This analysis of the Swiss health system reviews recent developments in
organization and governance, health financing, health care provision,
health reforms and health system performance.
The Swiss health system is highly complex, combining aspects of managed
competition and “corporatism” (the integration of interest groups in the policy
process) in a decentralized regulatory framework shaped by the influences
of direct democracy. The health system performs very well with regard to
a broad range of indicators. Life expectancy in Switzerland (82.8 years) is
the highest in Europe after Iceland, and healthy life expectancy is several
years above the European Union (EU) average. Coverage is ensured through
mandatory health insurance (MHI), with subsidies for people on low incomes.
The system offers a high degree of choice and direct access to all levels of care
with virtually no waiting times, though managed care type insurance plans that
include gatekeeping restrictions are becoming increasingly important. Public
satisfaction with the system is high and quality is generally viewed to be good
or very good.
Reforms since the year 2000 have improved the MHI system, changed the
financing of hospitals, strengthened regulations in the area of pharmaceuticals
and the control of epidemics, and harmonized regulation of human resources
across the country. In addition, there has been a slow (and not always linear)
process towards more centralization of national health policy-making