Blame the Swiss...

[Jeff In Milwaukee]

If you're wondering about the model for the Senate Healthcare Reform Bill, the answer might be that it bears an uncanny resemblance to the healthcare system in Switzerland.

ZURICH — Like every other country in Europe, Switzerland guarantees health care for all its citizens. But the system here does not remotely resemble the model of bureaucratic, socialized medicine often cited by opponents of universal coverage in the United States.

Swiss private insurers are required to offer coverage to all citizens, regardless of age or medical history. And those people, in turn, are obligated to buy health insurance.

The article points out that the mandatory insurance plan offered by the private companies must be on a non-profit basis, but insurers are able to offer extended coverage (perhaps equivalent to our "cadillac plans") on a for-profit basis. On the down side, the Swiss pay higher deductibles and co-pays than an average insured person pays in the United States.

Since being made mandatory in 1996, the Swiss system has become a popular model for experts seeking alternatives to government-run health care. Indeed, it has attracted some unlikely American admirers, like Bill O’Reilly, the Fox News talk show host. And it has lured some members of Congress on fact-finding trips here to seek ideas for overhauling the United States system.

The Swiss approach is also popular with patients like Frieda Burgstaller, 72, who says she likes the freedom of choice and access that the private system provides. “If the doctor says it has to be done, it’s done,” said Mrs. Burgstaller. “You don’t wait. And it’s covered.”

Link

[FiveGoodMen]

1. "You don’t wait. And it's covered."

Anyone here think that's how OUR health care will work?

[timeforpeace]

9. They have what, 10 million people? We're talking 330 million here. Can't be the same.

[enlightenment]

2. Not so much a comparison.

The Swiss maintain tight regulatory control of the non-profit companies.

That is light years from the 'reform' being discussed in Congress.

[Libertas1776]

3. "mandatory insurance plan offered by the private companies must be on a non-profit basis"

No way in hell that is ever going to happen here with big insurance fucks.

[Jeff In Milwaukee]

4. 85% of payments have to go for treatment

That leaves the insurance companies only 15% of your premium for overhead and administrative costs -- which is actually not a lot. By the time that pay for the kibble to feed the bureaucratic monster, there probably really ISN'T a whole hell of a lot left for profits.

[Blue_Tires]

8. even better: the insurers would have no $$$$ left to buy

senators' votes or an endless string of prime-rate commercial advertising...that alone would have made it worthwhile...

[Jeff In Milwaukee]

10. Lobbying Reform - The Next Mountain to Climb

And by lobbying "reform" I mean that lobbying outside of meetings with non-paid representatives of constituent groups should be banned outright. Donations from PACs and bundling of contributions should be outlawed.

Probably a couple more things that should go be the wayside, but those would be a darned good start.

[girl gone mad]

15. If they need more money..

all they have to do is raise rates.

[Blue_Tires]

21. that's why i really wanted the cost controls and regulation, if nothing else

[rfranklin]

20. Medicare does it on about three percent...

so there is a monumental amount of waste or profit in the private insurance business.

[Jeff In Milwaukee]

23. I go for the former...

Full Disclosure: I work for a non-profit healthcare provider.

Our billing department deals with dozens (and dozens) of providers, and each has multiple "products" that it offers to different individuals, groups, and businesses. And then you have to figure out with each one of several hundred different insurance products, what benefits is the insured allowed?

It's bewildering and it requires a small army of clerks to make it happen. Medicare billing (although it often doesn't meet the cost of the care provided) is at least a far less complicated billing process.

Look for the mandatory plans to be stunningly similar to one another, regardless of which company is the provider.

[Shagbark Hickory]

36. Newsflash.. They currently spend 75-80% so an extra 5% is not really a big deal.

ORiginally they were trying for 95%. That's more like it.

[janx]

5. Howard Dean mentioned this on MTP Sunday. n/t

[Blue_Tires]

6. I think "uncanny resemblance to the Swiss system" is stretching it a mile

I would have LOVED for the bill to have this:

Insurers must insure everybody on a nonprofit basis
Prices cost-controlled and heavily regulated
Subsidies
and although the story doesn't say, I'm willing to bet the Swiss plan doesn't play politics with covering abortion

Of course, for all the so-called conservatives supposedly in love with the Swiss plan; there would be another hammer-and-sickle teabag march tomorrow if the Senate was considering any of the above...

[Jeff In Milwaukee]

7. The Senate Bill leaves out quite a bit...

But this is clearly the model they were looking at when they wrote this legislation.

[kenny blankenship]

11. Bullcrap.

Let them tell the insurance companies: you'll provide health insurance to all and you'll provide basic essential health insurance AT NO PROFIT.

Then you could make this assertion.

Switzerland made basic essential health care insurance non-profit long before they contemplated an individual mandate to force purchase of policies. In fact, because of the non-profit nature of Swiss insurance they already had 94% of their population covered BEFORE the individual mandate forcing people to buy insurance was passed.

The mandate has nothing to do with the high rate of coverage in Switzerland. NON-PROFIT basic insurance has everything to do with their high rate of coverage.

If you want to make Switzerland your model, please be honest. That will mean telling the insurance companies they're about to take a massive haircut. See how far you get taking Switzerland as your model instead of as your rhetorical shield. Also, if you want to adopt Switzerland as the model of what's established and true, you can no longer say the mandates are the essential part of the plan. Controlling insurance company greed was the success of the Swiss system, as it is in the French system, the Canadian system, the British system and so on.

The real model is Mitt Romney's Massachusetts plan with guaranteed corporate profits and inescapable mandates. This fine Republican plan has the highest costs of any state in the US and covers about the same % of people as Switzerland managed to do without mandates.

I thought WE were going to do better. We could have just elected Romney if we were for this shit.

[PeaknikB]

13. We don't let you drive on public roads w/o insurance...

Why should you be allowed to not have health insurance for yourself?

[girl gone mad]

16. I can walk on the public roads, take a bus, take a taxi...

get a ride from a friend.

I'm not forced to buy a car and an insurance policy to use the roads.

No offense, but you didn't think that one through.

[PeaknikB]

19. but if that taxi is in an accident

Why should the American taxpayer be responsible for your injuries? You must have car insurance because there is an inherent risk to driving. Same with doing pretty much anything else, you need to have insurance.

[immoderate]

25. You seem confused.

The taxi company must have insurance, the passenger is not mandated to have the insurance. Where does the American taxpayer come in to this? Are you proposing that someone buy separate insurance every time they ride a taxi or a bus?

And what makes you think car insurance provides the best model? In some countries, insurance fees are rolled into fuel costs. Those that drive more and have bigger vehicles (which can cause more damage) wind up paying more. I'm not saying this is good for health care any more than our current system is. But it might be.

--imm

[PeaknikB]

35. we require them to insure themselves

Maybe a taxi service wasn't the best example, but we do require them to be covered in the event of an accident. If you are riding a bike and fall, you are generally responsible. That is why you must carry insurance, otherwise if you don't have the money the tax payers would be liable.

[immoderate]

26. You seem confused.

The taxi company must have insurance, the passenger is not mandated to have the insurance. Where does the American taxpayer come in to this? Are you proposing that someone buy separate insurance every time they ride a taxi or a bus?

And what makes you think car insurance provides the best model? In some countries, insurance fees are rolled into fuel costs. Those that drive more and have bigger vehicles (which can cause more damage) wind up paying more. I'm not saying this is good for health care any more than our current system is. But it might be.

--imm

[piratefish08]

29. You are not FORCED to drive a car. No car, no insurance.

Bullshit comparison.

[Hamlette]

12. Switzerland does not allow abortion on demand, only for life and health of the mother

not even for rape or incest.

And this new bill does make it mightly close to non profit (if not non profit) as 80-85% of premiums must go to pay for care. That leaves 15-20% for admin and profit. If you've ever worked under the 15% threshold, you know how tight that can be.

The bill does have subsidies, where do you think the $871 billion goes?

There are some cost controls, probably not enough but that remains to be seen.

But covering 30 million Americans and saving 30,000 lives a year is reason enough to kill the bill?

(edited to correct: Switzerland changed its abortion law in 2007 and now allows for defect of child and rape, still, no abortion on demand).

[Blue_Tires]

17. i never said 'kill it'; i just wanted it to be more like the Swiss system

in reality; not a hazy, sorta-like manner that leaves out a lot of the good stuff...

[suffragette]

22. Was the 2002 law in Switzerland changed?

Or am I reading it incorrectly?

See my post below as well as http://www.nytimes.com/2002/06/03/world/swiss-voters-lift-restriction-on-abortions.html

Swiss Voters Lift Restriction On Abortions
By ELIZABETH OLSON
Published: June 3, 2002

GENEVA, June 2— Swiss voters agreed today to ease the country's abortion laws, among Europe's strictest, and bring them closer to much of the rest of the continent's laws and actual practice in Switzerland.

About 72 percent of voters approved a measure permitting abortions in the first 12 weeks of pregnancy, provided the woman requests the procedure in writing and agrees to counseling and medical advice. After 12 weeks, a woman may obtain an abortion only if she can show a physician that her physical health is endangered or that she faces ''profound distress.''

The Swiss vote leaves Ireland, Poland and Portugal with Europe's most restrictive abortion laws, according to the Alan Guttmacher Institute, a nonprofit group that researches reproductive health.

~snip~

The government, which supported relaxing the law, said most abortions in Switzerland are performed between the 6th and 10th weeks of pregnancy.

Last year, lawmakers adopted a measure to liberalize the law, but opponents challenged the proposal by gathering enough signatures to bring it to a nationwide vote.

In practice, most women have been able to obtain a clinic abortion as long as they could get a second medical opinion favoring it, usually from a psychiatrist. Most doctors accepted this as evidence of risk to a mother's health, but this requirement is dropped from the new law, which takes effect in October.

edited to add info from article

[Odin2005]

30. The Swiss are VERY socially conservative.

Women couldn't vote there until the 70s.

[Hamlette]

39. my "favorite" Swiss law is no food sales on Sunday

except in restaurants. That means, they unplug vending machines on Sunday. Can't even get a can of Coke on Sunday.

Very odd place.

[Jeff In Milwaukee]

40. Really....

Is this from religious convictions or at the behest of the restaurant lobby?

If its for religious purposes, then I'm assuming nobody in Switzerland is familiar with Mark 2:23-28

23 And it came to pass, that he went through the corn fields on the sabbath day; and his disciples began, as they went, to pluck the ears of corn. 24 And the Pharisees said unto him, Behold, why do they on the sabbath day that which is not lawful? 25 And he said unto them, Have ye never read what David did, when he had need, and was an hungred, he, and they that were with him? 26 How he went into the house of God in the days of Abiathar the high priest, and did eat the shewbread, which is not lawful to eat but for the priests, and gave also to them which were with him? 27 And he said unto them, The sabbath was made for man, and not man for the sabbath: 28 Therefore the Son of man is Lord also of the sabbath.

[suffragette]

14. Looks like the fundies in Switzerland tried to make abortion illegal

and lost - resoundingly.
And from this article, insurance there covers it.
http://www.prochoiceforum.org.uk/ocrabortlaw2.php

Swiss vote for legal abortion
Press release from SVSS
June 04, 2002

At last women in Switzerland obtain the right to decide for themselves whether or not to have an abortion.

On June 2nd, with a spectacular proportion of 72.2 percent ayes, Swiss voters have accepted abortion on request of the woman within the first 12 weeks of pregnancy. Simultaneously a fundamentalist initiative which asked for a complete ban of abortion was on the ballot. It was rejected with 81.7 percent of the votes.

This is a great victory for women in Switzerland who have been fighting for the right to choose for over 30 years. The new legislation adopted by the Swiss electorate allows abortion within the first 12 weeks of pregnancy, at the written request of the woman who finds herself in a situation of distress. The decision lies with the woman. Before the abortion is done, the doctor has to inform and counsel the woman and give her the addresses of specialized counselling centers where she can receive more information and help. Young women under the age of 16 have to visit a counselling center before an abortion can be performed. The costs of the abortion will be covered by health insurance.

More at link.

[hfojvt]

18. the Swiss. Damn that Helvetian Confederation!!

Wait? Don't they speak FRENCH in Switzerland? :argh:




* (I know, I know, not in Graubuenden where the Walsers live)

[Jeff In Milwaukee]

24. And don't get me STARTED about the cheese...

Fuckin' holes EVERYWHERE!

[provis99]

27. what has Switzerland ever done for civilization?

Apparently, the cuckoo clock, Alpine horns, and enforced private health insurance are their grand contributions.

[JackDragna]

28. At least they haven't been busy killing their neighbors..

..like every major power in Europe has for the last, I dunno, thousand years. :)

[Jeff In Milwaukee]

31. Not a big chocolate fan, are we?

[Blue_Tires]

32. Don't forget the Chevrolet brothers!

Louis, Arthur and Gaston

[Nikki Stone1]

33. "the mandatory insurance plan offered by the private companies must be on a non-profit basis"

NON PROFIT! THAT'S THE KEY.

That's what keeps costs down. The Swiss get it and shouldn't be blamed.

[PM Martin]

34. Swiss insurance companies are NOT allowed to make a profit

on the coverage they offer. Swiss insurance companies CANNOT rescind coverage!
Swiss insurance companies must offer coverage at a fair cost to ALL CITIZENS.
The bill going forward does have these promises.

[Jeff In Milwaukee]

38. Actually, they are allowed to make a profit...

Only the bare-bones, mandated insurance plan is required to be offered on a not-for-profit basis. Swiss insurers can then offer enhanced plans with greater coverage at a profit.

The Senate Bill allows insurnace companies to pocket only 15% for overhead and profit. Considering the administrative costs involved with process insurance claims, these plans will have very little in the way of profit. And I believe the Senate Bill doesn't allow for terminating or denying coverage for pre-existing conditions or for creation annual or lifetime maximums.

[1]

37. i never trusted those swiss...

with their little watches, secret bank accounts, guards at the vatican...

just too much going on there...