[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.

[ggrrhh_ta]

Fortunately, life-threatening, chronic, bankruptcy-inducing, rare-and-disabling conditions represent a relatively small portion of the total healthcare spending (removing the most widespread chronic conditions). Those are also the least profitable things to insure (require a constant and sustained spending to maintain the knowledge/capability and fund research even if underutilized) if we want to ensure that any human can get reasonable access to those treatments regardless of their wealth. For this reason, countries like Switzerland or Germany maintain a "healthy" public (with lots of adjectives) healthcare system alongside.

[bhupy]

This is where you might be out of your element, it seems. Life-threatening / chronic / bankruptcy-inducing conditions do not represent a "relatively small" — at least in the US, 90% of health expenditure is on chronic health conditions (https://www.cdc.gov/chronicdisease/about/costs/index.htm) — this includes heart disease, stroke, cancer, and diabetes. I work in the industry and this comports with what I see on the ground as well.

In Switzerland (and also the Netherlands), the vast majority of this is covered by private health insurance, not via any sort of public health insurance. That's what sets Switzerland and the Netherlands apart from other peer developed countries, and they have results to show for it.

Regarding rare conditions, we agree — even the US has a public healthcare system alongside which covers rare conditions (e.g. end stage renal disease). US's Medicare Advantage system of private individual health insurance for senior citizens (with Original Medicare as a public option) is also a proven model with results to show for it. The CBO expects that by 2032, 61% of health insurance expenditure for senior citizens will be by the private sector (https://www.kff.org/medicare/issue-brief/medicare-advantage-...).

[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.