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HEALTH

How is Swiss healthcare system different from the rest of Europe?

Switzerland’s health infrastructure is consistently rated among the best in the world, but how does it compare with other countries?

How is Swiss healthcare system different from the rest of Europe?
Switzerland has an efficient, though expensive, healthcare system. Photo by Hush Naidoo Jade Photography on Unsplash

Whether in terms of politics, social system or economy, the Swiss often chart their own course, which fundamentally diverges from that of its European neighbours.

Healthcare is no exception.

The differences lie primarily in who finances the scheme — public versus private — and how the overall system functions.

Like much of the European Union, Switzerland has a universal health system, which means everyone in the country is covered by insurance and has access to medical care.

In most countries, the government typically has control, to a lesser or greater extent, over funding, health insurance, and health providers.

In France, for instance, most healthcare costs are covered by the state healthcare system, known as assurance maladie, and this is funded by taxes – healthcare costs account for about 13 percent of the average person’s gross salary.

In Germany, health costs are shared by employers and workers, with employees paying 7.5 percent of their salaries into a public health insurance fund, and companies matching that amount.

Italy’s national, system, called the Servizio Sanitario Nazionale, or simply SSN, which is financed mainly though federal and regional taxes, automatically covers all residents. Medical care is largely free of charge at the point of service.

Public healthcare also exists in Austria, with certain portions of salaries being automatically deducted to fund the scheme. However, healthcare is free of charge for low-income people or those who who are disabled, studying, or retired.

Although no longer part of the EU, the UK health system is also based on state healthcare via the NHS. It is funded by taxes which account for about 4.5 percent of the average citizens’ gross income.

What about Switzerland?

The system here is fundamentally different in that it is not tax-based or financed by employers, but rather by individuals themselves.

Everyone must have a basic health insurance coverage and purchase it from one of dozens of private carriers.

Basic insurance — KVG in German and LaMal in French and Italian — is compulsory in Switzerland. It doesn’t come cheap — premiums are based on the canton of residence and age, costing 300 to 400 francs a month on average — but it is quite comprehensive; it includes coverage for illness, medications, tests, maternity, physical therapy, preventive care, and many other treatments.

READ MORE: Everything you need to know about health insurance in Switzerland

There are no employer-sponsored or state-run insurance programmes, and the government’s only role is to ensure that all insurance companies offer the same basic coverage to everyone and that they have the same pricing.

While companies can’t compete on prices or benefits offered by the basic compulsory insurance — which are defined by the Health Ministry — they can, and do, compete on supplemental polices which offer perks not included in the basic coverage.

READ MORE: What isn’t covered by Switzerland’s compulsory health insurance?

All policies have deductibles (also called co-pays) that can range from 300 to 2,500 francs a year.

After the deductible is reached, 90 percent of all medical costs will be covered by insurance, with 10 percent being paid by the patient; however, this co-pay is capped at 700 francs a year for adults and 350 francs for children under 18.

The government does subsidise healthcare for the low-income individuals and households – defined as those for whom insurance premiums exceed 10 percent of their income.

What percentage of a person’s income goes to health insurance premiums?

This depends on wages and premiums, for instance, whether a person chose the cheapest option with a high deductible or the expensive one with a 300-franc deductible.

Generally speaking, however, based on the average monthly income of just over 7,000 francs, about 6.5 percent is spent on premiums.

What happens if you don’t take out an health insurance policy?

Anyone who arrives in  Switzerland must get insured within three months. If you don’t, the government will choose one for you and send you the bill. If this happens you may end up with more expensive premiums than you might have gotten if you shopped around yourself.

If you are still delinquent on your payments, your healthcare will be restricted to emergencies only; any other non-urgent medical treatment will be denied, unless you pay for it out of pocket.

The pros and cons of the Swiss system

Let’s look at the ‘cons’ first. Basically, there is one: the cost.

Not only are insurance premiums high and steadily increasing, but, at 7,179 francs per capita, Switzerland has the third most expensive healthcare scheme in the world — behind only the United States ($12,318) and Germany ($7,383).

Unlike taxpayer-funded models, there is no price grading according to income, so people on a low income pay a high proportion of their income for healthcare than higher earners. 

However, the system is generally efficient, has an extensive network of doctors, as well as well-equipped hospitals and clinics.

Patients are free to choose their own doctor and usually have unlimited access to specialists.

READ MORE: EXPLAINED: How to see a specialist doctor in Switzerland without a referral

Waiting lists for medical treatments are relatively short.

According to a survey by the Organisation  for Economic Cooperation and Development  (OECD) on how long patients in various countries typically wait for an appointment with a specialist, the share of people in Switzerland waiting a month or more is 23 percent, compared to 36 percent in France, 52 percent in Sweden, and 61 percent in Norway.

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HEALTH

Why do so many foreign doctors practice in Switzerland?

Slightly more than 40 percent of medical professionals working in Switzerland are of foreign origin, and their numbers are growing. What is the reason for this upward trend?

Why do so many foreign doctors practice in Switzerland?

In 2023, there were 16,590 foreign physicians working in Switzerland, according to a press release published by the Swiss Medical Association (FMH) on Wednesday.

While that in itself may not seem like a huge number, it constitutes 40.4 percent of the physicians practicing in Switzerland.

And this figure is not static: it has grown from ‘only’ 9,756 a decade ago.

Why has this been happening?

At least part of the answer lies in the general shortage of qualified personnel that has been plaguing many sectors of Switzerland’s economy — including healthcare.

“This increased need to call on foreign specialised personnel reminds us that there are not enough doctors trained in Switzerland to cover needs,” the FMH said.

Medical experts have been sounding the alarm about this scarcity.

According to FMH’s president Yvonne Gilli, Switzerland is training too few doctors, which will create a “healthcare gap” and have dire consequences in the near future, especially since more people are living longer and are developing chronic illnesses.

READ ALSO : Why Switzerland faces dire problem of doctor shortages 

Where is Switzerland recruiting doctors from?

Germany is by far the country that ‘exports’ the most doctors to Switzerland, (50.2 percent).

Italy comes next with 9.5 percent, followed by France (7.1 percent) and Austria (6 percent).

The reason for this is simple and pragmatic at the same time: these physicians not only speak one of the national languages, but they are also EU nationals, which means they can work in Switzerland with no problem.

That’s because the agreement on the free movement of people allows the recognition of diplomas from EU and EFTA states, though doctors coming from those countries must still obtain an authorisation to practice in Switzerland.

Are Swiss doctors required to speak English?

Most physicians working in Switzerland have some level of English proficiency, ranging from basic to fluent because much of medical literature, as well as some exams, are in English only.

However, the only official requirement set by both the Federal Office of Public Health (FOPH) and the FMH is that doctors practicing in Switzerland must speak the language of the canton in which they work (which is why physicians from Germany, Italy, France, and Austria are recruited) . 

Nowhere in the official requirements list, however, is there any mention of the obligation to be proficient in English in order to be able to practice medicine in Switzerland.

READ ALSO : Do all doctors in Switzerland have to speak English? 

And if you are new in Switzerland and are looking for a physician, this article will provide useful information:

READ ALSO: What you should know about finding a doctor in Switzerland
 
 
 
 

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