“Swiss Abroad should not be treated as second-class citizens.” mentary benefits. They leave Switzerland again as soon as their medical procedure is over. Does no one know how many such cases there are? No, because no one keeps track of them. What you can do is compare things like the price of medicine. Drugs cost significantly more or less depending on which country you are in. This is precisely the type of data that we need. It would be an important basis for any political debate. All the letters I receive relate to individual cases. I want to bring these cases into context and fundamentally improve the current system. The Federal Council has always stressed that a person’s place of residence dictates eligibility for health insurance. The government should acknowledge that a different situation applies to Swiss Abroad. Other countries do. For example, the Caisse des Français de l’Étranger offers French expats the opportunity to take out voluntary cover while maintaining continuous rights to French social security. There is currently a lack of appreciation here in Switzerland of what is at stake. Not enough people know that access to public healthcare in countries like Thailand, Costa Rica, Brazil, or the Philippines is not automatically guaranteed. Critics frame emigration as a voluntary choice against Swiss insurance. What is your view? This is a flawed argument. If you have a Swiss passport, you can return to Switzerland for an expensive procedure at any time. People who are seriously ill choose to exercise this right. It is a strain on our system. Has sentiment towards the Swiss Abroad deteriorated overall? Yes, it has. I have been working on the CSA for the last 15 years and have noticed that the mood has turned. “If you move abroad, it’s your own fault if your benefits are no longer covered” is a phrase I hear increasingly. This worries me. Broadly speaking, a “now it’s my turn” attitude has become more prevalent. People forget that the 838,600 or so Swiss Abroad also have rights. Expats should not be treated as second-class citizens. Elderly people are leaving Switzerland because they can no longer afford to live there. They deserve a fair deal. How likely do you think it is that your motion will succeed? There are politicians in every party who are sensitive to the interests of the “Fifth Switzerland” – so I am confident. But it could still take months before they start debating the motion. What matters, I think, is that the issue remains on the political agenda. If your motion were to fail, would the issue be off the table for you? I will stay politically engaged and continue to talk to private health insurers. The authorities should provide more information, as I said before. Many expats underestimate how Losing basic health cover If you live in Switzerland, you must have health insurance in Switzerland – regardless of nationality or residence status. Anyone who moves abroad – except government employees or individuals posted abroad by their employer – loses this mandatory insurance cover. Bilateral agreements mean that expats can often get equivalent healthcare coverage in EU and EFTA countries. The situation is trickier in non-EU/EFTA countries like Brazil or Thailand, where Swiss Abroad barely have any access to public healthcare. These expats have no other option but to take out private health insurance. Younger people without previous medical issues usually have no problem doing so. But insurers are wary if someone has already reached a certain age or has existing issues. They have little interest in taking on a new customer who could generate substantial healthcare costs. They will, in such cases, exclude certain benefits or reject an application outright. Generally, they will also adjust their premiums based on individual risk and have the right to terminate insurance policies at any time. “Older Swiss Abroad, in particular, can be left in a desperate situation,” says the Centre Party National Councillor Elisabeth Schneider-Schneiter. Despite paying into a mandatory basic health insurance scheme for decades, many of them will no longer have adequate cover after leaving Switzerland. In the worst case, they can be refused medical treatment. “This goes against any notion of fairness.” Around 838,600 Swiss were living abroad at the end of 2025, of whom 357,063 were residents in countries outside the EU/EFTA area. (ERU) difficult and expensive it can be to get health insurance. Consulates and the Organisation of the Swiss Abroad also need to give advice. A CSA working group has been looking at the issue for a long time. What is it currently doing? We are thinking of commissioning our own study and are speaking to a number of universities. But ideally, it should be the government’s job to get the facts right. Swiss Review / October 2026 / No. 4 29
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