The Swiss healthcare Model: Worth looking into?

Regina Herzlinger is a Professor at Harvard that has written extensively on healthcare and recently on consumer driven healthcare (CDHC). This information is taken from her article “ Consumer driven health care: Lessons from Switzerland” in JAMA 292: 1213, 2004.” The country provides universal health care at a lower cost albeit with some drawbacks. CDHC is supposed to combine free demand and supply, transparency and include oversight from the government. In Switzerland consumers purchase insurance not the e government or employers. The money to buy the insurance may come from the government or employer but consumers know the full cost before buying the insurance themselves. Insurers provide information to consumers about the product including design and cost. Compulsory benefits include hospital acre and other benefits are optional which require additional payment such as private rooms or child care for sick parents. They also have high deductible plans like the U.S has. No plan offers complete coverage and out of pocket payments are common. Physician fees are negotiated between the physician association and the Swiss insurance association. No supplemental billing is allowed. Hospitals also have limited pricing freedom. If they run deficits they are guaranteed subsides from public funds within reason. Private hospitals charge higher rates which may be covered by supplementary policies or out of pocket payments by patients. Insurance companies are also rightly regulated and must accept all compulsory insurance applicants although they may reject supplemental applicants. Almost no information on pricing is available on physicians and hospitals although premium rate changes are publicized in the media. Individual municipalities do provide means testing based taxpayer supported low income compulsory insurance. The central government supervises insurer financial solvency and fees. High deductible plans have the largest market share and managed care a small market share. 
Comments: The consumer has significant control over their choice. There appears to be some bias against the very sick. There is universal coverage ultimately guaranteed by the government. Risk adjustment is centrally applied to insurers. The Swiss model does consume a larger fraction of the GDP than most countries but has 30% lower per capita cost compared to the U.S