Tuesday, October 14, 2008

Health Care in Switzerland

After hearing about what a terrible health care system we have in the States from movies like "Sicko"' I thought it was about time to blog about my experiences with the Swiss health care system. I have had a bit of experience because I seem to get sick regularly - nothing serious, thank heavens - but nevertheless I have been to a few doctors in CH so far and have had to use 'the system.' Here is a list of some of the observations I have made.

1. Like everything in Switzerland, health care is not cheap.
This is the number one thing that surprised me the most about the Swiss Health Care system. You hear all about how the Swiss have access to some of the best health care in the world and it makes them happier, etc. but unlike socialized systems in Sweden and Australia, and even in comparison to tax based plans in Germany, the health care is paid out of pocket here and starts at about CHF 220 per person per month with a very high deductible... So while taxes are low, health care is pretty expensive because taxes and employers do not take any of the weight off. In comparison, I paid about $225 per month for family insurance in the States and that was employer supported.

With or without a high deductible, you always pay the medical expenses out of pocket first, then get reimbursed. I find this tough as well because if it is a big bill, you have to find the dough to pay for it first. Tough system.

One point though: The one major benefit of the plan we chose is that we pay the same monthly fee for life, no matter how old and crippled we get, which is great. So we basically lock in the young, healthy rate. That is a benefit later in life, for sure.

2. Health insurance is mandatory and basic coverage is universal.
I am not sure how they enforce this but everyone has to have health insurance and unlike campaigns in Massachusetts where they tried this and failed because people couldn't afford health care - they'd rather pay the penalties, they're cheaper, than the health care costs - somehow, Switzerland succeeds (I think).

We had a grace period of three months when we arrived to get it. All the health insurance providers must provide basic health insurance and this is what the prices on services like Comparis show, based on your age and such. So we were told to go with the cheapest because hey, basic health insurance is basic health insurance and we don't need anything fancy (like special maternity plans or alternative medicine plans or private super coverage). So we went with the cheapest.

3. Medical quality is good. Very good.
I have been SUPER impressed by the conditions of the doctors, hospitals, and dentists here in Switzerland. SUPER impressed. For example, I had my annual women's check up - you know the one - and the chair they put me in to check my bits was fully automated. I mean, this thing could have rocketed me to the moon and back. No "Please move down, a bit more, a bit more.." etc. because all the Doctor had to do was tilt the chair this way and that, up and down and it was done. It was "almost" heaven.

The dentist I have took digital photos of my teeth mid-exam to show me where he wanted to work ( it is scary to see 9 x 11's of your teeth on a TV monitor but very cool).

And every doctor I have been to has a computer with Internet access to check prescription names and compare overseas medications to ones that can be prescribed in Switzerland.

Now if only they could spell my last name correctly!!!

4. The doctors are on time and available at short notice.
I have barely had to wait more than 10 minutes for an appointment. Seriously. Enough said. Impressive.

I think that they either allow more time with patients or are just, like everything Swiss, overly efficient. Nevertheless, I have not felt rushed and have not had to really wait. Love it.

I also have always been able to get a general doctors appointment at short notice. Specialists I have had to wait longer for and book in advance, but urgent appointments have always been available which is great.

5. Some doctor's bill by the hour and then in 15 minute increments.
This was one bill that I got... just putting it out there. It surprised me. I felt like they were charging for doing my taxes, not a medical exam. Different... but I understand it.

6. I can go to any doctor in Switzerland.
Unlike plans in the States where you have to sometime go to doctors on your plan, I can go to whomever I want.

I asked one doctor if he was on my insurance once and he just stared at me like I was from another planet. That is how it should be. I should be able to see whatever doctor or specialist I want because when it comes down to your health you deserve the best... and no doubt, you get it here.

7. Some Swiss Doctors bill quarterly.
This is one I am still trying to get used to because I know I am going to get hit with some huge bill around Christmas for all the doctors appointments in the last 3 months. Not great. I think you can ask to be billed immediately, and I will be doing that from now on to space out the costs. Because again, the higher the deductible, the higher the threshhold to full reimbursement for medical and therefore the more out of pocket.

Then again, if I don't get sick the less I have to pay... two way street.

8. Doctors outside of Zurich can also hand out prescriptions.
I am not sure where the boundaries of this stop and start, but one doctor told me that doctors outside of Zurich can also fill prescriptions. This is great, because once I needed something immediately, and I loved that I did not need to factor in an extra trip to the pharmacy. This definately influenced my choice in terms of a long term general practitioner, because I think there are definite benefits to one stop shopping.
Those are my experiences. Please let me know if I missed something or misworded something a I am definately not an insurance or health care expert. But all in all, I am impressed with the health care system in Switzerland and find that I am getting quality care. I hope that in the next few years I can say the same for the state of health care in the US!


naechstehaltestelle said...

Just wanted to add that if you see a pediatrician, your wait times can be unbearable. I typically wait 45 minutes, which, with a sick 2 year old is complete chaos.

M'dame Jo said...

The insurance companies are supposed to reimburse you in 3 weeks or so, so you can receive the money before having to pay the bill. If you have an important amount to pay, the thing to do is to send all the paperwork to the health insurance asap to get the money in time to pay.

Swiss Miss said...

Do you have any problems finding doctors that speak English? I think that is the worst part for me. But yes, I agree, in general the health care is very good. I also like the way I can make an appointment for say, tomorrow, or next week if I want, opposed to having to wait months in the US.

Jessica said...

That is a good point, actually, Swiss Miss, regarding English. I actually don't have to worry about that as I get by with German just fine. But a few times I have had to explain things in English and everyone seems to understand me just fine. But the German certainly helps.I think you can find English speaking doctors pretty easily though. They, like all Swiss, probably say they dont speak English well, then they all end up speaking perfect English naturally.

Bluefish said...

Health care is a very important to me and I certainly like the concept of universal health care.

I like the health plan in Canada because I don't have to be rich to receive care.

jazibe said...

i'll comment on the pregnant part, since i am going through that now:
-ALL pregnancy related issues are covered by your BASIC insurance. from Prenatal care, to delivery.
-if you are PLANNING to get pregnant, do take a look at your insurance and decide if you want/need any upgrades (half-private, private, and all other extras you could get specifically for maternity). Once you're pregnant, you're stuck with what you have and cant change it.
-Get insurance for the baby before he/she is born, so that any problems/illnesses he/she might have from birth are covered right away (billing for the baby doesn't start until birth).

Anonymous said...

I think it's great that they separate the tax and the medical insurance. Here we have the highest tax rate in the world because the insurance is included but we end up paying for all those drunken and obese people instead

rösti said...

If you are waiting 45 minutes for the pediatrician, get a new one. That is NOT normal! At least not in Switzerland.


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