Swiss Review 5/2021

Swiss Review / October 2021 / No.5 8 Focus The public pays a lot Healthcare services are expensive in Switzerland and are paid for mainly by the people who use them. In 2018, the bill was 798 francs per capita per month. Private households bore 63 per cent of the costs, with compulsory health insurance premiums covering just under half of the costs. The government covered around 30 per cent, according to the Federal Statistical Office. Health expenditure as a share of GDP has risen significantly in recent decades, accounting for 11.2 per cent in 2018 – one of the highest proportions in Europe. The USA easily topped the list on 16.9 per cent, followed by Germany (11.5 per cent) and France (11.3 per cent). Spain recorded 9.0 per cent and Ireland 6.9 per cent. The fact that costs are increasing is a source of concern for many in Switzerland – healthcare and health insurance consistently rank high on the annual Credit Suisse Worry Barometer. For the record: the highest costs in Switzerland are related to hospital stays, the lowest to preventive medicine. (ERU) and help with personal hygiene. Doctors will make diagnoses, pro- vide treatment and prescribe therapies. Physiotherapists or occupa- tional therapists will do the rest. “We have a lack of uniform struc- tures and processes in outpatient care,” says Ursula Meidert of the Zurich University of Applied Sciences (ZHAW). There is often insuffi- cient consultation. This can lead to duplication of effort or gaps in care as well as the wrong care. Quality varies considerably Like many other aspects of Swiss life, the healthcare sector has a fed- eral structure. Federal government makes the guidelines, which the cantons then implement. The cantons delegate certain tasks to the municipalities, who in turn are partially responsible for long-term care as well as outpatient care for the elderly. Hence the availability of medical and social services varies considerably fromplace to place, as does the effectiveness with which these services work together. “Pflege macht krank” (healthcare is bad for you): on 12 May 2021, healthcare profession- als marched in protest through the streets of Basel with placards bearing slogans to ex- press their displeasure. Such protests had al- ready been happening on a regular basis before the COVID-19 pandemic. Photo: Keystone