SHARE
COPY LINK
For members

HEALTH INSURANCE

EXPLAINED: How the Swiss health insurance system is based on solidarity

Much has been said about Switzerland’s compulsory health insurance, most of it pertaining to its high — and continually growing — costs. But there is also another aspect of the scheme many people may not know about.

EXPLAINED: How the Swiss health insurance system is based on solidarity
Everyone contributes equally to Swiss health insurance. Image by Simon from Pixabay

For many people in Switzerland, the obligatory medical insurance is a sore point.

Premiums keep rising — by 8.7 on average in 2024 — and relief is not on the horizon in the near future.

While there are some ways to save money on a health plan, overall these policies are expensive, and you will hear many people grumble about this cost — even though Swiss healthcare system is known for its excellent level of care.

What you may have not known is that the whole scheme is based on the principle of solidarity, the extent of which is rare in other nations’ health insurance systems.

What exactly does this mean?

Rather than applying an individual approach to healthcare insurance, Switzerland’s system is based on the idea that all insured people form a group.

You can think of this system in terms of a huge pot to which each resident of Switzerland makes a contribution (that is, premium payments), so that in an emergency there are enough resources available to give someone the help they need when they need it.

This kind of ‘one for all’ approach takes precedence over the ‘to each his own’ attitude prevalent in many other countries.

“This means that even those who are in perfect health and never need to see a doctor pay their monthly premiums and thus indirectly provide for those who are ill and need more medical support”, according to a report by the WIRE research think tank.

In other words, all the people of the same age group living in the same canton pay the same premium, rather than different rates based on their income or other personal circumstances.

This applies only to the obligatory basic insurance (KVG / LaMal); supplemental insurances have a different rate base.

Under this system, “it is the task of the federal government, cantons, municipalities and health insurance companies to keep this group balanced” the report says. “That’s why decisions in the Swiss healthcare system are always taken in the interest of the group as a whole.”

How did this system originate?

This principle of solidarity between the healthy and the sick has a long tradition in Switzerland and is even enshrined in the health insurance law.

“In practice, this also results in solidarity between young and old, because young people on average have little need of medical care, but the risk of illness increases with age”, the WIRE report points out.

“Uniform premiums also mean that there is solidarity between men and women, as the latter generally claim more medical benefits due to pregnancies and births and longer life expectancy,” it added.

How does this system compare with health policies in other countries?

According to the report, in an international comparison, the Swiss health system “displays greater solidarity than the US health system”, where anyone who is not insured has to pay for medical treatment out of their own pocket, “which is why many people get into debt”.

Switzerland’s approach is “also more liberal than Germany’s where health insurance premiums depend on a person’s income”.

Likewise, it is also more liberal than the health systems in France and the UK, “which rely more on fiscal contributions from the state”.

As for the question whether those countries’ health system are superior to Switzerland’s, the report notes that “this is doubtful because state healthcare systems financed by taxes are also forced to compensate for dwindling tax revenues, for example by increasing deductibles, which reduced the solidarity between the insured in different income bracket”.

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

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members

HEALTH INSURANCE

In which Swiss cantons is most income spent on health insurance?

For many people in Switzerland, the obligatory health insurance premiums represent a significant financial burden. But how much you will pay depends on where you live.

In which Swiss cantons is most income spent on health insurance?

The price of the compulsory health insurance (KVG / LaMal) has been an ongoing topic of discussions for years, as costs keep climbing and no relief is in sight.

But this has become even more pertinent now, as Swiss voters will weigh on two initiatives relating to health insurance premiums on June 9th (read more about it below).

Everyone agrees that insurance rates are high and that they account for a big chunk of many people’s budgets.

But how big exactly?

As so many other things in Switzerland, the cost of health insurance is determined by cantons, which means residents of some areas will pay higher premiums than others.

READ ALSO: Why do Swiss healthcare premiums vary so much per canton?

So where in the country are you likely to spend the biggest portion of your salary on health insurance?

This is the picture that emerges based on figures from the Federal Office of Public Health (FOPH) and research carried out  by Ecoplan independent political and economic consultancy:

Families

A typical family (‘typical’ for this particular study) with two young, pre-school-age children and a net income of 97,992 francs a year, will spend the biggest chunk of their income (16.5 percent) on health insurance in Basel-City.

Next are Neuchâtel (14.9 percent) and Bern (13.2 percent).

On the other hand, in Zurich, Switzerland’s (and the world’s) most expensive city, that proportion is 12.2 percent — still high, but lower than in a number of other cantons.

As a comparison, that rate in the canton of Graubünden is only 6 percent.

 Single individual

The research looked at a 24-year-old unmarried person who earns 47,500 francs net.

Their health insurance premiums amount to 8.8 percent in Neuchâtel, followed by 8.2 in Basel-Country, and 8 percent in Vaud — all three, the highest in Switzerland.

If that person lived in Basel-City, on the other hand, their premiums would represent  only 4 percent of income.

Pensioners

For the retiree living alone and receiving a net income of 33,750 francs, social assistance and supplementary benefits cover the costs of the premiums.

READ ALSO: Is Swiss health insurance cheaper or even free for pensioners?

What do we learn from this study?

Primarily, that how much of your income is spent on health insurance is determined by your place of residence — not exactly a major revelation, but the figures are interesting nevertheless.

Keep in mind, however, that these numbers are approximate, and a lot depends on each person’s circumstances — that is, the exact salary and family situation, as well as the kind of co-pay deductions their insurance plan has.

What’s on the agenda for the June 9th referendum?

Two initiatives related to the cost of health insurance will be voted on:

  • ‘Premium relief initiative calling for no more than 10 percent of income to be spent on health insurance premiums 
  • ‘Cost brake initiative for lower health insurance premiums
SHOW COMMENTS