"In the German health care system, decision-making powers are traditionally shared between national (federal) and state (Land) levels, with much power delegated to self-governing bodies. It provides universal coverage for a wide range of benefits. Since 2009, health insurance has been mandatory for all citizens and permanent residents, through either statutory or private health insurance. A total of 70 million people or 85% of the population are covered by statutory health insurance in one of 132 sickness funds in early 2014. Another 11% are covered by substitutive private health insurance. Characteristics of the system are free choice of providers and…
Health Insurance Coverage In Germany
"Since 2009, health insurance has been mandatory for all citizens and permanent residents, either through SHI [Statutory Health Insurance] or private health insurance (PHI). SHI covers 85% of the population – either mandatorily or voluntarily. Cover through PHI is mandatory for certain professional groups (e.g. civil servants), while for others it can be an alternative to SHI under certain conditions (e.g. the self-employed and employees above a certain income threshold). In 2012, the percentage of the population having cover through such PHI was 11%. PHI can also provide complementary cover for people with SHI, such as for dental care. Additionally,…
The Swiss Federal Health Insurance Law of 1994
"In 1991, the Federal Council proposed a new Federal Health Insurance Law (KVG/LAMal) with three main aims (Federal Council, 1991): (1) to strengthen solidarity by introducing universal coverage and ensuring that people with low incomes receive subsidies for purchasing insurance; (2) to contain the growing costs of the health system by a host of measures targeting both the demand and the supply side; and (3) to expand the benefits basket and ensure high standards of health service provision. By Swiss standards, this law completed the legislative process relatively quickly: it was passed by Parliament in March 1994 and accepted in…
Patient Rights in Swiss Law
"Individual patient rights are enshrined in a range of cantonal laws and federal legislation, and they are included in private law, public law and penal law. This fragmented regulation contributes to considerable intransparency of patient rights and is perceived to be a barrier to increasing the mobility of patients, as it has resulted in legal uncertainty concerning the applicable law (cantonal state liability law versus federal private law) (FOPH, 2015g)."Enshrined in a variety of cantonal and federal laws, patients have the right to:"• choose their physician and hospital freely (although restrictions may apply depending on the insurance plan); "• receive…
Financing of the Swiss Health System
"The MHI [Mandatory Health Insurance] system as outlined by KVG/LAMal is – at least to a certain extent – based on the concept of regulated competition (Enthoven, 1988). MHI companies compete in a highly regulated market by offering different MHI policies for a standard benefits package (section 3.3.1), which all residents have to purchase. MHI companies are not allowed to turn down applications from persons who want to purchase insurance and they may not make profits (nor losses) from providing MHI. Excess earnings have to be reinvested in the company and must benefit the insured."Resources are raised not only through…
Health Care System Expenditures in Switzerland
"Public expenditure on health consists of three parts (Figs. 3.5 and 3.6):"• MHI [Mandatory Health Insurance], which was the largest purchaser in the health system in 2012, spending 35.8% of THE [Total Health Expenditure] (right-hand side of Fig. 3.5). Revenues of MHI companies (left-hand side of Fig. 3.5) come from premiums paid by MHI policy-holders (30.0% of THE) and/or subsidies for premiums (5.8% of THE) paid out of budgets of the Confederation and cantons."• Other social insurance (SI), which accounted for 10.7% of THE. The SI consists of the health-related parts of the accident insurance (UV/AA), the old-age insurance (AHV/AVS),…
