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Switzerland
Country overview
Switzerland ensures access to health care through a system of mandatory health insurance (MHI), which has been compulsory for every resident since 1996. The Swiss health system is highly decentralized. The federal level defines the legal framework for managed competition in the statutory health system and supervises developments at lower levels of the system.
Cantonal governments are responsible for the provision of health care and for the implementation of federal policies. Several coordination bodies exist to improve the collaboration of cantons amongst each other and with the federal government. Popular initiatives and referenda play a prominent role in influencing health policy-making, both at the local and the national level. Certain reforms of the health care system entail a positive referendum by the Swiss population.
MHI is offered by competing non-profit insurers overseen by the Federal Office of Public Health. It covers most general practitioner and specialist services, home care services, physiotherapy (if prescribed) and some preventive measures, as well as several pharmaceuticals and medical devices. Hospital services are also financed by MHI, although vastly subsidized by the cantons. Routine dental care (except for children) is excluded from public coverage.
Financial flows are split between different government levels and social insurance schemes. Resources are collected mostly through taxes and MHI premiums, with a substantial part allocated to the various social insurance schemes, in particular to subsidize MHI premiums for lower-income households.
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