UBC July 2024 - Health Care

Photo by Marcus Aurelius

Welcome back to July's UBC. This month I'm going to be talking about cultural differences between Switzerland and the USA.

Today let's discuss Health Care. 

What is a substantial problem in the US, is more of a luxury problem in Switzerland, mainly due to the rising costs, which, frankly, probably affects each and every society. 

So in Switzerland, every person has to have a basic health insurance. Admission is compulsory. There are over 50 private companies offering various models. The basic package provides general medical care in the event of illness, accident and maternity. 

Health care in Switzerland is not linked to having a job / an employer. It is your own responsibility to chose an insurance company and your individual coverage depending on your personal situation. 

You need to make a lot of decisions when you sign up for your health insurance: Do you want a free choice of doctor or do you want to go to the extra trouble of phoning the health insurance company every time before you want to go to the doctor and give them the opportunity to advise you by phone because they think your cold doesn't justify a visit to the doctor. 

If you have to go to hospital, do you want to stay in the general ward, in a double or single room? What deductible do you want? The deductible is the uncovered annual amount that you have to exceed before you ever see a cent from the insurance company. And so it goes on, so many details to consider and decide - and pay. Then there's the demographic aspect: Do you live in a city or the countryside, how old are you, are you female? 

On top it is highly recommended to have additional coverage for alternative medical treatments, cures, dental treatment, rescue costs or preventive health measures. To take out supplementary insurance, you must complete a health declaration. This enables health insurers to assess your insurance risk and decide whether to accept or reject an application, or whether to exclude pre-existing conditions from cover.

In other words, for people who need additional coverage it's hard if not impossible to actually get it. This is why parents should sign up their babies right away and pay during all these years the kids don't need it. It's a money game. 

It is almost impossible to make a general statement about how much a health insurance premium costs in Switzerland. I can only say that I pay CHF 715.95 a month for Colin and myself. At today's rate that's almost USD 800! The prices are adjusted every year. The individual situation is taken into account: have you incurred a lot of costs? In addition, there is the annual inflation and the uncovered costs in general. 

Annual price increases are usually between 0.5 and 1.5%, but in 2023 the average was 6.6%. My guess is that this is the aftermath of the pandemic: Postponed surgeries and (cancer) treatments were finally carried out, and there were more infectious diseases because people's immune systems were weakened by sheltering at home and wearing masks for so long. But that's just my personal guess.

What if you can't afford basic healthcare? Every person resident in Switzerland is entitled to a premium reduction if their income and assets are below a certain threshold. The premium reduction is granted by the cantons (states) and varies. In recent years, more than 2 million people have consistently benefited from premium reductions. That is a fifth of the population. 

What about accident insurance? 

If you don't have a job, you need to include it in your basic health care coverage.

If you are employed, it's part of your benefits. You as an employee will have a deduction of 1 to 2 percent of your gross salary.

Non-occupational accident insurance is paid for by the employee alone. It comes into play if you suffer an accident in your  free time. For example, if you have an accident while doing sports and break your leg. Accident insurance not only covers the costs of a doctor, transport and hospital, but also the loss of earnings during the recovery. In the form of a daily accident benefit, the insurance covers 80% of the salary from the third day onwards, before which the company pays the loss of salary.

The employer, on the other hand, finances the occupational accident insurance alone, which covers possible accidents to employees during working hours.

Daily sickness benefits insurance is not compulsory. However, it may be provided for in the employment contract or collective agreement, and most employers have taken out one. The amount of the deductions varies between 0.5 and 3 percent. These amounts are paid half by the employee and half by the employer.

In most cases, after a waiting period of 30 - 90 days, this type of loss of wages allowance insurance pays out for around 720 days if an employee falls ill. it comes into play when someone has a long-term illness, be it mental or physical. 

I recently wrote about the situation concerning general practitioners in Switzerland. There are not enough, and it's hard to even find one near your place of residence. Once you have been admitted as a patient, you will find out that two other people have also been given your 9am appointment, and you're stuck in a waiting room.

As I was saying in the beginning though: luxury problems. I am sure compared to other countries, our system, albeit expensive, works relatively well. 

I chose the "call your health insurance before going to see the doc" model, and I use it. So much so that I don't want to go to see the doctor in the first place, but would much rather speak to a specialist on the phone. They usually call back within the hour, are competent and efficient, and if they feel you have to be seen in person, they will tell you to make that appointment. Also, they're reachable 24/7, like after hockey practice.  

What is the situation for you like? Do you have health insurance? A GP in your area? What are waiting times to get an appointment, and how much time to you spend waiting at the doctor's office until they see you?