Karl Zbinden's hospital room overlooked the snowy banks of the Aare River on a bleak January afternoon. The gaunt, 53-year-old biologist was in bed with pancreatitis, a serious condition that emerged after a kidney transplant.
Like all Swiss citizens, Zbinden has health insurance. And, like all Swiss, he pays for it himself with no help from his employer.
An American in his situation might face tens of thousands of dollars in expenses. But under the Swiss health-care system, individuals pay about a third less on health care than the average American, in part because of government-enforced price controls.
President Bush is pushing for health care reforms based on individual choice. The Swiss system offers some of those choices, and some health economists say their system works better.
"I think we're going to get there soon, not eventually," said Regina Herzlinger, a Harvard Business School professor who's studied the Swiss system. "The major reason is, most people agree that employer support for health insurance is just not going to continue."
Every resident of Switzerland is required to buy health insurance. If they don't, they pay stiff monetary penalties. Companies have no role. Health-care plans are chosen at the kitchen table, not through employee benefit departments.
And the plans can be costly. A family of four in Switzerland pays an average of $680 a month in premiums. Government assistance helps pay premiums for those less well off.
Health-care prices are set each year after negotiations between insurance companies and medical providers. The fee schedule has to be approved by the Swiss canton (or state) governments -- an approach Uwe Reinhardt of Princeton University compares to the doomed health-reform plan drafted by the Clinton administration.
Drug costs also are subject to price ceilings, but they still seem fairly expensive, at least in the minds of Swiss consumers.
"Within Europe, we are almost the only country left with a strong drug company sector," said Swiss congressman Felix Gutzwiller, a medical doctor who also heads the University of Zurich Institute for Social and Preventive Medicine.
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