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Towards More Choice in Social Protection?: Individual Choice of Insurer in Basic Mandatory Health Insurance in Switzerland

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  • Francesca Colombo

Abstract

There is a considerable interest in some OECD countries in understanding how greater choice in health markets can be combined with the equity and efficiency goals of health systems.This paper reviews the system of free choice of insurer in basic mandatory health insurance that was introduced in Switzerland with the 1994 Health Insurance Law (LAMal). The thrust of the reform was to increase solidarity in basic health insurance while enhancing choice among individuals and competition on quality-price ratios among insurers. The reform encompassed regulatory mechanisms to facilitate the switching mechanism and choice-led competition, such as measures to ensure cross-subsidisation across individuals of different risk and income, information disclosure requirements for insurers, and the mandatory participation to a risk equalisation mechanism for all insurers offering basic health insurance.The analysis presented in this paper suggests that some features of the individual choice ... Certains pays de l'OCDE manifestent un très grand intérêt à comprendre comment un plus grand choix sur les marchés de la santé peut aller de pair avec des objectifs d'efficacité et d'efficience des systèmes de santé.Ce rapport examine le système de libre choix du fournisseur de l'assurance-maladie de base obligatoire qui a été introduite en Suisse avec la loi sur l'assurance-maladie de 1994 (LAMal). Le but de la réforme était d'augmenter la solidarité de l'assurance-maladie de base tout en offrant un plus large choix à chaque individu ainsi qu'une concurrence au niveau qualité/prix parmi les assureurs. La réforme englobait des dispositifs régulatoires pour faciliter le mécanisme de changement ainsi que les mesures pour assurer un échange de subvention parmi les individus ayant des niveaux de risques et de revenus différents, des besoins en transparence d'informations pour les assureurs et la participation obligatoire dans un mécanisme d'égalité des risques pour tout assureur ...

Suggested Citation

  • Francesca Colombo, 2001. "Towards More Choice in Social Protection?: Individual Choice of Insurer in Basic Mandatory Health Insurance in Switzerland," OECD Labour Market and Social Policy Occasional Papers 53, OECD Publishing.
    • Handle: RePEc:oec:elsaaa:53-en
    DOI: 10.1787/664178220717
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    Citations

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    Cited by:

    1. Mathias Kifmann, 2006. "Risk selection and complementary health insurance: The Swiss approach," International Journal of Health Economics and Management, Springer, vol. 6(2), pages 151-170, June.
    2. Frank, Richard G. & Lamiraud, Karine, 2009. "Choice, price competition and complexity in markets for health insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 71(2), pages 550-562, August.
    3. Pearson, Mark & Martin, John P., 2005. "Should We Extend the Role of Private Social Expenditure?," IZA Discussion Papers 1544, Institute of Labor Economics (IZA).
    4. repec:hal:spmain:info:hdl:2441/3ihldo33ik9ee94procjtfki5f is not listed on IDEAS
    5. Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
    6. Brigitte Dormont & Pierre-Yves Geoffard & Karine Lamiraud, 2007. "The influence of supplementary health insurance on switching behaviour: evidence on Swiss data," PSE Working Papers halshs-00587785, HAL.
    7. Brigitte Dormont & Pierre-Yves Geoffard & Karine Lamiraud, 2007. "The influence of supplementary health insurance on switching behaviour: evidence on Swiss data," PSE Working Papers halshs-00587785, HAL.
    8. Brigitte Dormont & Pierre‐Yves Geoffard & Karine Lamiraud, 2009. "The influence of supplementary health insurance on switching behaviour: evidence from Swiss data," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1339-1356, November.
    9. Daniel Osberghaus & Astrid Dannenberg & Tim Mennel & Bodo Sturm, 2010. "The Role of the Government in Adaptation to Climate Change," Environment and Planning C, , vol. 28(5), pages 834-850, October.
    10. Jan Kerssens & Peter Groenewegen, 2005. "Consumer preferences in social health insurance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 8-15, March.
    11. Okma, Kieke G.H. & Crivelli, Luca, 2013. "Swiss and Dutch “consumer-driven health care”: Ideal model or reality?," Health Policy, Elsevier, vol. 109(2), pages 105-112.
    12. Stefan Greß & Ralf Kocher & Jürgen Wasem, 2004. "Wettbewerbsorientierte Reformen im Gesundheitssystem der Schweiz – Vorbild für regulierten Wettbewerb in der deutschen GKV?," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 5(1), pages 59-70, February.
    13. repec:spo:wpmain:info:hdl:2441/3ihldo33ik9ee94procjtfki5f is not listed on IDEAS
    14. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    15. Dalit Daily-Amir & Hansjörg Albrecher & Martin Bladt & Joël Wagner, 2019. "On Market Share Drivers in the Swiss Mandatory Health Insurance Sector," Risks, MDPI, vol. 7(4), pages 1-25, November.
    16. Greß, Stefan & Okma, Kieke G. H. & Wasem, Jürgen, 2002. "Private health insurance in social health insurance countries: Market outcomes and policy implications," Wirtschaftswissenschaftliche Diskussionspapiere 01/2002, University of Greifswald, Faculty of Law and Economics.
    17. Stefan Greß, 2002. "Freie Kassenwahl und Preiswettbewerb in der GKV: Effekte und Perspektiven," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 490-497.
    18. Dannenberg, Astrid & Mennel, Tim & Osberghaus, Daniel & Sturm, Bodo, 2009. "The economics of adaptation to climate change: the case of Germany," ZEW Discussion Papers 09-057, ZEW - Leibniz Centre for European Economic Research.
    19. repec:dau:papers:123456789/1623 is not listed on IDEAS

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