스위스의 의료보험 개혁동향과 과제 = Trends and Future Tasks of the Switzerland Health Insurance Reform

다국어 초록 (Multilingual Abstract)

With the introduction of the Federal Law on Health Insurance(LAMal) in 1996, the Swiss health system underwent significant structural changes. The LAMal has made some progress in terms of universal coverage and subsidies for low-income families. However, LAMal did not seem to succeed in the aim of introducing cost containment through competition between insurers. The main reason for this is that real competition is hindered by fragmented markets. In addition, Swiss experience demonstrates the tendency of insurers to compete based on risk selection rather than cost. On the other hand, the main reason for failure/delay in adopting reforms is direct democracy and federalist tradition. The political decision-making structure is crucial for enabling not only reform, but also the speed of change. Swiss citizen can intervene directly in the political decision process by referendum to approve or reject reform proposals. Historically, this has slowed down major change. In addition, Swiss federalist tradition has resulted in large regional variations. The Swiss health care system holds important lesson, including evidence about managed care, for Korea.

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