The Path Switzerland Took to Establish Its Mandatory Health Insurance Coverage
Switzerland's Mandatory Healthcare: A Unique Approach
Swiss healthcare system, with its obligatory health insurance, stands out from Europe's norm. This system, with its higher costs and unique function, isn't just an anomaly in terms of financials but also in how it operates. Here's an informal exploration of its history, rationale, and exceptions to this rule.
Historical Roots
Tracing back to the 19th century, the roots of the current healthcare system aren't newfound. The government, in response to a typhoid fever epidemic in Valais in 1866, kicked off a stronger role in health policy-making.
In 1890, the parliament granted federal authority to legislate on sickness and accident insurance. However, various health and accident insurance proposals faced rejection in referendums. A significant shift happened in 1912, as voters accepted a package of benefits, allowing freedom to choose providers and ambulatory care, drugs, and hospital stays.
During this time, insurance coverage remained optional. However, a turning point came in 1991, when the Federal Council proposed a new Federal Health Insurance Law (KVG/LAMal), which became compulsory in 1996 after a referendum in March 1994.
The Compulsion Factor
The government made health insurance mandatory to ensure universal coverage and access to care regardless of income or health status, preventing situations where people skip necessary medical care due to cost. This could not be achieved if insurance were optional, leaving some contributing to the system and others not.
Think of it as a mammoth pot, where each Swiss resident contributes (premium payments), ensuring there are sufficient resources available for everyone in emergency situations. This 'one for all' approach overshadows the 'to each his own' attitude prevalent in numerous countries.
Solidarity at Play
According to a report by the Saints health research foundation, even healthy individuals paying monthly premiums indirectly support those with more medical needs. This can happen only if health insurance is mandatory.
Exceptions to the Rule
While the law mandates health insurance for all Swiss residents, some groups are exempted. Supra-national workers, pensioners, diplomatic personnel, and international organization employees are among those not required to take up KVG/Lamal. If individuals have their equivalent insurance cover, they may request exemption from compulsory health insurance.
References:
- Tagesschau
- Swiss Health Research Foundation
- Swiss Federal Office of Public Health
- World Health Organization (WHO) Global Health Exchanges
In 1890, the government was granted federal authority to legislate on sickness and accident insurance, but the proposals faced rejections in referendums until 1912, when a package of benefits was accepted, allowing optional insurance coverage. However, a major shift occurred in 1991, when the government proposed a new Federal Health Insurance Law (KVG/LAMal), which became compulsory in 1996 after a referendum, ensuring universal healthcare coverage.
The government compulsory health insurance is intended to provide solidarity, as even healthy individuals paying premiums indirectly support those with more medical needs. This 'one for all' approach contrasts with a 'to each his own' attitude in many countries and aims to prevent people from skipping necessary medical care due to cost.
While health insurance is compulsory for all Swiss residents, some groups are exempted, including supra-national workers, pensioners, diplomatic personnel, international organization employees, and those who have their equivalent insurance cover.
