Switzerland has been “rediscovered” as a source of inspiration for the American health care system – which is somewhat ironic, since, as former Swiss health minister Thomas Zeltner tells Tsung-Mei Cheng in an August 2010 Health Affairs interview, Switzerland’s model of “managed competition” among private health insurance plans is rooted in the work of longtime Health Affairs contributor Allan Enthoven.

As Health Affairs Editor-in-Chief Susan Dentzer notes in her introduction to the journal’s August issue, titled Lessons From Around The World, “it’s not sensible to reduce another country’s complicated health system to just one or two bullet points.” As the Zeltner interview makes clear, Dentzer says, the Swiss system has

been governed by laws and regulations that place the emphasis on “management” as much as on “competition.” Specifically, Zeltner points to his nation’s requirement that health plans and providers negotiate with each other over prices—with the Swiss government watching over the negotiators’ shoulders and determining prices if negotiations fail.


Zeltner retired in December of last year after 19 years as head of Switzerland’s federal Office of Public Health (for national duties) and as secretary of health (for international activities) for nineteen years. He oversaw the health care overhaul Switzerland undertook in 1996, which has much in common with reforms now underway in the United States. In his interview with Cheng, Zeltner explains how the Swiss private health insurance system works, the significant regulatory role that the government plays in Swiss health care, the strengths and weaknesses of the Swiss health system, and what lessons his experience with that system holds for the United States

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