The Netherlands and Switzerland: Models for U.S. Health System Reform?

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<p>A new Commonwealth Fund report finds that policies in the Switzerland and Netherlands that achieve near-universal coverage and low administrative costs can help inform the U.S. health care reform debate. According to <a href="/publications/fund-reports/2009/jan/the-swiss-and-dutch-health-insurance-systems--universal-coverage-and-regulated-competitive-insurance
">The Swiss and Dutch Health Insurance Systems: Universal Coverage and Regulated Competitive Insurance Markets</a>, both countries have effectively covered all but 1 percent of their population--compared with 15 percent uninsured in the U.S.--by putting in place both an individual mandate to purchase health coverage and premium assistance for people with low incomes.<br><br>While the U.S. spent $6,700 per capita on health care in 2006, Switzerland spent $4,300 and the Netherlands just $2,800. Even while spending less, both countries ensure health coverage for most of their populations and also enjoy better health outcomes than the U.S. Administrative costs in the Netherlands and Switzerland, meanwhile, average about 5 percent of total health care costs, compared with 7 percent in the U.S.<br><br>The study, which was prepared by a team of researchers led by Robert E. Leu of the University of Bern, also notes that the Dutch and Swiss systems feature patient choice, broad access to care, and low rates of disparities in care. "These countries can serve as idea labs for health reform in the U.S., and we should seek to learn from their successes and failures, just as we learn from the experiences of states like Massachusetts," says Karen Davis, The Commonwealth Fund's president. "There are examples of universal, comprehensive, high-quality, efficient health care systems that can show us the path to high performance."</p>