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To the Editor: Drs Herzlinger and Parsa-Parsi argue that the Swiss health care system is largely consumer-driven and that this explains its superior performance compared with the United States in terms of cost control and universal and equitable access.¹ The notion that the Swiss system could serve as a model for the United States will come as a surprise to many Swiss compatriots. We are in the midst of a vigorous debate on the future of our health care system, with stakeholders and politicians agreeing on only 1 point: the need to reform a system that seems financially unsustainable.

Costs are far from being under control: the monthly premium for the compulsory health insurance has increased by about 68% since its introduction in 1996.² This compares with 6% inflation over the same 9-year period. A third of the population fulfills criteria for public subsidies of compulsory insurance, and this proportion . . . [Full Text of this Article]

Erik von Elm, MD, MSc; Matthias Egger, MD, MSc, MFPHM
egger@ispm.unibe.ch
Department of Social and Preventive Medicine
University of Bern
Bern, Switzerland

Daniel Pewsner, MD
Medix General Practice Network
Bern, Switzerland

Brigitte Bisig, PhD
Department of Social and Preventive Medicine
University of Zürich
Zürich, Switzerland

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