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September 8, 2004

The Swiss Health System: Regulated Competition Without Managed Care

Author Affiliations

Author Affiliations: Department of Economics and Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ.

JAMA. 2004;292(10):1227-1231. doi:10.1001/jama.292.10.1227

Health services researchers around the globe have known for decades that the United States, with a comparatively young population, spends much more on health care than do other nations1,2 (Table 1). As US annual health spending continues to exceed that in comparable nations by ever wider margins, and as US health policymakers begin to run out of ideas for how to constrain that growth, interest in the performance of health systems abroad has increased in recent years. One need not import another country's political system or social ethic to learn from the techniques they use to seek cost-effective health care. Cost-effective health care delivers the maximum attainable benefit for a given sacrifice of resources or, alternatively viewed, minimizes the sacrifice in resources for a given level of benefits. While economic circumstance and a preferred social ethic may lead some nations to spend more on health care to achieve higher levels of benefits than others, in principle, all nations should strive for cost-effective health care at whatever level of health spending they have chosen.

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