Top notch health care comes at a price.

Author:O'Dea, Clare
Position:Health
 
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The consumer-driven Swiss health system is admired for quality of care and the equitable access to service. But ever-increasing costs and a lack of efficiency in the system are now causing concern.

High standards in the Swiss system have been achieved through sustained high spending and universal private insurance coverage. But total health expenditure per capita in Switzerland is increasing steadily. In fact the Swiss spend more on health care, visit the doctor more often, enjoy unrestricted access to specialists, and spend longer in hospital than anywhere else in Europe, other than Germany.

According to WHO figures, combined public and private spending in 2002 was SFr 5,315 per person in Switzerland. The health system in the country now accounts for nearly eleven per cent of the Gross Domestic Product, a three per cent increase since 1985.

The problem of climbing health care costs is common to most developed countries where growing public expectations are fuelled by expensive new technologies. Although satisfaction with the Swiss health service is high, the focus is turning to efficiency and value for money.

Inflated by high salaries

Leading health economist and professor Peter Zweifel, of Zurich University, argues that there is over-supply in the Swiss system "There are too many hospitals, beds and doctors but politicians cannot close hospitals because the lobby is too strong. From the medical professionals' and administrators' point of view there is no reason to change."

Zweifel explains that supply is artificially high because the insurers cannot strike a deal with hospitals, which are also funded by cantonal governments. "Insurers cannot act as prudent purchasers of health care on behalf of their clientele and that is the weak link." Parliament is expected to discuss a new hospital funding scheme in 2006.

Rising health care costs reflect the way society is changing. A recent analysis conducted by the KOF Institute for Business Cycle Research in Zurich concluded that rising salaries in Switzerland's medical profession, an ageing population and an increase in working women were major factors in soaring health costs.

A moratorium has been placed on new general practices since 1992, although the KOF study found that a high number of doctors per capita in Switzerland had little influence on the rising costs.

Instead, co-author Jochen Hartwig explains, "care work, in particular, which was previously done within the family by women, without...

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