Is the Swiss Healthcare system just perfect and the NHS, well just the opposite?

When I visit Switzerland, it is immediately obvious that everything just works.  It is quite tempting to make damning comparisons with my homeland.

Ignoring the obvious one, about public transport that actually runs on time, I cast my mind to the Swiss healthcare system.

Apparently it is an example to the world, of how a healthcare system should be run and the US affordable care act has at least, been partly modeled on the Swiss system.

Some may say it is unfair to compare the respective healthcare systems of the UK and Switzerland due to the latters relatively low population size and high wealth per capita.  But who cares I will do it anyway.

I should say I have never received medical treatment in Switzerland and the below is formed on an interesting report I read, some discussions with end users of the system and a doctor friend who is based there.

Some points I picked up about the Swiss system:

COSTS

  • It is private, however it is means tested, those with reduced incomes pay lower premiums, or in some cases have the full premiums met by the government
  • Insurers can’t discriminate based on pre-conditions, risk or age and must insure all applicants at the same rate
  • The Swiss have to make a contribution. In a given year an excess (or deductible) of anywhere between CHF 300 and 2500 is paid towards treatment, with premiums adjusted accordingly.  They also must make an additional copayment of 10% of the total costs, up to a cap of CHF 700 (at the time of writing one CHF is worth slightly more than one US Dollar)

PATIENTS

  • In this private system the patient is king.  If a doctor does not offer an appointment at a convenient time or the right service, the patient can threaten to go somewhere else or indeed do so.  Swiss patients are treated like customers, because, well they actually are
  • Things happen quickly.  A Swiss patient can make a same day or next appointment with a GP/PCP.  Blood tests, for example, can be taken and results delivered on the same day. At my primary care practice, it takes me 1 week to get an appointment with the doctor, a further week to get an appointment with the nurse to take the bloods and another week to get the results.  So 1 day versus 3 weeks
  • Urgent MRI scans can be booked in with results the next day
  • A broad range of investigations happen at the primary care doctors office.  e.g. stress ECG tests and ultrasounds

TECHNOLOGY

  • The impression I get, is not that the Swiss have the most advanced and innovative individual pieces of health technology, rather the system fits together and actually works
  • Doctors don’t spend their days chasing after test results.   IT systems in the same hospital can actually talk to each other.  This is a direct contrast to the experience of UK doctors in my recent video blog post

There are of course big differences between the 2 health systems.  The Swiss seem to accept making a contribution, often up to 25% of the total costs.  The English would no doubt hate the idea of paying, even though we do anyway, via our national insurance contributions and taxes.

The NHS is changing but surely the top priorities are to:

  • accelerate the patients transition to a customer of health and wellness
  • make sure the technology works, in an integrated way and reduce some of the huge inefficiencies

I am interested in comments or thoughts, from Swiss, English, patients, doctors… or indeed anyone with an opinion.

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2 thoughts on “Is the Swiss Healthcare system just perfect and the NHS, well just the opposite?

  1. I’m a student doctor in the UK & I completely agree that the NHS could learn from the Swiss model in harnessing the best parts of consumerism and introducing some measure of co-payment for appointment slots in primary care (at least, as a start). However, no elected government in the UK would ever want their legacy to be “the ones that privatised the NHS”. I think there are political hurdles to be jumped in the NHS to make its functioning more frictionless & I really think we need to re-examine some of the founding premises & principles of the NHS as some of them may be a mile-stone hanging around our neck.

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    1. Hi Tobi, thanks for your comment, great to get your perspective! Yes I can’t see any government proposing it in a hurry. The key founding principle of the NHS ‘free at the point of need’ sounds very nice but acts as a barrier to any radical change. I’d be interested to hear more about the political hurdles to make the functioning of the NHS more frictionless as you put it. I do appreciate technology and processes will not work without the willingness and cooperation of people in the NHS at all levels. The feedback I get from other doctors, is that there is a significant inertia to change generally.

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