Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: Drs Herzlinger and Parsa-Parsi
attempt to account for apparently better health care in Switzerland than in
the United States despite approximately one third less expenditure per capita.1 They seek an explanation in the function of the insurance
system. Examination of their data, however, raises a question of the actual
cost of individual services provided. The Swiss have a higher rate of inpatient
admissions with a substantially longer length of inpatient stay. They also
have more practicing physicians and more pieces of expensive equipment per
population unit. Although utilization rates for that equipment are not specified
and the use of pharmaceuticals and their costs are not addressed, the only
thing that appears to be less utilized in Switzerland than in the United States
is physician visits. Given the higher number of inpatient days per population
unit, a substantial part of the savings may be from a lower relative cost
of providing individual elements of care, especially inpatient care, rather
than from a more efficient delivery system.
Tuckfelt M. Holes in the Swiss Health Care System. JAMA. 2005;293(19):2337–2341. doi:https://doi.org/10.1001/jama.293.19.2339-b
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