final project 1 milestone 1_ihp501.docx

After three months of arrival in switzerland all

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After three months of arrival in Switzerland, all residents are legally required to purchase MHI. Swiss insurance policies are typically only at the individual level, resulting in MHI needing to be purchased for any dependents (Sturny, 2015). Despite the fact that employers do not offer MHI, there are no uninsured people residing in Switzerland (Sturny, 2015). Nonresident visitors must pay for healthcare costs upfront, but are entitled to claiming expenses through their insurance in their home country (Sturny, 2015). Undocumented immigrants usually do not have MHI, and has thus become an unsolved and understudied issue acknowledged by the Federal Council (Sturny, 2015). Publicly funded MHI is offered by nonprofit insurers that compete for customers under the supervision of the Federal Office of Public Health (FOPH) (Sturny, 2015). The FOPH is responsible for setting premiums that cover past, current, and estimated future costs for those with insurance in a given region (Sturny, 2015). Within each region and insurer, premiums vary based on age group, level of deductible, and alternative insurance plans (Sturny, 2015). Publicly funded MHI does not cover all healthcare related services, making the need for private health insurance necessary for some people, or voluntary health insurance (VHI). VHI companies are for-profit, can vary benefits and premiums, and have the ability to deny applicants based on medical history (Sturny, 2015). Often times, an insurance company will offer MHI, with a for- profit branch that offers VHI (Sturny, 2015). Mandatory health insurance covers most general practitioner (GP) and specialist services, pharmaceutics, medical devices, home care services, mandatory maternal leave, prescribed physiotherapy, and some preventative measures including vaccines, general health exams, and
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INTRODUCTION AND GENERAL STATE OF HEALTHCARE 6 early detection screenings among certain risk groups (Sturny, 2015). While hospital services are covered by MHI, they are highly subsidized by cantons (Sturny, 2015). Mental illnesses are only covered if provided by certified physicians and non-physician care is only covered if prescribed by an MD and provided in their practice (Sturny, 2015). Long-term care is only covered if determined as medically necessary (Sturny, 2015). Dental and vision care are only covered until the age of 18 under MHI, although private dental and vision insurance is available (Sturny, 2015). Because some residents are healthier than others, Swiss residents have the ability to choose their deductible rate, ranging from $300 to $2,500 (Sturny, 2015). Once the deductible is reached, the person is responsible for 10% of healthcare bills up front, with a limit of $700 per year per adult, and $350 per child, discouraging needless visits to the doctor (Sturny, 2015). It is clear that Swiss healthcare system is one of the best in the world. However, it is also apparent that the system is quite complex. The system offers a high degree of choice and direct access to all levels of care, but the cost of the healthcare system is relatively high compared to the rest of the EU (FOPH, 2018a).
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  • Winter '17
  • Dr. Ruth

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