Eveeryone in the US has been looking for new models of health care systems for a long time. Journalists alternately cling to and tear apart systems in various countries while academics and analysts write whole tomes trying to draw lessons applicable to the USA. Just when it seemed we'd run out of countries (Britain, Canada and France are such old news, and Cuba's politically off-limits), Switzerland started getting more attention.

On Sept 30th the NY Times ran an article about the benefits of the Swiss health care system and how perhaps they could provide answers to the US (http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?_r=1&ref=health). Other news agencies have been and are running similar stories (Here's NPR's from July 08). The gist of the argument is that the Swiss are managing to insure the entire population using only private insurance companies. Competition is maintained, coverage is mandatory and everything runs more or less smoothly, or so it seems. The NY Times quotes Regina Herzlinger, Harvard Business School professor, as saying, “What I like about it is that it’s got universal coverage, it’s customer driven, and there are no intermediaries shopping on people’s behalf. And there’s no waiting lists or rationing.” Outcomes are quite good, with a high life expectancy (79/84 m/f - http://www.who.int/countries/che/en/) and overall satisfaction with the system is good, but how much of a utopia is it really? Some news articles touched on the ideas of high costs...both overall (While it's no USA, Switzerland's health care still costs 11% of GDP) and individually. Premiums are paid mostly by individuals and are regressive, though the government does step in to help the 35-40% of households paying more than 8% of their income to premiums. (NYTimes) Cost-sharing (copays etc) are also higher in Switzerland than other countries. But for all that, it might be worth it if the system works?

The thing is, it's not working. At least not perfectly. The Neue Zurcher Zeitung, one of Switzerland's main newspapers, ran this article today with the headline "Health Insurers have too little reserve; Premiums of 18 funds could increase in the summer." The article talks about how the private insurance companies are struggling and how at least 18 of them will most likely raise their (already very high) premiums within the next year or risk folding completely. It looks as though even this country, then, is not as much of a model as we'd hoped.