The Healthcare System in Switzerland Works
Stanley Feld
M.D.,FACP,MACE
Paul
Krugman is starting to drive me crazy with all his fact free declarations about
the healthcare system.
He recently declared that consumer driven healthcare has
been a bust everywhere it has been tried. Paul Krugman as an “expert” has once
again made a declaration that contradicts the facts. He is clearly not
interested in being confused by facts.
Paul Krugman is against putting consumers in
control of the healthcare system. He feels,
as President Obama feels, that a central committee (IPAB) should be in charge
of deciding what to do with limited health care resources.
He has said,
"Consumer-based" medicine has been a
bust everywhere it has been tried. Medicare Advantage was supposed to save
money; it ended up costing substantially more than traditional Medicare.
Medicare Advantage costs the government more
money because the government gave the private insurance companies a $3,000 bonus
per senior to get Medicare out of the government’s hands.
This is one of the principle reasons I am not a fan of
Medicare Advantage.
In reality Medicare Advantage provides more
services at lower premiums and deductibles for seniors. Seniors with Medicare Advantage use
fewer services resulting in a lower cost of total services and more profit for the
healthcare insurance industry.
Paul
Krugman is wrong. Switzerland has the
most consumer driven healthcare system in the world and the Swiss government
pays far less than most countries while the Swiss get a high quality of care.
His ideology
blinds his mind. The healthcare system in Switzerland is a consumer driven
healthcare system that works for the Swiss. The Swiss government makes the
rules and then gets out of the way.
The
Swiss healthcare system can be used to start a constructive conversation about
healthcare reform in America that can satisfy both conservatives and liberals
and save the U.S. from bankruptcy resulting from expanding entitlements.
The
healthcare system in Switzerland is a consumer driven healthcare system in
which consumers have choice. It has resulted in a low income tax rate,
universal healthcare, and satisfied stakeholders
The
Swiss system could not be totally transformed into an American system because
of America’s embedded ideology and prejudices as well as stakeholder vested interests.
However it outlines the government’s role in a healthcare system and highlights
the power of a consumer driven system.
America’s
healthcare system must undergo significant changes. Most of these significant
changes have been ignored by President Obama in Obamacare. It empowers
government and not the consumer.
Paul Krugman has stated flatly, "Patients
are not consumers"
This
attitude toward patients points out the disrespect for the intelligence and
judgment of consumers.
The elements
critical to meaningful reform of America’s healthcare system must include the
following changes.
1.
There must be significant and meaningful Tort Reform to decrease the practice
of defensive medicine.
2.
There must be significant reform of the healthcare insurance industry’s
financial rules to stop the industry from listing non-direct care expenses as
direct patient care.
3.
There must be regulations to cause the healthcare industry to be competitive
for consumers’ business. Government should not be the consumer of healthcare.
4.
There must be legislation to change the healthcare insurance industry’s incentives
for profitability in order to create innovative healthcare insurance products
that will reduce healthcare costs.
5.
There must be significant financial incentives for consumers to be motivated to
save healthcare dollars.
6.
Consumer must responsible for their health and healthcare dollars. The
entitlement mentality must be eliminated.
7.
Hospital systems should be competing for patients’ healthcare dollars and not
government healthcare dollars.
8.
Physicians must be responsible to consumers and not hospital systems or the
government.
9.
Insurance costs must be community rated.
The
healthcare system must be a consumer driven system just as purchasing
groceries, automobiles, computers and televisions are. If the product is poor
the company will go out of business.
America’s goals should be universal healthcare
coverage with freedom of choice, and reduction of healthcare costs.
It is worth understanding the Swiss healthcare
system as a starting point to meaningful reform of the American healthcare
system.
These are the major features
of the Swiss Healthcare System:
1.Swiss citizens
buy insurance for themselves.
2.There are no
employer-sponsored or government-run insurance programs.
3.Insurance
prices are transparent to the beneficiary and community rated.
4. The
government defines the minimum insurance benefit packages that must be offered.
Everyone must have the minimum
healthcare insurance coverage.
5. All
packages require beneficiaries to pick up a portion of the costs of their care
(deductibles and coinsurance) in order to incentivize citizens to be
responsible for their health and the control of healthcare dollars spent.
6. My ideal
medical savings account would provide a positive incentive by rewarding
citizens who did not spend the first $6,000 dollar to keep that money in a
retirement account.
7. Patient
incentive is a critical element in healthcare reform because incentives provide
consumers with a reason to take care of their health and healthcare
dollars
8.The Swiss government
subsidizes health care for the poor on a graduated basis, with the goal of
preventing individuals from spending more than 10 percent of their income on healthcare
insurance.
9. Citizens
can be responsible for a significant component of healthcare costs in Switzerland.
10. Consumers
often opt for the cheaper healthcare insurance packages. They have freedom of
choice. Many Swiss consumers choice chose
minimal insurance plans combined with high-deductible insurance plans.
11. Citizens
are free to choose comprehensive insurance coverage or some form of
supplemental coverage. It is not a one size fits all system.
12. Ninety-nine
percent (99.5%) of Swiss citizens have health insurance.
13.There are
about 100 different private insurance companies in Switzerland with multiple
healthcare insurance plans.
14. It is clear
that the government has made the rules and then has gotten out of the way. The
rules have set up a market driven competitive healthcare system.
15. The result
has been that healthcare insurers are competing for consumers’ business on
price and service. Consumers gravitate to the best price and service that fits
their needs.
16. The Swiss
healthcare system not only helps to curb health care inflation but most
beneficiaries have complete freedom to choose their doctor.
17. The setup
of the system has resulted is low waiting times for physician and hospital
services with a minimum of bureaucratic slow downs.
18. The Swiss healthcare
system aligns all the stakeholder incentives by empowering the consumer while
helping less fortunate consumers.
19. Government
spending on health care in Switzerland is only 2.7 percent of GDP, by far the
lowest in the developed world.
U.S.
government spending on health care was 7.4 percent of GDP in 2008 and will
exponentially grow under Obamacare.
“ If the U.S. could move its state health spending to Swiss
levels, it would save more than $700 billion a year.”
Dr. Regina Hertzlinger has an excellent description of the
Swiss healthcare system in the following You Tube.
Switzerland’s
healthcare system cannot be superimposed on the U.S. healthcare system. It can
be used as a starting point to empower consumers to drive the healthcare system
and be part of the solution.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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jelly andrews • October 22, 2012
This is very informative. Before I read this one, I thought having Medicare is really an advantage. I thought it is beneficial to all. Thanks for sharing something meaningful as this one.
insurance • November 12, 2012
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