Introduction

Switzerland has a very decentralized health care system the main characteristics of which are described below.

Private health insurance is the dominant form of basic coverage. Since the adoption of a new Health Insurance Law in 1994, purchase of a health insurance policy is mandatory and coverage is thus universal. The benefits package included in the basic coverage is the same for everyone, premiums being neither risk-related nor income-related, but vary from area (canton) to area and from sickness fund to sickness fund. At least once a year beneficiaries can change the sickness fund they want to be a member of, without any restriction (i.e. whatever their age, sex, health status, place of residence, etc.). Subsidies are available to people with low socio-economic status to help them with the payment of their premiums.

Sickness funds pay for all treatments, except those covered by the Swiss accident assurance fund, which is an independent, non-profit company under public law.

Additional health insurance for benefits not included in the basic coverage may be purchased (e.g. for homeopathy, acupuncture or inpatient treatment in a private, for-profit clinic). Premiums are then risk-related and are not regulated by the Health Insurance Law of 1994. Between one-quarter and one-third of the population buy an additional health insurance policy. It must be noted that such a policy may not cover deductibles and co-payments related to the basic package of benefits.

In the ambulatory sector, physicians and other health professionals (nurses, physical and occupational therapists, etc.