While healthcare delivery in the United States is famous for its non-standard format, mainly due to different states and policies, healthcare in Switzerland is known for its uniformity. Switzerland has a unique healthcare system, which is customer-driven and offers universal coverage despite demographical differences (HealthCare, 2018). Unlike the United States, the health care system in Switzerland lacks the aspect of intermediaries shopping on behalf of individuals. That is, these two countries have very diverse and completely different ways and approaches to delivering medication to its citizens.
Therefore, this paper aims at comprehensively analyzing and examining the healthcare systems of U.S. and Switzerland. Specifically, the paper encompasses aspects such as medical coverage on children and older people, whilst exploring insurance for preexisting conditions and financial impacts on patients.
Healthcare Access for Children, the Unemployed and the Retired
As reported by Chin et al. (2018), United States has a tendency of continuously introducing medical reforms, which usually interferes with healthcare delivery for the unemployed, children and the retired. Nonetheless, the Affordable Care Act offers more than $5 billion dollars to cater for retirees through their companies. This is particularly helpful to Americans retiring as early as aged at 55 years and older. The Act also caters for their spouses and children. With regards to Switzerland, retirees are having a better healthcare compared to the United States.
By Swiss law, each employee’s retirement fund is usually characteristic of contributions from a pension plan operational through the country (Schusselé et al, 2018). Also, the unemployed are protected by tax-free personal savings, which are similar to America’s IRA accounts. Switzerland has better healthcare delivery for its retirees, children and unemployed due to the combination of funds Swiss citizens save while working. Compared to the U.S., retirees in Switzerland receive higher percentages of their previous salaries through pension plans, which add up to about $1750 monthly.
Medical Coverage between U.S. and Switzerland
A significant difference in the two countries is the ability of patients to access and consume health in value and cost-conscious ways. In the United States, only one-tenth of its citizens are capable of buying insurance on their own while the rest have to rely on their employers. As for Switzerland, each person buys medical insurance for him/herself. That is, and as reiterated by Mantwill and Schulz (2017), Switzerland has no middlemen in healthcare delivery. The goal of the Swiss health care system is to prevent its citizens from incurring more than 10 percent of their earnings on insurance. This is because of too much expenditure on healthcare insurance results in cost inflation.
Moreover, the Swiss government introduced a program similar to Medicare, which aims at controlling prices at hospitals. With the program, it means that insurers are obliged to charge similar rates to both the young and the old generations (Pavolini et al., 2018). The same program also protects patients from charges on preexisting conditions.
Requirements to getting Referral
In the United States, a written order is required for a patient to see a doctor. Moreover, in many HMOs (or health maintenance organizations), patients need to get a referral from a medical expert. Failure of getting a referral results in the plan not paying for the services. On the other hand, in Switzerland, referrals have no strict requirements like in the United States. Since the medical insurances are personal, the patient has the privilege of picking a referral of their preference. Chin et al. (2018) note that this doesn’t just work for Switzerland, but it also reduces waiting time, thus speeding up healthcare delivery. Specifically, every Swiss citizen is referred to a hospital that fits his or her insurance policy and they don’t have to rely on their employers for medical cover.
Coverage for Preexisting Conditions
America’s current laws demand that health insurance companies are more than obliged to cover a patient’s medicals despite having pre-existing conditions. That is, health insurers don’t have the power to charge more than what the patient paid. Some of the preexisting cognitions being tolerated include asthma, diabetes, and cancer. Moreover, Chin et al. (2018) explain that the insurance companies cannot limit benefits either, thus, once an American patient has insurance, he or she cannot be denied treatment.
Similar sentiments are shared in Switzerland, whereby every applicant has the freedom to be treated regardless of preexisting medical conditions.
Of course, there are a few tariffs and rates applicants need to meet, but as long as an insurance cover has been presented, then medical care is expected (InterNations, 2018). The only difference between Switzerland and the United States is the availability of “daily benefits insurance,” which guarantees Swiss patients of continued sick pay whenever an employee has a prolonged number of days from work.
Financial Implications Affecting Patients
Schusselé et al. (2018) argue that the U.S. health care system is bankrupting the nation. As per the research’s findings, the United States has been spending more on health care than it should, thus it has been crippling the country. For instance, the country spends an average of $10,367 per person, thus amounting to about 18 percent of America’s GDP. This figure is eight points above most developed countries like Switzerland. Supposedly, the biggest culprit is the Medicare program, which has been growing more than twice the rate of United States’ inflation.
Worse, this is expected to accelerate with baby boomers coming to age and reaching retirement stage. Because of this, Mantwill and Schulz (2017) suggest that a shift from a “fee-for-service” to a “value-based” approach is the most effective way to decrease healthcare expenditures. The second financial impact on health care is Medicaid’s expansion, which has had a favorable influence on safety-net hospitals, which are meant to care for low-income earners. From 2013 to 2017, safety-net hospitals in states that expanded the Medicaid program experienced a positive and larger increase in Medicaid inpatient days and revenues (Schusselé et al, 2018). It also reduced the uncompensated cost of health care in the respective states.
From a conclusive point of view, this paper has analyzed and identified key topics on healthcare differences between the United States and Switzerland. Some of the important topical aspects include financial impacts, coverage on preexisting conditions, referrals and general medical cover on retirees. Unlike the United States, healthcare in Switzerland characterizes an embodiment of favorable terms that America needs to emulate. Pavolini et al. (2018) recommend that the U.S. ought to consider shifting control of investments on health care from the government to the citizens.
A perfect example is emulating Switzerland’s value-based approach whereby the country’s healthcare system doesn’t support the presence of middlemen. This way, patients and insurance applicants enjoy a balanced healthcare delivery. Another example is Switzerland’s premium-support model, which creates a fair system that caters for everyone regardless of a patient’s financial background and medical history.
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HealthCare. (2018). Referral Requirements in the United States — HealthCare.gov Retrieved from https://bit.ly/2QwVdEO
InterNations. (2018). Staying Healthy: Hospitals and Doctors in Switzerland. Retrieved from https://bit.ly/2zUFOJe
Mantwill, S., & Schulz, P. (2017). Low Health Literacy And Healthcare Utilization Among Immigrants And Non-Immigrants In Switzerland. Patient Education And Counseling, 100(11), 2020–2027. DOI: 10.1016/j.pec.2017.05.023; Retrieved from https://bit.ly/2yjLWsn
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Schusselé Filliettaz, S., Berchtold, P., Kohler, D., & Peytremann-Bridevaux, I. (2018). Integrated Care In Switzerland: Results From The First Nationwide Survey. Health Policy, 122(6), 568–576. DOI: 10.1016/j.healthpol.2018.03.006; Retrieved from https://bit.ly/2y4OeMH