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Lessons From Switzerland

Regina E. Herzlinger, DBA; Ramin Parsa-Parsi, MD, MPH

JAMA. 2004;292:1213-1220.

Switzerland's consumer-driven health care system achieves universal insurance and high quality of care at significantly lower costs than the employer-based US system and without the constrained resources that can characterize government-controlled systems. Unlike other systems in which the choice and most of the funding for health insurance is provided by third parties, such as employers and governments, in the Swiss system, individuals are required to purchase their own health insurance. The positive results achieved by the Swiss system may be attributed to its consumer control, price transparency of the insurance plans, risk adjustment of insurers, and solidarity. However, the constraints the Swiss system places on hospitals and physicians and the paucity of provider quality information may unduly limit its impact. The Swiss health care system holds important lessons, including evidence about its feasibility and equity, for the United States, which is now embarking on its own consumer-driven health care system.

Author Affiliations: Nancy R. McPherson Professor of Business Administration, Harvard Business School (Dr Herzlinger), and Harvard Medical International, Boston, Mass (Dr Parsa-Parsi).

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