Well, for one thing, they are three things the Swiss apparently do pretty well.  Along with the banking, watches and of course Fondue (which under the best circumstances involves both cheese and chocolate).

Over the past several couple of months I’ve heard that the Swiss, in addition to the great things above, have health care a model that works.  I have heard about it mostly in the context of our nation’s own health care debate, but only in passing.  Today I got motivated and did a little digging.  There are some appealing things about Swiss healthcare, that are, in my opinion worthy of debate.

To some extent, Swiss health care is consumer driven although not particularly market driven at several levels.  Basically, it works like this: 

• Almost everyone in Switzerland is required to carry basic insurance.
• It is purchased individually for each person and not as part of a group.
• Basic (required) coverage is not priced based on risk but on age group. 
• The prices of medical procedures are totally transparent and regulated by the government. 
• The pricing is negotiated between the medical industry and the insurance industry and approved by the government.  
• Insurance companies are forbidden from making a profit on basic medical coverage (but can on supplemental products). 
•  Each family member’s cost for insurance is based on their age and in addition to the deductible for which they are 100% responsible, there’s also a premium, plus 10% cost sharing once the deductible is met. 
• For individuals who can not afford insurance, the Swiss government subsidizes it.

So, as with high deductible health plans, the Swiss consumer is responsible for the full deductible and the premium before their insurance kicks in.  And Swiss health care, while less expensive on average than health care in the U.S., is not cheap.   Basic coverage runs upward of $8,000 per yea for a family of four. 

So, is the Swiss model Good?   Bad? Or Ugly?

I suppose beauty is in the eyes of the beholder but I can tell you what I like. 

1. Anyone, regardless of age or health can get coverage.
2. There is no free ride and thus somewhat of an incentive to be healthy.
3. There is transparency in pricing of medical services.  
4. The Swiss can select their own doctors.
5. Swiss health care insurance is portable because it is not tied to an employer benefit.

I can also tell you what I am unsure of:

1. I did not see, in what I read, any real incentives to lead a healthy life like wellness screenings, credit for being healthy, or health savings accounts (HSA).
2. Lack of competition within the medical establishment to drive administrative costs down.
3. The medical community’s and the countries overall satisfaction level with the basic compulsory care.  

It’s an interesting model.  Highly regulated on one end, but for supplemental insurance products, it is highly competitive.  In the overall U.S. health care debate, it will be interesting to see if elements of what is working in Switzerland translate to the U.S. consumer.  We shall see.