Swiss Reject Single-Payer

Published December 2, 2014

Voters in Switzerland rejected a referendum that would have replaced the nation’s current health care system with a state-run single-payer system similar to those of Canada and Great Britain.

Switzerland’s current health care system involves dozens of heavily regulated nonprofit insurers selling coverage directly to individuals, and all citizens are required to purchase a basic plan. Premiums are subsidized for low-income citizens.

“The people rightly reasoned that the pervasive cost burden of the health care system would not be properly addressed through further nationalization,” said the president of the Swiss Mises Institute, Patrik Vonlanthen-Keller, praising the late-September vote.

The vote also drew praise from U.S. observers. “This was an overwhelming vote that showed the Swiss people value competition and choice in their health care,” said Grace-Marie Turner of the Galen Institute, an Alexandria, Virginia think tank focused on health care policy. “It is a fantasy that a single-payer, government-run health system would be more efficient than private, competing plans.”

Averted Rationing, Price Controls

Under the plan proposed in the referendum, Switzerland’s 60 insurers would be replaced with a single state-run insurer collecting premiums and directly paying doctors, hospitals, and other providers. Instead of premiums being set by insurers, premiums would have been set by government and varied by income.


“The way that government-run health systems get prices down is through rationing and price controls”, said Grace-Marie Turner, rejecting the argument single-payer was needed to deal with rising health costs. “Now [the Swiss] can get on with the business of figuring out how to make their private system more cost-effective.”

Approximately 62 percent of Swiss voters opposed the referendum and favored keeping the current market-oriented system.

Darren Nelson ([email protected]) writes from Brisbane, Australia.