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HEALTH

Everything you need to know about hospital care in Switzerland

Chances are that sooner or later, all of us will have to use a Swiss hospital, whether for an outpatient procedure or inpatient care. What are the different types of healthcare facilities and what can you expect from each?

Everything you need to know about hospital care in Switzerland
A sign of the Switzerland's largest private hospital group Hirslanden, here in Lausanne. Photo by Fabrice COFFRINI / AFP

There are more than 280 hospitals throughout Switzerland, and the general level of care is excellent.

While they all have the same mission — to treat patients — these health facilities differ in size, structure, and the way they function.

The biggest ones are university hospitals, followed by cantonal, and then municipal / district hospitals.

University hospitals 

Let’s start with university medical centres.

Switzerland has five university-affiliated cantonal medical centres: The largest is Geneva’s University Hospital (HUG). Next is Vaud’s facility in Lausanne (CHUV), Inselspital in Bern, as well as University Hospitals in Zurich and Basel.

A part of the Geneva University Hospitals (HUG) buildings. Photo by Fabrice COFFRINI / AFP

They have a dual purpose: to treat patients, of course, but also to train and provide research opportunities to medical students from universities associated with a given hospital.

Many of the chief physicians also teach at the university, and carry the title of professor in addition to doctor.

Teaching hospitals are typically larger that ‘regular’ hospitals, with different services — such as for instance orthopedics, maternity, psychiatry, or various specialised polyclinics — located in different buildings nearby.

Cantonal hospitals

All Swiss cantons have their own cantonal hospitals, which are not associated with universities, but are bigger and provide more services than smaller municipal and/or district hospitals.

They are usually located in or near each canton’s capital, sometimes in several neighbouring locations.

Municipal or district hospitals

These hospitals are usually the smallest medical facilities, serving a given town and its immediate area.

Sometimes, several neighbouring towns band together to get one hospital covering several communities. They are known as district hospitals.

All of the above medical facilities are public, financed mostly by the canton or municipalities, with other funds coming from other sources as well.

Which hospital can you be treated at?

This is determined by various factors.

According to the Federal Office of Public Health (FOPH), “a patient is basically entitled to a free choice of healthcare professional or public care facility”.

If you have a life-threatening emergency, the ambulance will take you to the nearest hospital.

In the event you need to be hospitalised, you will likely go to the hospital at which your surgeon usually operates; sometimes he or she is associated with more than one hospital, in which case you can choose.

It is possible too that the kind of surgery you require is so specialised that a local hospital doesn’t have the capacity to perform it, so you will be operated on at a university hospital, which typically has more specialised doctors and equipment.

The University Hospital of Lausanne (CHUV). Photo by FABRICE COFFRINI / AFP
 

Does your basic health insurance (KVG in German and LaMal in French and Italian) cover treatment in all of the above hospitals?

Yes, provided that you are treated in your canton of residence, as KVG / LaMal will only pay for treatment (both outpatient and in-hospital) in the canton where the patient lives.

The reason is that each canton sets its own healthcare premiums, some of which are higher than others, so if you live in a ‘cheaper’ canton and want to be treated in a more expensive one, your provider may not like it.

However, this rule applies only to non-urgent situations; emergency cases are treated differently.

“In an emergency, you can go to any hospital in Switzerland,” the FOPH said, adding that it must be an authorised public health facility, rather than a private clinic, which in principle is not covered by the basic insurance (see below)

It defines “emergency” as a situation when “your state of health does not permit you to be taken to a hospital in the canton where you live. You will be transferred to a hospital in the canton where you live as soon as this is possible and sensible”.

FOPH also allows out-of-canton treatment for “particular medical reasons” — that is, if the required care can’t be provided at a public healthcare facility in your canton of residence.

READ MORE:  Will my Swiss health insurance cover treatment in another canton

If you have a supplemental insurance, however, it may cover you for out-of-canton medical treatments.

What about private hospitals?

Commonly known as clinics, they are more exclusive than public hospitals, and open only to people with private or semi-private insurance (clinics do, however, accept KVG / LaMAL for outpatient procedures only).

While in a public hospital you may have to share the room with other patients (unless you have private insurance), in a clinic you will be in a private or semi-private room and have all the perks of a five-star hotel.

Unlike public hospitals, which are funded by the government, clinics are owned privately.

For instance, the Hirslanden chain of clinics belongs to the UBS bank, while another chain, Swiss Medical Network, is funded by Credit Suisse.

READ MORE: Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

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For members

MONEY

What you can be fined for in Switzerland if you don’t follow everyday rules

If you are a new arrival in Switzerland, or even if you have been living here for a while but are not familiar with local laws, these are the rules you need to follow to avoid being slapped with a fine.

What you can be fined for in Switzerland if you don't follow everyday rules

Switzerland has numerous rules and regulations in place for a variety of infractions.

The good news (if you can call it that) is that you can be fined only for not complying with official laws. If you break one of many unwritten rules, you may get hostile looks and comments, but no legal repercussions.

Some of the offences are obvious — not speeding or being drunk while driving; not causing a disturbance in public; and not instigating or participating in criminal activities, among other infractions — everything that you shouldn’t do anywhere, not just in Switzerland.

Others, on the other hand, like the ones mentioned below, are more related to Switzerland’s own, and often quirkily unique, regulations.

These are some of the rules you may inadvertently break and the fines that could be handed to you for non-compliance.

Not registering your address at your commune

When you rent an apartment or buy a property in Switzerland, you will have to announce your arrival at your local municipality. 

The ‘address registration’ rules may come as somewhat of a shock to people from some other places, like the United States, where you can move from one location to another and stay pretty much under the radar.

Not so in Switzerland because Swiss authorities want to know who is living in their country and where.

When you settle in a new home, you have 14 days to announce your arrival in your new commune of residence, though in some places the deadline may be longer.

This is how to go about this process.

(The entire process will have to be repeated when you move to another home, even if you remain in the same commune. You will have to de-register your old address and register the new one.)

What happens if you don’t do this?

Local authorities will find you anyway sooner or later — probably sooner — and impose a hefty fine on you, the amount of which will depend on the reason why you didn’t register in the first place.

Not having a health insurance

Health insurance is compulsory in Switzerland for all legal permanent residents.

Anyone who moves here must get health coverage within three months of their arrival. 

If you fail to do so, your local authority will choose a plan on your behalf and you will have to pay the premiums.

If you don’t (and have no valid reason for being exempted from this obligation), two things will happen.

Firstly, you could be denied medical care other than in case of emergencies.

Secondly, your unpaid bills will add up, and you could be subject to debt proceedings. This, in turn, could be held against you if you ever decide to apply for naturalisation.

READ ALSO: Could personal debt stop you from becoming Swiss? 

Driving without a vignette

If you use Swiss motorways, even if it’s only for a short stretch, you must purchase a 40-franc sticker to affix to the inside of your window shield.

Unlike many other countries, Switzerland has no tolls on their highways, so the vignette compensates for the cost of maintaining the roads.

Vignettes are valid for one year, from January 1st to December 31st, and can be purchased at petrol stations, post offices or online.

If you drive on the motorway without a vignette or if it is not stuck on correctly, you risk getting a 200-franc fine.

READ ALSO: What you need to know about Switzerland’s motorway charge sticker

Trash disposal and recycling

In nearly all Swiss towns and villages, trash must be segregated and placed in special bags or in bags that have a special sticker on them, and placed in a designated collection point on assigned days.

Not segregating your trash — for instance, throwing out PET bottles with tin cans or paper, or not putting it out on correct days — can result in heavy fines, the amount of which is determined by each individual commune.

Municipal workers have the right to go through trash bags to identify garbage offenders — and they do.

Just to give you an idea of the amount you could be expected to pay, a woman in the Lausanne area was fined 190 francs after she allegedly put out her garbage on a Wednesday, rather than on Monday, which was a designated trash collectin day on her street.

Another offender, a US citizen living in Zurich, threw a carton box with his name and address into a ‘regular’ trash can, instead of recycling it.

At the time of this incident, the offender had not yet received his fine, but it was expected to be as high as 320 francs. 

This article will help you avoid such penalties. 

Being loud on Sunday

Under the law, Sunday is a day of rest in Switzerland, so you should do nothing to disturb your neighbours, either sonorically or visually.

This means no loud noises like lawn mowing, vacuuming, or recycling bottles. Also, you cannot hang your laundry out to dry, as the sight of your undies may be offensive to your neighbours on a Sunday.

This is what  a 35-year-old German woman should have known, but clearly didn’t: she committed a faux-pas of recycling glass on Sunday.

Her reaction after being slapped with a 250-franc fine: “I can understand that people don’t want to be disturbed, but going to the police over a few bottles seems a bit much”.

Not in Switzerland, apparently.

If someone complains and, even worse, reports you to police, you can expect a warning at best (if this is your first offence), or monetary penalties which depend on the noise ordinance in your community.

Just as an example, fines for excessive noise in Geneva could be as high 150 francs.

READ ALSO: Six things you shouldn’t do on a Sunday in Switzerland 

Buying your train ticket too late

If you purchase your ticket on your Swiss railway app just as the train is pulling out of the station, you commit an offence

This may be taking the notion of punctuality to new heights, but one of Swiss trains’ (SBB’s) regulations states that a ticket is not valid if it is purchased after the departure of the train, even if by a split second.

Anyone who does this, for whatever reason, is considered a fare dodger.

If you do this, you could be slapped with a 90-franc fine which, depending on the distance you are travelling, may be much more than you actually paid for your ticket.

That is the amount for first-time offenders.

For the second and subsequent infractions, the fine increases to 130 and 160 francs, respectively.

But that’s not all,: you could also be fined for putting your luggage on an empty seat of a crowded train, thus preventing another passenger from sitting down.

“The general rule is that one person only can occupy one seat,” said SBB spokesperson Jeannine Egi.

In theory, passengers can be asked to buy a ticket for their luggage. However,  this measure is rarely used in practice.”

“The train staff can enforce the ‘house rules’ on trains using their own judgement,” Egi said.

READ ALSO: Why putting your luggage on the seat on a Swiss train could cost you 

These are just some of the rules you may accidentally break while in Switzerland.

But there are others as well:

READ ALSO: Six ways you can be fined in Switzerland 

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