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Medicine & Liberty
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CH-1800 Vevey - Switzerland
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The costs of mandatory health insurance

Swiss mandatory health insurance voted in 1994 created insurance cartels  endowed with wide rationing potential. As part of their tax or pensions money vanishes into bank bailouts and Madoffian neverlands, Swiss  also have to pay for the interference of sickness insurance lobbys with the provision of heath services.

Growing administrative constraints have gradually deprived Swiss physicians of the time they had for their patients. Regulators are now depriving them of the diagnostic tools needed to treat them adequately. Federal bans on new practices, rationing of public hospital beds, and now the latest drive to limit medical  laboratories by arbtrary and unilateral cuts on reimbursement of lab tests, leads to a degradation of  Swiss medical care without influencing costs.

IATROFON was the etymological (& the spiritual) forebear of Medlib's Voxmedici tribune. Shortly before his death Robert Jaggard MD, Secretary  general of IATROS (a now dormant physician organization) and editor of Iatrofon, anticipated what we witness  today in Switzerland and beyond. This is what he wrote in 1992 on political interference with health services:

Politicians commonly cry out for "universal health care" and "affordable and available health care", and then they turn right around and set up programs to limit and restrict the availability of care while at the same time driving up costs.

The Swiss believed that democratic institutions and a cautious approach to accounting, were strong enough to keep their health services as healthy as their banks. UBS, their banking star had enough friends in parliament to survive lapses in  prudence. Patients have no real friends other than their families or their doctors. They now have to contend with an overbearing health insurance cartel (SantéSuisse)  that emerged from socialist healthcare reforms voted in 1994, a great ally of federal policy makers but no friend  of doctors and their patients. Its powerful  interference has resulted in "restricting the availability of care while at the same time driving up costs... " (as Bob Jaggard would have said). The problem is that once a cartel is runs at fullpower, whether in Medellin or in Bern, there is no easy way to tame it... and health cartels are not disposed off with without pain!

Americans should think twice before spreading mandatory health insurance laws accross their land.



Alphonse Crespo MD

January 30, 2009