October 1, 2014

Tip to the Washington Post and other media: No, the Swiss health system is not the same as Obamacare

Jon Walker, Firedog Lake - Several reporters have compared the Swiss health care system to Obamacare after Switzerland’s recent vote to keep it, including the Washington Post: “Switzerland rejects single-payer, will keep its own version of Obamacare” and Vox: “Switzerland rejects single-payer in landslide, keeps its version of Obamacare.”

The similarities between the two systems are mostly superficial, both mandate people buy individual insurance. The differences, though, are huge. Obamacare is basically the Swiss system with all the important rules that make it work properly removed. Four of biggest elements Obamacare’s basic structure lack are:
  • All basic health insurance in Switzerland is provided on a nonprofit basis, while the Affordable Care Act exchanges are full of for-profit companies.
  • The premiums people are expected to pay for what is a good package is capped by the government to assure it is actually affordable for everyone. While the ACA provides subsidies for some low income people, it doesn’t provide this basic protection.
  • The maximum allowed deductible/out of pocket allowed in Switzerland is a fraction of what is permitted on the Affordable Care Act exchanges, so that it actually protects people from serious financial problems if they get sick
  • Most importantly, Switzerland uses an all-payer system to set a uniform price schedule. This helps control costs and reduce the administrative waste caused by hundreds of payers each negotiating individual prices with thousands of providers. It also stops the absurd practice of out-of-network providers extorting excessive payments from them.

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