Health care lessons from the Swiss

The Unablogger

The Unablogger

Supporters of Obamacare keep changing the target, much like a street hustler’s shell game. First, they held out neighboring Canada as a model. But when horror stories of denied care and long waits in Canada surfaced, they claimed Obamacare would be more like England. And when horror stories from England surfaced, Democrat media claimed it would be more like Switzerland, a model probably chosen because information about its plan is pretty scarce over here.

Well, last month I had the opportunity to attend a gathering that featured two women from Switzerland, who were there to tell us what their everyday lives were like, and to answer our questions about life there. These women knew very little about U.S. politics and had no underlying political agenda to taint their observations. I took the opportunity to ask them how they liked their health care and how their plan worked.

The initial response of both of them (and the end of the story as far as the main-stream media is concerned) was that they were very satisfied with their health care. They were unaware (either from their own experience or that of their acquaintances) of any significant waits for treatment, any refusal to provide desired treatment, or of any Swiss acquaintances going to another country to seek medical treatment.

One of the ladies offered (and the other agreed) that there were several important reasons that made their health care so good.

First and foremost, the ladies’  plan was so good because it was so well funded. It turns out that (a point not mentioned by Obamacare proponents) there isn’t so much a Swiss health care system as there are 23 separate systems, with each canton (analogous to our states) having its own health care system. The Swiss experience in other cantons, both noted, would be different. Though not wealthy themselves, the ladies live in the canton of Graubunden (also called Grisons), where chic alpine ski villages St. Moritz, Davos and Arosa are situated. The area is a mecca for wealthy people, including many bankers and doctors who work elsewhere in Switzerland or even in nearby foreign countries. Graubunden lures and retains lots of wealthy residents by consciously having lower tax rates than its neighbors. Low tax rates, she noted, applied to huge amounts of income produced lots of revenue (sounds a lot like Reaganomics) for funding deluxe health care for relatively few people (Graubunden’s total population is under 200,000).

Next, they explained, their health care is good because they have good doctors, because Graubunden’s health care system pays its doctors very well. This high pay, along with the canton’s low tax rates, beautiful scenery and desirable lifestyle, attract highly paid highly skilled medical professionals. Doctors from other countries (especially Germany) flock there. In contrast, Obamacare is to be funded in part by paying doctors less (in spite of a larger patient load). Medical schools are already experiencing drops in enrollment of students from the U.S.

The ladies also insisted that a key to successful health care plans in Switzerland was the compulsory purchase provision, which may be unconstitutional in the U.S.  Every Swiss resident is obligated to buy health insurance. People there don’t get to game the system by only buying it when they need it. This works in Switzerland because of an ingrained Swiss cultural trait not common in the U.S. The Swiss are compliant, conforming people. If the law says you do it, you do it. When another member of the audience asked what the penalty was for not buying the insurance, the Swiss women were perplexed. “What do you mean, ‘What if somebody doesn’t?’ Everybody does. It’s compulsory.” Uh, good luck with that in the U.S.

Finally (and somewhat related to compulsory purchase), Swiss health care systems are not strained by the demands of undocumented immigrants. While Switzerland does have immigrants (the ladies estimated as much as 20% of its population), those immigrants are documented and buy the insurance just like everyone else. Those who follow Swiss immigration procedures are welcome, but the Swiss have zero tolerance for undocumented immigrants. The ladies explained, when Swiss authorities find them, they “send them back.” U.S. politicians don’t have the backbone for such a policy, and many even encourage illegal immigration for political gain.

So, while universal health care in the wealthy Swiss canton of Graubunden is a genuine success story for government-run health care, it probably wouldn’t work nearly as well in a country with the economics, demographics, culture and size of the U.S.

One response to this post.

  1. Posted by bill conway on October 21, 2009 at 7:21 pm

    Great analysis and explanation–along with exposing the myths in Ombamacare. We can only hope our conservative politicians in DC don’t cave.


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