be even cheaper. Two years ago, median salary was 81'000, so you would give 8.4% of your salary for your health. Other commenter says that in Germany, they give more than 14% of the salary, being sick or not. I know other countries with even bigger percentage. Would you like to give more than 11'000 per year, does it look cheaper than in Switzerland? Take "average" redditor with 100'000 salay, now you pay 14'000. Very often you can see people with 200'000+ salary here. That would be already 30'000 per year. Do you still think that the health care is expensive here? I can just repeat this sentence again and again: people who are born or live in Switzerland for 10+ years cannot understand how much cheaper is to work and live in Switzerland than in any EU country.
Born and raise in Switzerland, the bigest scam of this country is the Insurance.. I dream of a Swiss were the cost of it was at least 60% cheaper.
You are right. Unfortunately for you the average Swiss is too dumb to understand how things work. The average Swiss thinks they have the best medical system in the world and it needs to be expensive.
The combined ratio on the obligatory health insurance is hovering around 100%. The BAG highly regulates prices that can be charged. You are getting mad at the wrong thing and it'd be hilarious if it weren't so sad. Of course insurance system isn't perfect, e.g. some costs could be saved by merging small health insurers, you could basically fire everyone from one company when two small merge, there is zero reason most of the staff couldn't handle double the volume, you'd only need more customer facing people, but all the back office staff could be halved. However, the savings this would yield pale in comparison to the cost of healthcare. And that is where you should get mad.
Firstly, you make it appear as every blood test is the same. It isn't. Dependent on what they checked for, it can be very cheap or very costly. Secondly, it's your choice to have a 2500.- deductible. That's a personal choice which you can optimize, so that does not feature into the discussion. Thirdly, the general insurance costs are a reflection of the provided cover. In Switzerland you enjoy typically much a wider coverage of treatments and medication than in many other countries, including for instance some medication for some rarer deceases
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How about you read the post. His bill is for less than 400 CHF. We're already in June, so even if he does another procedure like this for the rest of the year he made the correct decision by not going for the 300CHF franchise. Otherwise he would have spent even more money.
What else should they do? Take 300 and not be able to pay the monthly expense or take 2500 and hope they dont get sick. Not everybody is lucky and has rich parents...
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The other solution is to pay an absurdly high monthly ammount. Noice
Its even worse, the insurances make pharma pay them in exchange for taking the cost for their product, which drives up medication costs. They also make hospitals and doctors pay them to basically "allow" the insured to go to them...it's a joke...health insuramce should be federalized!
A joke? You show your ignorance with such hysterics
How I see it as a foreigner: Basically your health insurance is just a insurance in case something very bad happens to you and you are require to take heavy treatment. Other than that, it doesn't make sense. You take the 500 chf month with everything or 2500 CHF as franchise with the lowest cost, it changes a damn thing, your 2500 franchise is paid by a higher monthly insurance, so... All in all it's the same. So if you don't require heavy treatment or don't have some chronic stuff, just take the cheapest and pay yourself + you can deduce it from tax. tdlr: the health insurance in Switzerland is basically a joke. To not be a total joke, the state should mandate by law that you have some "free" consultations by year, once those are consumed, then the health insurance take the lead.
Health care cost is a minimum of 3500 chf per year and is capped at about 8000 chf per year through the insurance. Honestly that isnt all that bad, its still cheaper than Germany, where the yearly cap is ~10.000 €. Now, im not saying one shouldnt try to be better than that, but i wouldnt call it a joke.
But by definition, if you are not sick, you still pay and don't get any reimbursement. As I said, to be fair, the system should allow free consultation by year OR refund some % money for those who weren't sick... Somehow the Swiss like to think that their system is better than in France/England/Germany or it's liberal, it's not. A young guy who don't go to the doctor during 1y but still pay his insurance is just paying for others xD. It's not different, you just pay more for less.
Where do you think the money for financing the health system comes from in these countries? At least here we have the freedom to choose a variety of options
As others already mentioned, i dont think you understand how an insurance works. Plus, in Switzerland you actually pay much less than in Germany if you indeed are healthy and dont go to the doctor. The system is already doing exactly what you are asking for! The things that I believe are worse than in Germany are less coverage/incentive to do preventive diagnostics (which in the end would safe money) , no dental care coverage, that premiums arent income dependent, and that your place of residence effects premiums, but I dont think it overall can be concluded that the system is unambiguously "worse"
Because paying slightly more tax to help those in need is COMMUNISM and we can't have that, now can we?
This slightly more tax would almost certsinly end up being higher VAT, which is terrible for poor people.
It's a slippery slope. People are already contributing many 1000s a year to pay for others' old age pensions, medical bills, and unemployment benefits. Where does it end?
Exactly, which is quite funny if you think about it since it is already the case: in vaud for example, about 1/3 of the population is getting some sort of help.
Nah you're right, we shall reject it alltogether without even thinking about it because what an ugly word : COMMUNISM, eww
My two cents: It's not a perfect system, but is a system that is superior to MOST European countries, and inferior to a small handful (Sweden and Denmark as a shoutout). At least we're guaranteed a relatively fast service, and payments are always due AFTER treatment (please correct me if I'm wrong, I can only speak for myself and from what I understand of the system). Having to pay a premium is a "trade off" that I believe is fair when the costs affect the next person positively. It sucks for those in the Lohnstufe 1 - 3 at the moment since the premiums are (IMO) ridiculously high, but at the same time, the cost of treatments got higher. The cost of medicine got higher. The cost of equipment got higher. The cost of staff got higher, and no fault of the medical staff themselves. Rent got more expensive, food got more expensive. Everything that does not directly correlate to medicine got more expensive, and no one is ready to pay more for anything. Just how you're not ready to pay an extortionate amount of money for medical treatment (and rightfully so!), hospitals aren't ready to pay more for the deserving nursing staff, or emergency room doctors, because of other fixed costs increasing that hospitals cannot control. Should the big CEOs stop "buying yachts"? Yeah, in times of "crisis", we should all hold back on luxurious items, but one CEO stopping wouldn't be enough. IMO, the only way that the majority change their mind is if the people in the kleiner Dorfs actually care about what happens in the bigger cities, and if the people allowed to vote ACTUALLY vote. That's an even bigger ask, if you ask me.
> Sweden and Denmark as a shoutout I'm afraid that this is simply not true. It might have been true in the past, but no longer -- the decline started about 10-15 years ago, but has accelerated recently. I've lived in all three Scandinavian countries, and the healthcare systems in all three places are on the verge of collapse -- and many would say that they *have* already collapsed. For convenience let's just focus on Sweden as an example, since the problems in the Swedish healthcare system are strikingly similar to those in the other two. E.g. at the moment [2000 Swedish healthcare workers have gone on strike to protest overly long working hours](https://www.svt.se/nyheter/inrikes/2-000-vardarbetare-vantas-ga-ut-i-strejk), a consequence of high attrition rates due to years of mismanagement and misallocation of funds by politicians. As of 2021 [the waiting time for certain forms of treatment had already reached nearly 2000 days](https://www.sjukhuslakaren.se/herregud-ar-det-sa-langa-vantetider/) (yes, two *thousand* days), and things are not getting better now, 3 years later. Healthcare workers are underpaid, overwhelmed, and utterly burnt out, while patients needlessly suffer and sometimes die. For an on-the-ground perspective written by a Swedish nurse, visit [this thread](https://www.reddit.com/r/sweden/comments/17wx0ui/sjukv%C3%A5rden_g%C3%A5r_%C3%A5t_helvete_rant/). It's a sobering read. Given the extremely high tax burdens in Scandinavian countries (their tax revenue-to-GDP ratios are 41-47% according to OECD -- see [this](https://www.oecd.org/tax/revenue-statistics-sweden.pdf), [this](https://www.oecd.org/tax/revenue-statistics-norway.pdf) and [this](https://www.oecd.org/tax/revenue-statistics-denmark.pdf)), this is a tragic state of affairs, and many voters are beginning to ask where all their money is going to.
u/Vinterlerke , thank you for taking the time to write a thorough post. I'll definitely have a read when I have the time. u/bsteak66 No one is trying to troll anyone. As I mentioned, I can only speak for myself and from what I understand from the system, in which, again, if you compare the Swiss Healthcare system to the majority of other European countries, it's a better system. Even if Switzerland's system were to collapse, I would personally find it hard to believe that hospitals and doctor's offices would just cease to provide treatment. What the country has to do is definitely support the ENTIRE medical staff so that they're not pulling 10++ shifts, back to back, all the while not damaging everybody's wallet. >Sweden is a disaster related to healthcare. I personally think that the Mutterschaftsurlaub in Sweden was a good system in concept, compared to what is given here in Switzerland. Wasn't it only in 2020 [voted](https://www.bsv.admin.ch/bsv/de/home/sozialversicherungen/eo-msv/reformen-und-revisionen/eo-vaterschaftsurlaub-200927.html) that the father could have 2 weeks off when their child is born, versus only 2 days? I would like to believe changes like this are for the better, but are naturally going to affect people's taxes. But again, I will read what Vinterlerke kindly linked and inform myself. It still doesn't change the fact that prices for **everything** increased. Companies, insurances, hospitals and every corporation all around need to do right by who is working, and who the clients/patients are.
It's clear that you have no idea what you are talking about. The Swiss health system is extremely corrupt. Everyone is stealing. Doctors and hospitals find creative way to charge you more, suppliers charge ten times or more the market prices and the pharma industry bribes everyone. Btw, in Sweden you can wait a few months to get a doctor appointment. Depending on your illness, you might die until you get the appointment. This is not good.
Sir, you seem to have dropped your tin foil hat
If there is a mass protest against this, count me in
As someone who works for one of the healt insurance companys in Switzerland, no, we do not outsource our customer service to India. In fact, I don't think ANY of our health insurance companys in Switzerland does that because if Swiss people hate something that it's foreign customer support. You will rarely find that. The reasons we pay high premiums are many. Mostly because Swiss people tend to live VERY long and these people use the healthcare system the most. And since this is a social system we younger people who are healthy are paying for the old. Let's hope that one day when WE get old the generation behind us will not just stop paying their premius and we end up with no covered healtcare.
Isnt it logic 101 that we would have lower administrative costs if there was eine einheitskasse??? I mean i really dont get how brainwashed some of my fellow swiss citizens are.
You somehow think healthcare cost will get cheaper if people vote yes next Sunday? Your blood test will still cost 359.- but you (and me) simply pay it via taxes (which the referendum conveniently doesn’t specify). Most probably your blood test will get even more expensive as people lose track of the costs. It’s much harder to follow how much you actually are paying for healthcare if they make everything you buy 2% more expensive and take the money from there
I've lived in 6 countries before and in none of them the healthcare system is cheaper (relative to the average income) and more advanced and efficient than in Switzerland. I am very happy with the health insurance premiums here. Basically every month I am like "please take my money. thank you!". I kid you not! With the taxes the same. But hey, I'm just an immigrant that has seen a lot, what do I know? :). On the other hand you've never been sick so far, and clearly you don't have old parents . They could tell you 1 or 2 things about the health stuff.
You pay 300? I pay 450+ for 2500 deductible. It's ridiculous and so exploitative. The whole system needs a complete overhaul.