Today the NYT introduces us to the “Swiss Model” of healthcare, a scheme that keeps its citizens healthy, while remaining affordable, althewhile skipping any kind of public scheme. It most resembles the Baucus Bill, in that insurance companies must accept everyone, and everyone must in turn buy insurance.
The Swiss government does not “ration care” — that populist bogeyman in the American debate — but it does keep down overall spending by regulating drug prices and fees for lab tests and medical devices. It also requires patients to share some costs — at a higher level than in the United States — so they have an incentive to avoid unnecessary treatments. And some doctors grumble that cost controls are making it harder these days for a physician to make a franc.
The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 per cent of personal income, and about 35 to 40 per cent of households get some form of subsidy. In some cases, employers contribute part of the insurance premium, but, unlike in the United States, they do not receive a tax break for it. (All the health care proposals in Congress would provide a subsidy to moderate-income Americans.)
Anyone who’s been to Switzerland knows right off the bat why keeping its citizens healthy isn’t going to be much of a problem. It’s a nation full of physically active, cycling-happy, ski-bums, who eat better food. That matters a lot. Replace a big chunk of the Swiss population with chubby, McDonald’s-eaters, and see if the system holds up so well.
Another problem is that we can’t get there from here. As the article goes onto note, the system leans heavily on doctors, pressuring them about costs and money savings, which is great — but in our system, where so many doctors wasted years of their life and hundreds of thousands of dollars in education, all with the expectation of comfortable luxury, there’s just no way to turn things around. Economists might call that path dependency.
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