“History Now!”: The Health Insurance Paradox

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Health insurance companies are showing solidarity. Healthy people pay for the sick, young people pay for the old, and the state financially subsidizes the weaker. But health insurance companies are also examples of social injustice. Anyone who is insured usually still has to pay for a doctor’s visit – the keyword deductible. People with high incomes can afford competitive supplemental insurance and a private hospital room with a doctor’s visit. And employers in this country do not contribute to health insurance. How did this paradox arise?

In the beginning there was an ancient hospital here. Here they cared for the sick and cared for the needy – Christian charity thanks to church property. The first health insurance companies appeared in the Middle Ages: craftsmen paid regular contributions to their guild’s support fund so that their families were protected in the event of illness or death. For workers in the mining industry, there were so-called miners’ associations that operated in a similar way. Medieval solidarity in your own bubble.

With industrialization, factories came into being and accidents in factories became common. Relief funds supported only workers involved in accidents by paying daily allowances. This also applied to Federal Bern. Member of the National Council Ludwig Forrer and his scientific friend Hermann Kinkelin put it bluntly: accident insurance does not work without health insurance. In 1899, Parliament passed a social policy sensation: compulsory health and accident insurance, free choice of doctor, and employer participation. Disappointment ensued at the ballot box: voters rejected the law and chose personal responsibility over social responsibility. Employer participation became a thing of the past, and health insurance remained voluntary and unaffordable for many.

Business also lobbied, and with different interests. In the 1950s, the pharmaceutical industry wanted to change patent laws so it could benefit longer from its monopoly on expensive drugs. But health insurance companies sensed rising costs and threatened a referendum. The pharmaceutical lobby almost gave up until, at the last minute, it learned of the opposition of health insurance companies and pushed through a new patent law. The horse trade did not go unnoticed by the public: they insulted the health insurance companies as gravediggers of democracy – and the pharmaceutical companies were all right again.

The situation became turbulent starting in the 1970s: the federal budget was in poor shape due to the oil crisis. The government has cut the health insurance budget and health insurance companies have passed on the costs to the insured: premiums have exploded! At the same time, the federal government expanded health insurance, adding new benefits for elder care and nursing, and introduced lower premiums for the poor. After much delay, Switzerland has really stepped on the gas when it comes to the welfare state. Compulsory insurance for everyone finally came into being in 1996, almost a century after the first attempt.

In 1899 it was even more, with employers sharing the costs. Today no one talks about this anymore. However, a truly solidary health insurance company must offer more than just Pflästerlipolitik.

Why, in the most straightforward of all democracies, do not large majorities support income-linked surcharges that also place greater burdens on the rich, and do not advocate the abolition of the deductible? Are Mr. and Mrs. Schweitzer doing too well?

Source: Blick