Swiss Health Care Model-- health insurance that works

[TexasTiger 14,071]

Our health care system is very expensive in part because it involves significant profits to companies and shareholders not involved in dispensing health care. One of the attractions of single payer is eliminating this feature, but single payer has its own downsides. If we are going to have an insurance based model, perhaps the Swiss model provides a framework:

 

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Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Swiss Federal Law on Health Insurance (German: Krankenversicherungsgesetz (KVG); French: la loi fédérale sur l’assurance-maladie (LAMal); Italian: legge federale sull’assicurazione malattie (LAMal)). It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.^[3]

The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.^[3]

The universal compulsory coverage provides for treatment in case of illness or accident (unless another accident insurance provides the cover) and pregnancy.

Health insurance covers the costs of medical treatment and hospitalization of the insured. However, the insured person pays part of the cost of treatment. This is done by these ways:

• by means of an annual excess (or deductible, called the franchise), which ranges from CHF 300 (PPP-adjusted US$ 184) to a maximum of CHF 2,500 (PPP-adjusted $1,534) for an adult as chosen by the insured person (premiums are adjusted accordingly);
• and by a charge of 10% of the costs over and above the excess. This is known as the retention, and is up to a maximum of 700CHF (PPP-adjusted $429) per year.

In case of pregnancy, there is no charge. For hospitalisation, one pays a contribution to room and service costs.

Insurance premiums vary from insurance company to company (health insurance funds; German: Krankenkassen; French: caisses-maladie; Italian: casse malati), the excess level chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (complementary medicine, routine dental care, half-private or private ward hospitalisation, etc.).

In 2014, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are the following:^[12]

• CHF 396.12 (PPP-adjusted US$ 243) for an adult (age 26+)
• CHF 363.55 (PPP-adjusted $223) for a young adult (age 19–25)
• CHF 91.52 (PPP-adjusted $56.14) for a child (age 0–18)

 

• https://en.wikipedia.org/wiki/Healthcare_in_Switzerland

[TexasTiger 14,071]

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99.5% of Swiss citizens have health insurance. Because they can choose between plans from nearly 100 different private insurance companies, insurers must compete on price and service, helping to curb health care inflation. Most beneficiaries have complete freedom to choose their doctor, and appointment waiting times are almost as low as those in the U.S., the world leader.

https://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/#4ee18e767d74

[homersapien 12,172]

You are correct.  We have two interrelated issues - coverage and cost.

But God forbid we look to anyone else for an example of a system that's working better than ours.  

God doesn't think healthcare should be a basic right anyway.

[icanthearyou 4,468]

Sad.  The money is there.  We need a more efficient and humane method of allocation.  We need to think humanely and practically, not ideologically.  

Personally, I think we need a two-tier system.  Guaranteed basic coverage with optional coverage for "luxury" care and non-essential treatments/drugs/care.

[LakeBum 187]

I don't understand why the government needs to be involved.  Why force someone to buy something they may not want or need.  There is no insurance for food, housing, transportation and other basic needs, yet everyone probably needs some subset of these to live. They have jobs and pay for them, just like they should do for healthcare. There should be an option to buy catastrophic insurance if one wants to protect themselves from some unusual healthcare event, much like you can buy flood insurance or hurricane insurance.

[TexasTiger 14,071]

22 minutes ago, LakeBum said:

I don't understand why the government needs to be involved.  Why force someone to buy something they may not want or need.  There is no insurance for food, housing, transportation and other basic needs, yet everyone probably needs some subset of these to live. They have jobs and pay for them, just like they should do for healthcare. There should be an option to buy catastrophic insurance if one wants to protect themselves from some unusual healthcare event, much like you can buy flood insurance or hurricane insurance.

Every other country you'd probably care to live in has government involvement in health care. That's not coincidence.

[LakeBum 187]

14 hours ago, TexasTiger said:

Every other country you'd probably care to live in has government involvement in health care. That's not coincidence.

Yeah, I know I should be grateful that we have all those wise people in Washington that know what some dumb hick from Alabama like me needs more than I do.  It should be so peaceful to me that I don't have to worry about anything because all these people smarter than me will tell me what to do.   Sigh....

[icanthearyou 4,468]

1 hour ago, LakeBum said:

Yeah, I know I should be grateful that we have all those wise people in Washington that know what some dumb hick from Alabama like me needs more than I do.  It should be so peaceful to me that I don't have to worry about anything because all these people smarter than me will tell me what to do.   Sigh....

How do you equate the human decency of everyone having access to medical treatment with, "telling you what to do"?

 

 

[Proud Tiger 4,261]

This is just another kind of socialized medicine  and it is NOT working in Canasa for example. My own doctor moved to Alabama from Toronto because he was so tired of the gov't controlled medical care there.

[Brad_ATX 13,654]

51 minutes ago, Proud Tiger said:

This is just another kind of socialized medicine  and it is NOT working in Canasa for example. My own doctor moved to Alabama from Toronto because he was so tired of the gov't controlled medical care there.

But why did he move is the question?  Was it to make more money or was it to practice the medicine he so chooses?

Also, this leaves out the most important question:  Are the people of Canada, the one's actually paying for state sponsored health care, happy with the benefits that they receive?

Because if they are, then who gives a damn what a random doctor thinks.  The government is there to serve the people, and if the people are happy, then it seems the job is being done correctly.

[TexasTiger 14,071]

2 hours ago, LakeBum said:

Yeah, I know I should be grateful that we have all those wise people in Washington that know what some dumb hick from Alabama like me needs more than I do.  It should be so peaceful to me that I don't have to worry about anything because all these people smarter than me will tell me what to do.   Sigh....

Non sequitur. Do you actually disagree with what I said? If you had to live in another country, which would you choose?

[Elephant Tipper 430]

Financial accountability is the issue and the more removed the customer (the patient) is from those decisions, the more padding occurs, by politicians and the insurance companies to meet their objectives and not necessarily those of the patient.  With the forced simultaneous coverage of catastrophic and every-day care insurance rates have skyrocketed.  In two years my BCBS premiums grew 187% and my deductible by 33%. (Btw, my health and that of my family members is excellent)  Concierge medicine most likely is the best alternative.  This form of medical practice is growing.  Very cost effective and what ratings I've seen are impressive.

Atlas Medicine of Wichita, KS:  http://atlas.md/wichita/our-fees/

This includes unlimited visits.  Prescriptions at a fraction of the cost of pharmacies.

Monthly Membership Fees

• Children 0-19 years old, $10/month with at least one parent membership
• At this time, we are not able to provide routine vaccinations. Call to discuss how we can help arrange these for you.
• Adults 20-44 years old, $50/month
• Adults 45-64 years old, $75/month
• Adults 65+ years old, $100/month
• Employer groups with 5+ employees, $50/mo/adult
• Nursing home and home-bound patients, call for details

Benefits:  http://atlas.md/wichita/benefits/

Among the many benefits, house calls are included.  Same-day service.  Diagnostic and procedural benefits at no extra cost.  Annual physical.  Relaxed, extended visit with the physician (not a numbers game as found in those practices who receive insurance).  Unlimited access to your physician.  And more...

 

[AUDub 11,784]

 

H.R.1275 - World's Greatest Healthcare Plan of 2017

No joke. That's what they're actually going to call it. 

[TitanTiger 21,068]

I just find it hard to believe that a place like the US cannot figure out a way to borrow/learn from the various universal health care models and get everyone covered, keep costs under control and avoid most of the bigger pitfalls that countries like Canada, Britain, Germany, France and Japan have dealt with.  We have decades of data and experience to draw on to craft a better healthcare coverage plan that gets everyone covered to some reasonable degree and stop having the #1 cause of personal bankruptcy in this country be medical bills.  We can figure it out if we want to.  I just don't think everyone wants to.  It's not that it can't be done or that it's a pipe dream, it's that too many people are invested in the status quo and don't give a s*** about anyone else.

[TexasTiger 14,071]

6 minutes ago, TitanTiger said:

I just find it hard to believe that a place like the US cannot figure out a way to borrow/learn from the various universal health care models and get everyone covered, keep costs under control and avoid most of the bigger pitfalls that countries like Canada, Britain, Germany, France and Japan have dealt with.  We have decades of data and experience to draw on to craft a better healthcare coverage plan that gets everyone covered to some reasonable degree and stop having the #1 cause of personal bankruptcy in this country be medical bills.  We can figure it out if we want to.  I just don't think everyone wants to.  It's not that it can't be done or that it's a pipe dream, it's that too many people are invested in the status quo and don't give a s*** about anyone else.

This is exactly it.

[icanthearyou 4,468]

Since the seventies, the driving forces behind healthcare are greed, self-interest, economic power.  Nothing to do with partisan politics or, who is in the White House.

Political/economic ideology can not explain away or, provide an simple answer.

This is not a test of who we are politically/ideologically.  This is a test of our sense of human decency.  The rest of the developed world may not have found a perfect answer but, they can at least say they met the challenge with humanity, without political hypocrisy.

We are being enslaved by capital and healthcare.  Both parties have endorsed this model.  Sometimes passively, sometimes aggressively.

When our ideological interests override our collective social interests, our interests as a whole, our well being, we are either fools or, frauds.

If you look at this situation through a partisan, or ideological lens, take your pick.

[TitanTiger 21,068]

Those who believe the purity of their political ideology is more important than people fall into the same trap as the Pharisees fussing over what could be done on the Sabbath.  "The Sabbath was made for man, not man for the Sabbath."

 

[Elephant Tipper 430]

50 minutes ago, TitanTiger said:

I just find it hard to believe that a place like the US cannot figure out a way to borrow/learn from the various universal health care models and get everyone covered, keep costs under control and avoid most of the bigger pitfalls that countries like Canada, Britain, Germany, France and Japan have dealt with.  We have decades of data and experience to draw on to craft a better healthcare coverage plan that gets everyone covered to some reasonable degree and stop having the #1 cause of personal bankruptcy in this country be medical bills.  We can figure it out if we want to.  I just don't think everyone wants to.  It's not that it can't be done or that it's a pipe dream, it's that too many people are invested in the status quo and don't give a s*** about anyone else.

We already have the solution, Remove Government from Healthcare. 

Concierge service WORKS.  My physician is segueing into this model:

http://atlas.md/wichita/

http://atlas.md/wichita/benefits/

http://atlas.md/wichita/our-fees/

For catastrophic needs the individual should have a catastrophic policy. 

Allow individuals to decide what they do/don't need.

[TexasTiger 14,071]

1 hour ago, TitanTiger said:

I just find it hard to believe that a place like the US cannot figure out a way to borrow/learn from the various universal health care models and get everyone covered, keep costs under control and avoid most of the bigger pitfalls that countries like Canada, Britain, Germany, France and Japan have dealt with.  We have decades of data and experience to draw on to craft a better healthcare coverage plan that gets everyone covered to some reasonable degree and stop having the #1 cause of personal bankruptcy in this country be medical bills.  We can figure it out if we want to.  I just don't think everyone wants to.  It's not that it can't be done or that it's a pipe dream, it's that too many people are invested in the status quo and don't give a s*** about anyone else.

Too many people seem concerned that someone "undeserving" may get healthcare.

[TitanTiger 21,068]

1 minute ago, TexasTiger said:

Too many people seem concerned that someone "undeserving" may get healthcare.

Yes, there's a lot of that "who deserves what" mentality going around.

[icanthearyou 4,468]

7 minutes ago, TitanTiger said:

Yes, there's a lot of that "who deserves what" mentality going around.

I highly commend this mentality.  There are times when, we should be less concerned with "deserving" and, be more concerned with need.

What do any of us actually "deserve"?  Why?  Should "deserving" be purely a product of how we measure one's economic value?

[TitanTiger 21,068]

Just now, icanthearyou said:

I highly commend this mentality.  There are times when, we should be less concerned with "deserving" and, be more concerned with need.

What do any of us actually "deserve"?  Why?

I think you meant "condemn?"

[icanthearyou 4,468]

2 minutes ago, TitanTiger said:

I think you meant "condemn?"

Not really.  I was referring to the spirit of your post.  At least, my interpretation of your spirit.  Seems to reflect Christ.  Do any of us deserve God's grace, charity, love?

No, and yet,,, we do!!!

[Proud Tiger 4,261]

4 hours ago, Brad_ATX said:

But why did he move is the question?  Was it to make more money or was it to practice the medicine he so chooses?

Also, this leaves out the most important question:  Are the people of Canada, the one's actually paying for state sponsored health care, happy with the benefits that they receive?

Because if they are, then who gives a damn what a random doctor thinks.  The government is there to serve the people, and if the people are happy, then it seems the job is being done correctly.

It sure wasn't to make more money. He is also my neighbor and good friend, We have spent a lot of time talking about health care. The basic problem he grew tired of in Canada was not being able to get timely care for critical situations. Patients would die before they could get the specialist care they needed, I have lots of friends in Canada and many come to the U.S. for some of their medical care. i have to laugh at your last sentence. What gov't these days do you know of that puts the people first? I think Trump is trying to do that because he isn't owned by a lot of special interests like most politicians are.

[homersapien 12,172]

6 hours ago, icanthearyou said:

How do you equate the human decency of everyone having access to medical treatment with, "telling you what to do"?

 

 

The same way slave owners did?