The Swiss Healthcare System

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Magdalene Barber
8 years ago
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1 The Swiss Healthcare System

2 The Swiss healthcare system The healthcare system is one of the most important sectors of our social and economic system. Compulsory health insurance (AOS/OKP) accounts for a third of the costs in the Swiss healthcare system. These costs have been progressing steadily for decades. Health in Switzerland Total costs in the Swiss healthcare system in CHF billion Annual costs per insured in CHF 5,140 7,993 Compulsory health insurance Total costs for the compulsory health insurance in CHF billion Annual costs per insured in CHF 1,723 3,139 Number of jobs Our healthcare system generates more than 500,000 jobs

Health in Switzerland 1996 2011 Total costs in the Swiss healthcare system in CHF billion 36.5 62.

3 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF 5

Spitex Other Laboratories Physiotherapy Medical

4 Hospitalisation costs under the compulsory health insurance Swiss hospitals account for 35% of expenses under the compulsory health insurance (AOS/OKP), i.e. CHF 35 for CHF 100 worth of premiums. Hospitalisation costs under the AOS/OKP Inpatient treatment costs in CHF billion Outpatient treatment costs in CHF billion Medical infrastructure Number of hospitals in Switzerland 297 including 5 university hospitals Number of operating blocks 946 Number of MRI scans 139 Operating costs CHF 21.3 billion, of which 14.8 billion in salary costs Number of employees 174,142 employees, including over 14,000 hospital doctors

2 Medical infrastructure Number of hospitals in Switzerland 297 including 5 university hospitals Number of operating blocks 946 Number of MRI scans 139

5 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 4.8 bn 2011: 9.8 bn

Other Laboratories Physiotherapy Medical equipment.

6 Doctors under the compulsory health insurance Doctors account for 26% of expenses under the compulsory health insurance (AOS/OKP), i.e. CHF 26 for CHF 100 worth of premiums. Costs of medical benefits (medical practices) Benefits in CHF billion Doctors in Switzerland Number of generalists 4,433 7,515 Number of specialists 8,278 23,334 Total number of doctors 12,711 30,849 Breakdown of doctors Number of doctors in the inpatient sector 14,095 Number of doctors in the outpatient sector 16,232 Others (cantonal doctors, etc.) 386

3 Doctors in Switzerland Number of generalists 4,433 7,515 Number of specialists 8,278 23,334 Total number of doctors 12,711 30,849

7 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 3.2 bn 2011: 7.3 bn

8 Medication under the compulsory health insurance Medication accounts for 18% of expenses under the compulsory health insurance (AOS/OKP), i.e. CHF 18 for CHF 100 worth of premiums. Cost of medication Total cost of medicines in CHF billion Medication use per insured and per year in CHF 694 Number of medicines available in the Swiss market (approved by Swissmedic) 7,948 Beneficiaries of medication expenditure covered by the AOS/OKP Manufacturers in CHF billion 3.4 Distributors in CHF billion 1.2 Swiss Confederation in CHF million (VAT) 110 Pharmacies Number of pharmacies in Switzerland 1,649 1,731

3 5 Medication use per insured and per year in CHF 694 Number of medicines available in the Swiss market (approved by Swissmedic) 7,948 Beneficiaries of

9 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 2.3 bn 2011: 5.0 bn

10 Costs for care homes and home care under the AOS/OKP Care homes (EMS) and home care (Spitex) account for 9% of expenses under the compulsory health insurance (AOS/OKP), i.e. CHF 9 for CHF 100 worth of premiums. Costs for EMS and Spitex 2011 Total expenses in CHF billion 2.4 Breakdown of expenses Care homes (EMS) in CHF billion 1.8 Home care (Spitex) in CHF billion 0.6 Infrastructure Number of establishments and institutions 2,400 + Number of patients 100,000 Number of jobs in the sector 130,000

Costs for EMS and Spitex 2011 Total expenses in CHF billion 2.4 Breakdown of expenses Care homes (EMS) in CHF billion 1.

11 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 2.4 bn

12 Other benefits under the compulsory health insurance Other outpatient benefits (e.g. physiotherapy, laboratory costs and medical devices) account for 7% of expenses under the compulsory health insurance (AOS/OKP), i.e. CHF 7 for CHF 100 worth of premiums. Costs of other benefits under the AOS/OKP Laboratory costs in CHF billion Physiotherapy in CHF billion Other in CHF billion Total cost of other benefits in CHF billion 1.1 2

insurance (AOS/OKP), i.e. CHF 7 for CHF 100 worth of premiums.

13 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 1.1 bn 2011: 2 bn

14 Compulsory health insurance (AOS/OKP) Health insurers administrative expenses (for the basic insurance) account for 5% of expenditure, i.e. CHF 5 for CHF 100 worth of premiums. Total health benefits within the AOS/OKP, in reference to all parties concerned, account for 95% of expenses, i.e. CHF 95 for CHF 100 worth of premiums. Premiums and benefits Premiums per insured in CHF 1,547 3,013 Gross benefits per insured in CHF 1,723 3,139 General expenditure Total administrative expenses of health insurers in CHF billion Share of administrative expenses under the AOS/OKP in % of premiums 9 5 Administrative expenses per year and per insured in CHF Reserves Average annual amount of reserves per insured in CHF Reserve ratio in the AOS/OKP in % Other data Number of health insurers Number of jobs with health insurers 10,875 10,325 Number of medical invoices processed per year in CHF million approx. 70 approx. 80 Invoice control: controlling medical invoices has seen expenses reduced by 10%, i.e. the equivalent of more than CHF 2 billion a year.

Premiums and benefits 1996 2011 Premiums per insured in CHF 1,547 3,013 Gross benefits per insured in CHF 1,723 3,139 General expenditure Total administrative expenses of health insurers in CHF

15 Breakdown of LAMal/KVG costs for CHF 100 worth of premiums Hospitals Doctors Medication EMS and Spitex Other Laboratories Physiotherapy Medical equipment... Insurers CHF 35 CHF 26 CHF 18 CHF 9 CHF 7 CHF : 1.5 bn 2011: 1.3 bn

16 Statistical sources: u FOPH - Federal Office of Public Health u santésuisse - Swiss health insurers u Curaviva - Swiss association of retirement homes and social institutions u FMH - Federation of Swiss doctors u Interpharma u H+ - Swiss Hospitals Groupe Mutuel Health Life Corporate Groupe Mutuel Rue des Cèdres 5 CH-1920 Martigny Insurance company members of the Groupe Mutuel, Association d assureurs: Avenir Assurance Maladie SA EasySana Assurance Maladie SA Mutuel Assurance Maladie SA Philos Assurance Maladie SA CM Ville de Neuchâtel Groupe Mutuel Assurances GMA SA Mutuel Assurances SA Groupe Mutuel Vie GMV SA Pension funds managed by Groupe Mutuel: Groupe Mutuel Prévoyance GMP Mutuelle Valaisanne de Prévoyance September 2013 edition

Groupe Mutuel, Association d assureurs: Avenir Assurance Maladie SA EasySana Assurance Maladie SA Mutuel Assurance Maladie SA Philos Assurance Maladie SA CM Ville de Neuchâtel Groupe

HEALTH INSURANCE. Basic insurance coverage

HEALTH INSURANCE. Basic insurance coverage HEALTH INSURANCE Basic insurance coverage Everyone living in Switzerland must have health and accident insurance. This basic insurance coverage is compulsory for everyone, regardless of their age, origin