[ggrrhh_ta]

Social insurance is covered by AHV/SVA/IV (funded by salary deductions and cover congenital defects, invalidity, some rehabilitation therapies and other non profitable coverage) and of course healthcare is not fully privatized as you say: private insurances are private, offering highly regulated compulsory insurance and can offer less regulated additional insurance. Some hospitals/clinics/health and elderly centers (cantonal) are kept with public debt & public donations even if deficitary because private clinics would be unprofitable otherwise.

I don't know if you legitimately do not know that.

I did not talk about federal/cantonal to avoid writing a thesis in a comment. I never said it was centralized.

[bhupy]

You're conflating Switzerland's social pension with the Swiss health insurance system. Swiss pensions do not subsidize the cost of healthcare delivery, and are not used to cover health costs at the point of service (for real or alternative medicine). The payment of healthcare at the point of service is facilitated by a fully privatized industry of insurers.

Salary deductions pay for subsidies to lower income beneficiaries to purchase the same private health insurance (KV) as everyone else. This is more or less identical to the US's ACA, and in fact the ACA was modeled after the Swiss healthcare system.

The one big difference between the US's ACA and the Swiss healthcare system is that the ACA also included an employer mandate and stimulated a regime in which the majority of working-age adults receive their private health insurance from their employers as opposed to the individual market, which is not how the Swiss KV works.

[ggrrhh_ta]

I guess that you don't know that, for example, if you get operated of a congenital defect in Switzerland, the bill goes to the SVA instead of to your private insurance (and so on for specific cases)

I am not conflating anything, you have a superficial understanding that makes you think it is privatized. If you dig into the spending public & private and the actual details you would see that Switzerland is not privatized as people generally think.

[bhupy]

I'm referring to the majority of working age adults.

Even the US uses Medicare for certain congenital diseases as well (as well as end-stage renal disease).

The Swiss private KV system accounts for the vast majority of health expenditure, even more so than the US where half of health expenditure is nationalized in Medicare and Medicaid.

[ggrrhh_ta]

But another way in which Switzerland maintains its healthcare system with public money is through the -often deficitary- cantonal hospitals/clinics/health care centers (also helped at the municipal level)

[atdrummond]

As a heads up, ‘deficitary’ doesn’t mean ‘deficit running’ in English. It is closer to the word ‘deficient’ which I don’t think is your intended meaning. Thanks for the insightful comments.

[ggrrhh_ta]

Thanks for the comment! I was meaning the former (under debt).

The intention of my comments was to make clear that in that regard, Switzerland is not an efficient free market private insurance paradise. There are lots of nuances to it, and the private insurance system in fact brings in inefficiencies, namely, a very complex and costly cost itemization and enormous amounts of paperwork and stress for doctors, customers, employers, and the insurances (for example, if there is an accident in a public place involving a car, there are at least one or two days worth of people's times just filling in forms)

[bhupy]

I'm not sure that your argument makes the case you think it does. The majority of Swiss health expenditure is in the private sector (which differentiates it from many other healthcare systems). Subsidies and municipal market participants do not change that fact. In every industry in the world, the government may play a participatory role within a greater market. We see this in the US in the food industry as well (food stamps, food banks, etc) — but that still doesn't change that it is essentially privatized. If the US adopted, like-for-like, Switzerland's healthcare system, the US's public spending towards healthcare would decrease, not increase.

[atdrummond]

OK - sorry then! That makes total sense too; I was simply reading too much into the payments discussion happening. Thanks for being polite and for your contributions.

[refurb]

But that’s the same as the US. If you are born with a disability you can get social security insurance (SSI) payments that can also qualify for public (Medicaid) insurance.

https://www.cbpp.org/research/social-security/ssi-a-lifeline...