Is the swiss health care system a model for the United States?

Int J Health Serv. 2014;44(2):255-67. doi: 10.2190/HS.44.2.d.


Both supporters and critics of the Patient Protection and Affordable Care Act (ACA) have argued that it is similar to Switzerland's Federal Law on Health Insurance (LAMal), which currently governs Swiss health care, and have either praised or condemned the ACA on the basis of this alleged similarity. I challenge these observers on the grounds that they overlook critical problems with the Swiss model, such as its inequities in access, and critical differences between it and the ACA, such as the roots in, and continuing commitment to, social insurance of the Swiss model. Indeed, the daunting challenge of attempting to impose the tightly regulated model of operation of the Swiss model on mega-corporations like UnitedHealth, WellPoint, or Aetna is likely to trigger no less ferocious resistance than a fully public, single-payer system would. I also conclude that the ACA might unravel in ways unintended or even opposed by its designers and supporters, as employers, confronted with ever-rising costs, retreat from sponsoring insurance, and workers react in outrage as they confront the unaffordable underinsurance mandated by the ACA. A new political and ideological landscape may then ensue that finally ushers in a truly national health program.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Consumer Behavior
  • Cross-Cultural Comparison
  • Female
  • Health Benefit Plans, Employee / economics
  • Health Benefit Plans, Employee / legislation & jurisprudence
  • Health Benefit Plans, Employee / organization & administration
  • Health Care Costs / legislation & jurisprudence
  • Humans
  • Male
  • Middle Aged
  • Models, Organizational*
  • National Health Programs / economics
  • National Health Programs / legislation & jurisprudence*
  • National Health Programs / organization & administration*
  • Patient Protection and Affordable Care Act / economics
  • Patient Protection and Affordable Care Act / legislation & jurisprudence*
  • Patient Protection and Affordable Care Act / organization & administration*
  • Politics
  • Practice Management, Medical / economics
  • Practice Management, Medical / legislation & jurisprudence
  • Practice Management, Medical / organization & administration
  • Professional Corporations / economics
  • Professional Corporations / legislation & jurisprudence
  • Professional Corporations / organization & administration
  • Single-Payer System / economics
  • Single-Payer System / legislation & jurisprudence
  • Single-Payer System / organization & administration
  • Social Welfare / economics
  • Social Welfare / legislation & jurisprudence
  • Switzerland
  • United States