mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
Swiss System Offers Hints About US Under Obamacare


Readers trying to understand how Obamacare will transform our health care system should look to Switzerland. Bloomberg profiles the Swiss health care system, which is perhaps the closest global equivalent to what our health care market will become under the ACA.

Like Obamacare, the Swiss system does not use a single-payer system or offer a public option, but rather mandates that all citizens purchase insurance on a private market. Insurers cannot deny people with pre-existing conditions, or charge individuals in the same age range differently. Subsides are offered to poorer citizens who can’t afford the cost of insurance on their own.

Perhaps the most interesting part of the profile is that it vindicates something conservative and liberal critics of the ACA alike have long suggested. Insofar as Obamacare is like the Swiss system, it will expand access to insurance, but not lower the costs of care:

Still, Switzerland health-care system does not have all the answers. For starters, it’s one of the most expensive, according to the Paris-based OECD. The nation spent $5,270 on health care per person in 2010, the third-highest globally behind the U.S., at $8,233 per person, and Norway’s $5,388, OECD data show […]

The bottom line: the experience in Switzerland shows that a standard benefits package might work best in the U.S. rather than the myriad of offerings now under consideration. And Americans should not expect the health law to contain costs.

Comparative studies like this are incredibly important as we try to move forward with health care policy. Looking at how the systems in other countries operate can give us a better sense of where different kinds of experiments will lead. This is also all the more reason we should allow US states more autonomy in trying out different solutions to our health care crisis. International comparisons will always be helpful, but no studies would be more useful for national policies than the ones that look at US states.

Read the whole thing.

Features Icon
show comments
  • autigers1970

    I’m not sure I understand. The Swiss system is deemed expensive, but compared to the system we have it appears to be significantly less…somewhere around 35% less than what the US pays now. How is that not lowering the costs of care?

  • C Scott

    Note the profound difference: the Swiss model does not charge young people many times their natural premium to subsidize older people, which sets up intergenerational conflict and is intended to keep the party of government in power so as to pay the vague obligation built up by the young back in their old age. PPACA is intended to succeed again as Social Security did, to be seen as an account you “paid for” which can only be guaranteed by more of the same.

    Note also the simple base model; closer to catastrophic insurance and not prepaid helath plans for coverage of small and regular expenses like birth control and mammograms.

    A Swiss model would be far less objectionable than PPACA.

  • Jim Luebke

    Considering the major problem with our medical system is its unsustainability because of its cost, the “Affordable” Care Act is a tragedy rather than a triumph.

  • Bobby Gladd

    What about “bang for the buck” here? What kind of outcomes “quality”/”value” do the Swiss get? Comparing relative nominal per capita costs is rather weak in the larger picture. What is the “externalized” socioeconomic impact of the aggregate clinically subpar U.S. health care system?

  • Luke Lea

    Below is a link to an interesting analysis of the root causes of defects in the US health care system written by a young Chinese immigrant who lives in France. I don’t think there is anything original in his analysis but he puts it all together very nicely, writing in English, his third language after French and Mandarin. Very impressive:


  • Lorenz Gude

    From the Bloomberg article: “Health spending in Switzerland equaled 11.4 percent of gross domestic product that year, putting it tied for fifth with Canada among the OECD’s 35 nations. The U.S. spent 17.6 percent of GDP.”

    Notice the Hephalump in the house? 17.5%!!! I usually use 16% of GDP out of kindness but I am pretty sure it is more. I know the ACA limits it to 17.5% by 2017 which is the stuff of despair.

  • Douglas Levene

    Let’s look at Hong Kong, too. We just went to a family clinic at a fancy private hospital in Hong Kong – on a Sunday – seeking treatment for a lingering infection. Bottom line: top quality, Western-trained doctors, diagnosis, tests, two prescription medicines, everything, cost=USD $100. We paid out of pocket. Why is it that purely private medicine can deliver first quality medical care in Hong Kong for a fraction of the cost in the US?

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service