Words.
"Like the U.S., Switzerland is a country that values individual responsibility and holds a deep-rooted distrust in federal government interference in health issues, which traditionally have been handled by state -- or canton -- government. Switzerland in 1994 had a largely private financing system for healthcare, with competition among a large number of for-profit and nonprofit health insurers.
Many employers offered health insurance as a fringe benefit, although some were dropping coverage because of rising costs, while a growing minority of the population had no health insurance at all, as they were unable to afford rising premiums. Still, the majority of people had coverage and were generally satisfied with it. And Switzerland was second only to the United States in terms of the proportion of its GDP devoted to healthcare.
Lawmakers in Switzerland wanted to maintain the aspects of the health system that worked or were politically popular while improving access to medical care, eliminating inefficiency and waste and doing away with insurance discrimination. The lawmakers built on the existing foundation of competition among private insurers. They defined a comprehensive benefits package that all citizens were entitled to receive. And they coupled a mandate for all citizens to purchase a health insurance plan with its logical counterpart, the obligation of health insurers to accept all applicants and charge the same premium to everyone, regardless of age, gender or medical history. To make insurance affordable for all, government subsidies are provided to those with low and moderate incomes.
...After enactment by the parliament, Swiss healthcare reform was subject to a national referendum. The result of the popular vote was positive but extremely close. And yet now, 15 years later, no one in Switzerland questions the need for universal coverage.
Of course, universal coverage has not solved all of our problems. The costs of the medical system have not been restrained as much as anticipated, despite better control of drug prices and medical services. And the burden of higher health insurance premiums falls disproportionately on middle-class families, because they are too rich to receive subsidies and because premiums are paid for every member of the family, children included.
However, the objective of eliminating discrimination in insurance has been fully achieved, the quality of Swiss medical care remains among the highest in the world, and no one risks financial ruin when confronted with a serious illness. Free choice of doctor, health insurer and medical treatment have all been maintained. Healthcare reform has also enabled a significant increase in the transparency of the system overall, which is an essential condition for its proper management.
...In reforming healthcare, the most important action is to dare to make credible change, knowing that it can be perfected over time. The Swiss experience shows that it is possible for a government to establish its own system, something that best corresponds to its country's historical heritage and political values, in order to fulfill its fundamental duty: to guarantee that its population will receive, under all circumstances, the medical care it needs."
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