Overview

Key points

• The Swiss health system is decentralized, with responsibilities divided across federal, cantonal and municipal levels of government.
  
• The system’s governance allows influence by insurer associations, physicians and hospitals (through tariff and quality negotiations) and by voters (through direct democracy).
  
• Mandatory health insurance (MHI) with community-rated premiums and subsidies for low-income households offers relatively comprehensive coverage.
  
• Health spending in Switzerland is high, at US$ 8998 per capita and 11.8% of gross domestic product (GDP) (2021).
  
• The share of public spending on health was 4.3% of GDP in 2021 (against 7.1% in the EU) and out-of-pocket (OOP) payments were higher (23% compared to 19%). This risks creating financial barriers to access.
  
• There are relatively high numbers of hospitals but falling bed numbers.
  
• Primary and specialized care have traditionally been provided by self-employed practitioners in independent practices but new models of integrated care are seeking to enhance coordination and efficiency (through insurance plans with restricted provider choice).
  
• The health workforce is expanding, with high rates of nurses and physicians, but with many qualifying outside Switzerland (38.4% of doctors in 2021) and concerns about ageing.
  
• Digital transformation, telemedicine and initiatives like DigiSanté aim to improve delivery, access, and health outcomes, particularly in underserved areas.
  
• Switzerland has a high life expectancy at birth (83.7 years in 2022) and low premature mortality from noncommunicable diseases (NCDs), but most deaths remain associated with NCDs and mental health issues represent an increasing challenge.
  
• Immunization rates are high and management of communicable diseases such as HIV and tuberculosis (TB) is effective.
  
• Ongoing reforms aim to improve efficiency, strengthen primary and ambulatory care, address geographical disparities in access, and enhance emergency preparedness.