If I convert my monthly health insurance premium to Euro for the purposes of discussion here, then take the associated income tax deduction into account to determine the amount lost out of monthly net pay due to the purchase, it is roughly €290 for my wife and I. That is not a large enough cost for me to do a lot of analysis on, my time is probably better spent trying to figure out how to reduce my cable TV & internet bill – which can spiral out of control if not monitored and periodically renegotiated, or reduce irrigation water consumption (currently $200/month). It all adds up in combination but health insurance cost is certainly not the focus of my existence.
I pay 240 CHF per month, with a 2500 CHF deductible per annum. It covers all GP / specialist Dr. Med / hospital costs (pre-existing condition not a factor), 80% of medical transport (ambulance) costs, 800 CHF of dental work per annum (not part of deductible), 700 CHF worth of glasses (not part of deductible) every two years, foreign assistance and medical repatriation flights and other random stuff like naturopathy or thalassotherapy.
NB this is open to anyone – not necessary to be tied to an employer scheme – and not income-dependent (unless you fall below a certain revenue treshold at which point subsidies kick in).
My maximum contribution (assuming I need healthcare services) is CHF 5’380 per annum.
As a yardstick, an appendicitis surgery + 3 days recovery was billed 4’400CHF.
Adding to Peter’s “insurance makes sense if”:
[…]
- it is legally mandatory.
I am in the same situation as @T28 regarding Swiss health laws. A basic health insurance is mandiatory in Switzerland, however, you can choose your insurer and how much deductible you want and you can add various additional coverages which I have. Costs of the basic premium is also highly dependent on where you live. My canton is one of the highest, so my premiums are higher too. However, I get real good conditions for my child, which is in the same insurance, which compensates some of it. It has to be said that premiums here vary massively, as there is a live market with insurers but they also depend heavily on age, where you live and so on.
My premium at close to 60 years of age in the region of Zurich is around CHF 800.- per month, which includes no deductible, 2500 CHF of dental work, all medical transport and full cost of hospital in 2 bed rooms and a bunch of other stuff such as legal costs in health matters and all sorts of complimentary medicine, reconvalescence treatment e.t.c. As a consequence, my daughter who has exactly the same coverage however pais 140 CHF per month and will stay on something like this until she is off age and has her own contract.
My mother used to have the same contract as I do now (and which I could not get anymore were I to change insurers) and it paid off big time when she had to spend the last years of her life in a care facility, which was almost completely covered.
It’s expensive I know fully, however, the service is excellent. I’ve never had to deal with a doctors bill at all, everything goes direct. I know people close to me on different contracts with cheaper insurers but they keep quibbling over every bill. @T28’s contract looks great value indeed.
People change insurances quite often here, unless they have ongoing medical treatments, where you may loose your additional coverages.
Peter wrote:
I recall, many years ago, a BUPA saleswoman rather dishonestly selling their scheme saying it is especially good for cancer (the word which everyone fears most), but then someone in there told me BUPA offers nothing which the NHS doesn’t do.
This isnt true.
There are numerous procedures and tests that are not available on the NHS, or very difficult to convince the consultant they are justified.
The other significant difference for some is the time sensitive elective nature of private health care with which the NHS make no attempt to compete.
Finally with private you get to chose who performs the procedure, you dont with the NHS.
I believe you are correct today but I am correctly reporting what I was told then.
Of course there are many benefits with “going private”, of which the most obvious (and useful) is the ~£200 private consultation (probably within a week) versus what can be 6 months on the NHS.
I still don’t think health insurance is worth paying, in any scenario where you can afford to self insure 
Sadly I think it was more true a few years ago than it is today.
In many areas, services such as dermatology are becoming effectively unavailable other than for life-saving treatment e.g. skin cancer.
Most emergency treatment is still done well on the NHS, and in my experience the private sector often declines to get involved anyway. I have not been impressed by it overall (lots of hidden extras; sometimes unnecessary or unconventional treatments that we would not dare to offer on the NHS) but sadly I could envisage being forced to go private for many important-but-not-urgent conditions.
Yes there is a gradual process to get away from the “everything is free” concept which stated in 1947 and fairly soon became obviously unaffordable for the taxpayer.
When my family came to England in 1969, already very few dentists were doing NHS work and today it is practically zero.
Whether one believes this is right or wrong depends on one’s political / redistributive views; my view is that it is a misallocation of taxpayer funds to be providing “cheap” services which practically everybody can afford to pay for, but which overall cost the service a lot of money because they are common. Not that dentistry is necessarily cheap these days, at some £800 for a gold inlay (less if you go to Romania, etc).
Nevertheless the bottom line is that the NHS has always been marketed as “free” and consequently most people absolutely demand everything for free, regardless of whether they could easily pay. For example somebody on say 80k who has a potentially life threatening cardiac condition and who will not pay £200 for a private visit to a cardiologist, so gets a 6 month wait.
I am sure that in countries where health insurance is the norm (compulsory or not) things are seen differently. It’s human nature… if you run a fly-in and charge say €50/person booking fee (a tiny amount, in the context) you get a much bigger turnout
One of our diabetes nurse specialists used to have a patient on her books who had been having insulin since before the NHS was founded. Heartbreakingly her parents had another child who also needed insulin, but could only afford medicine for one of them.
Back in the day, medicine was comparatively simple and comparatively limited in scope. I think there are straightforward treatments that are clearly beneficial that everyone should have access to free of charge. No child should be left with wonky bones simply through inability to pay. No child should be denied insulin if they need it. And so on. Arguably adults have had a chance to make their fortune and are often responsible for their own ill health to a greater or lesser degree. I can see an argument they should pay for their healthcare. However it would still rankle to turn away someone with something easily treatable.
Personally I believe that whatever should be free for poorer people, should generally be free for richer people. We have anomalies where you can find yourself worse off if you earn more. If you believe in redistribution, then it would be more honest to increase income tax in the higher earning brackets than to keep the headline rate low and claw back whatever cash you can through bureaucratic means-tested benefits.
kwlf wrote:
it would be more honest to increase income tax in the higher earning brackets than to keep the headline rate low and claw back whatever cash you can through bureaucratic means-tested benefits.
That sounds like a simple and great idea BUT as the Civil Service now accounts for a largish part of the work force it is never going to happen. How many civil servants would need to find other jobs?
Also means testing trivia would cost way more than the money saved. For example loads of people get statins on the NHS. These cost pennies. In fact the NHS must spend far more processing the prescriptions and distributing them to chemists from where people collect them; the UK is only just barely getting around to postal delivery of prescriptions, and that business is evidently lucrative for the companies that are springing up to do the postal despatch. The total cost of “trivia” must be billions.
