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Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990–2014

Author

Listed:
  • A. Remund

    (University of Geneva
    University of Groningen)

  • S. Cullati

    (University of Geneva
    University of Geneva
    University of Geneva
    University of Geneva)

  • S. Sieber

    (University of Geneva
    University of Geneva)

  • C. Burton-Jeangros

    (University of Geneva
    University of Geneva
    University of Geneva)

  • M. Oris

    (University of Geneva
    University of Geneva)

Abstract

Objectives The ability to translate increases in life expectancy into additional years in good health is a crucial challenge for public health policies. We question the success of these policies in Switzerland, a forerunner of longevity, through the evolution of healthy life expectancy (HLE) across socioeconomic groups. Methods Education-specific HLE conditioning on surviving to age 30 was computed for 5-year periods from the Swiss National Cohort, a mortality follow-up of the entire resident population, and the Swiss Health Interview Survey, reporting self-rated health. We compare time trends and decompose them into health, mortality and education components. Results Between 1990 and 2015, comparable gains in LE (males: 5.02 years; females: 3.09 years) and HLE (males: 4.52 years; females: 3.09 years) were observed. People with compulsory education, however, experienced morbidity expansion, while those with middle and high education experienced morbidity compression. Conclusions Divergence of morbid years by educational levels may reflect unequal access to preventive care due to high out-of-pockets contributions in the healthcare system. This growing gap and the exhaustion of the educational dividend jeopardize future increases in HLE.

Suggested Citation

  • A. Remund & S. Cullati & S. Sieber & C. Burton-Jeangros & M. Oris, 2019. "Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990–2014," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(8), pages 1173-1181, November.
    • Handle: RePEc:spr:ijphth:v:64:y:2019:i:8:d:10.1007_s00038-019-01290-5
    DOI: 10.1007/s00038-019-01290-5
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    1. Nicolet, Anna & Perraudin, Clémence & Krucien, Nicolas & Wagner, Joël & Peytremann-Bridevaux, Isabelle & Marti, Joachim, 2023. "Preferences of older adults for healthcare models designed to improve care coordination: Evidence from Western Switzerland," Health Policy, Elsevier, vol. 132(C).
    2. Sonja Feer & Oliver Lipps & Julia Dratva & Isabel Baumann, 2022. "Health and labor force participation among older workers in Switzerland: a growth curve analysis," European Journal of Ageing, Springer, vol. 19(4), pages 1395-1406, December.

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