Country to Compare
Switzerland is one of the countries with an accessible and quality healthcare system. The country has adopted various legislation and policies to ensure effective medical care services. Unlike many countries, the Swiss healthcare system is highly decentralized and majorly funded by the residents.
Accessibility: Children, Unemployed, and Retirees
In Switzerland, any person can access medical services. The children, unemployed, and retirees largely depend on privately obtained insurance covers. Therefore, medical services are not limited to age in Switzerland (Tzogiou et al., 2021). However, unemployed Swiss patients have limited access since personalized insurance covers are expensive. The U.S. Medicare program allows access to healthcare for the aged, children, and unemployed persons with disabilities. Additionally, the Affordable Care Act addresses the healthcare costs as covered by insurers for retirees, children, and the employed. The unemployed have difficulties accessing services that are expensive. Thus, the Swiss healthcare system is more accessible than the U.S.
Coverage of Medications
Although accessibility to medications is easy in both Switzerland and the U.S., the two countries exhibit significant differences in health cost coverage. While 10% of Americans can purchase health insurance on their own, 90% cannot and depend on their employees (Alspaugh et al., 2021). The insurance covered by employees is restrictive, excluding some kinds of medications. For instance, the patients will have to pay for drugs using their own money. Meanwhile, in Switzerland, every citizen and resident purchases insurance coverage on their own (Tikkanen et al., 2020). Consequently, they prescribe an insurance cover of their choice. The majority of Swiss residents have insurance policies that cover drugs and medications, among other healthcare services.
Referral to See a Specialist
The medical coverage policies influence the choice of medical experts and the insurers’ decision to settle the hospital bills. In the U.S., a written order is mandatory for a patient to see a specialist doctor (Tikkanen et al., 2020). However, doctors must confirm that the patients’ employees have included the required specialist service in the covers. The strict system is because the majority of U.S. residents rely on employees to pay for their medical services (Collier et al., 2021). Meanwhile, in Switzerland, referrals have less strict requirements. Swiss medical insurances are personal, allowing the patients to pick their preferred specialized medication. Unlike, in the U.S., in Switzerland, the option of getting a referral lies on the patients. Therefore, getting a referral for specialized medical services is stricter in the U.S. than in Switzerland.
Coverage for Preexisting Conditions
The U.S. legal system plays a significant role in protecting consumers from exploitation. The system requires that insurers cover patients’ medical conditions despite having preexisting ones (Kates et al., 2021). Consequently, the insurers cannot charge more than what the insured paid. Asthma, diabetes, and cancer are some of the preexisting medical conditions that do not interfere with the payment of insurance. Although Swiss residents have the freedom to be treated regardless of their preexisting conditions, they must pay some required tariffs (Tikkanen et al., 2020). The Swiss and American medical systems prioritize patients’ needs in case they have preexisting conditions.
Finance Implications for Healthcare Delivery
The U.S. has adopted a medical coverage system that is detrimental to its Gross Domestic Product (GDP). Therefore, the medical services delivery in the U.S. is poorer than in Switzerland. The differences have two major financial implications for patients from the two countries. First, there is an increase in medical expenditures by U.S. residents. In 2020, the country spent $4.1 trillion, which was $12, 530 per person, and about 18% of the U.S. GDP (Harrill & Melon, 2021). The patients in the U.S. spend above what the insurance can cover due to employees’ restrictions. Second, Swiss patients spend less on medical expenses, utilizing the saved amount for other activities. Swiss patients decide what their insurance can cover depending on their medical conditions. Therefore, they do not spend much money above their insurance deductions.
References
Alspaugh, A., Lanshaw, N., Kriebs, J., & Van Hoover, C. (2021). Universal health care for the United States: A primer for health care providers. Journal of Midwifery & Women’s Health, 66(4), pp. 441–451.
Collier, S. A., Deng, L., Adam, E. A., Benedict, K. M., Beshearse, E. M., Blackstock, A. J., Bruce, B. B., Derado, G., Edens, C., Fullerton, K. E., Gargano, J. W., Geissler, A. L., Hall, A. J., Havelaar, A. H., Hill, V. R., Hoekstra, R. M., Reddy, S. C., Scallan, E., Stokes, E. K., & Yoder, J. S. (2021). Estimate of burden and direct healthcare cost of waterborne infectious disease in the United States. Emerging Infectious Diseases, 27(1), pp. 140–149.
Harrill, W. C., & Melon, D. E. (2021). A field guide to U.S. healthcare reform: The evolution to value‐based healthcare. Laryngoscope Investigative Otolaryngology, 6(3), pp. 590–599.
Kates, J., Dawson, L., Horn, T. H., Killelea, A., McCann, N. C., Crowley, J. S., & Walensky, R. P. (2021). Insurance coverage and financing landscape for HIV treatment and prevention in the USA. The Lancet, 397(10279), pp. 1127–1138.
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. (2020). International Profiles of Health Care Systems. The Commonwealth Fund. Web.
Tzogiou, C., Boes, S., & Brunner, B. (2021). What explains the inequalities in health care utilization between immigrants and non-migrants in Switzerland? BMC Public Health, 21(1).