Should Britain adopt a Swiss-style health insurance system?

FWIW, my own view is that the NHS is cheap but cheerless. It don't think the stats show it materially reduces British life expectancy as a whole, but personally I would any day take the Swiss system (or actually that of just about any western European country) over the UK's.

Or perhaps there's someone who will argue the Swiss should look to the NHS as their model for healthcare reform?

The NHS seems to forget it is a SERVICE, people don't get sick by appointment Mon-Fri, 9-5, make the overpaid consultants work a full 7 day rota then people might not dread going into hospital at weekends where you stand a significantly higher chance of not coming out again. I Have been involved in both systems and believe me, there is no way I would let the NHS get their hands on me, not even dead. My wife says the same and she worked for them for nearly 40 years. The Swiss system whilst not perfect is light years ahead.

I think the UK income demographics would not support a Swiss-style model.

There's simply not enough people earning enough to pay for their healthcare through what is ultimately a more expensive system. The government would end up paying more to top up the cover of the low-earners than it currently spends, just to finance the profit of the health insurance companies. That's the last thing the British economy needs.

This sounds simplistic to me. The Netherlands doesn't have radically different income demographics to the UK, but I believe they have introduced a Swiss-style health insurance scheme.

Also aren't Swiss health insurance companies non-profit?

I've heard very mixed views from people who've used the Swiss health system too.

And a thread on here about how it's best to call a taxi instead of an ambulance for cost reasons, was a bit of an eye opener.

To me, the Swiss sytem seems to bend over backwards to try and pretend it's not a national service but in reality (what with compulsory insurance, and discounted premiums for many people) it's not much different.

Except you need to fill in forms, get pink slips, and wonder whether they'll treat you here or drive you three hours back to your own canton before sorting you out.

I prefer the British system. It's not perfect (mainly because they're doing the opposite of here - running a national service but pretending it's a private enterprise) but it still works OK.

Only for the base insurance.

Tom

I think you will find that in most modern countries there is a safety net, whereby people on low income/no income/scroungers would still get medical care if needed. A Swiss style system would stop a lot of the abuse of the NHS with people wasting ambulance time for non essential things. A colleague has just retired last month after 35 years with the ambulance service and the number of calls they have to attend where people have a headache or run out of aspirin is amazing. This is only the tip of the iceberg. The whole system needs a good overhaul or better still adopt the system that seems to work in quite a few countries, insurance backed. Just as a matter of interest my health insurance payments here are less than I was paying in the UK for private health insurance.

Calling taxi sounds sensible if you don't need full fandango of an ambulance.

And I and my family have in the past had huge problems (to the extent that local MP became involved) with NHS bureaucracy, refusing to treat us where we needed treatment because of a GP registration in different location.

As I've said, I think the NHS is cheap but cheerless. It gives you basic cover but no frills and no choice.

An eye-opener for me was talking to a German friend who was amazed we didn't get to choose our obstetrician on NHS during pregnancy (if only that were the only problem ... I could have told her lots worse).

Since my wife had an extremely difficult pregnancy, we ended up paying privately out of pocket (£12k) for the obstetrician we wanted.

If you prefer the NHS, would you advocate it to the Swiss?

Netherlands has higher gross average income and a significantly more equal distribution of incomes - the UK has a much larger number of very low income families.

The fact they've introduced a system doesn't mean it's an improvement.

Haha, no. Funnily enough, they're not doing it from the goodness of their hearts. As pointed out above the base insurance is non-profit, but look at how its cost has increased over time compared to average wage.

Ok, but still invalidates the argument that "The government would end up paying more to top up the cover of the low-earners than it currently spends, just to finance the profit of the health insurance companies."

I really don't believe Britain is so significantly different from the Netherlands that it prevents us from introducing a similar health-care reform. We can argue endlessly on this though.

The specific point re profits was that "The government would end up paying ... just to finance the profit of the health insurance companies."

If they're non-profit for the basic cover, this argument doesn't hold up.

If you want frills, cheer and choice, you can pay for them in the UK just like here, the US or the Netherlands.

If people want the NHS to be like a five-star hotel chain, they need to pay for it and vote for it.

Choosing the obstetrician you want in an extremely difficult pregnancy after losing previous babies is not 'like a five-star hotel chain'.

I would be happy with NHS as basic cover, IF I could pay for add-ons. But it doesn't work like that. Either you go the NHS way, or you pay for the whole treatment separately. Hence £12k to get obstetrician of our choice.

If you think NHS is superior, would you advocate to the Swiss?

The system in the UK is better. You need treatment and you get treatment without worrying about the cost. That is a far better system than in Switzerland we the treatment you get depends on what level of insurance you pay, what extras you have included etc.

The problem in the UK is not the system but delivery. The NHS is overrun with penpushers and people trying to make hospitals profitable rather than focusing on patient care.

From what I've seen of the hospitals in Zurich I don't think the system here has anything to offer.

Would you advocate it to the Swiss?

No because the NHS is badly broken due to spiralling costs and inefficiencies. The Swiss system works well in Switzerland because generally people here are better off.

However, for the fundamental ideology I think the NHS cannot be beaten.

However it should introduce a user pays system and reduce the number of freeloaders who simply think they are sick. It doesnt need to be as expensive as switzerland to work, Australia also has many people on low income and introduced a forced private system with a public system where you pay according to your salary so the higher your income the more you pay into the system (fair no but thats life!)

The NHS is broken and needs to be privatised in many areas and take away the culture of expecting you just deserve it because it exists.

Difficult cases make bad law. Don't think it's always easy to persuade your health insurance companies to give you the cover you think you're entitled to, or to pay up for care you've already had. You can spend months out of pocket, or not receive reimbursement at all.

It can be a fight to get the treatment you want on the NHS as they are under pressure to reduce costs. But if you think NHS bureaucracy is bad, try fighting a health insurance company's legal team.

I think the NHS works well in the UK where wages are low and there is pressure to keep costs low, and the Swiss system works well here where people can afford the extravagance of treatments which are not strictly necessary, not cost-effective, or not even evidence-based.

The NHS is broken, but you do not need to privatise it to fix it. You can have strong management in the public sector. Privatising it would just bring a new set of problems.