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Last week, the Medical Society of the District of Columbia (MSDC), convened healthcare leaders from across the country and around the globe, from California to Romania, for a healthcare forum of the United States healthcare system. The keynote speaker was Prof. Dr. Thomas Zeltner, founder and first chairman of the WHO Foundation and former secretary of health for Switzerland, and Dr. Eliot Sorel, past president of MSDC, moderated the forum. Access to quality healthcare for Americans has been a centuries-long quest, stemming back to the Medical Society's founding in 1817 by an Act of Congress. With a global pandemic underway and the United States healthcare model up for debate and facing a third Supreme Court challenge in November, the topic could not be more timely. The webinar recording and materials are available at bit.ly/SwissMed.

The Swiss health care system has regularly been mentioned as a potential model for the United States. Switzerland has accomplished access to care for all its citizens through a public and private integrated model that is not predicated on employment. According to Zeltner, the adoption of this model required careful collaboration between major healthcare stakeholders: citizens/patients, health service providers, health insurance companies, government regulators and employers. Another key facet of the model was its shift from employer-based insurance to mandatory individual insurance. In this way, the Swiss healthcare debate resembles the debate in the United States.    

Switzerland has reaped several benefits from its healthcare reform that have positively impacted the Swiss population:
  » high patient satisfaction: 87% of the Swiss general public rate healthcare as very or rather positive  
  » high life expectancy: 83.7 years, second highest life expectancy among countries in the Organisation for Economic Co-operation and Development.
  » proximity to primary care: 93% of the public live 30 minutes or less from a primary care physician
   » high physician satisfaction: 84% of Swiss physicians are satisfied with practicing medicine  

Nevertheless, Zeltner indicated that Switzerland's healthcare system still faces challenges. These include: high and rising health costs, social inequality, lack of transparency, limited progress with digitalization, and a shortage of qualified healthcare professionals. Switzerland is identifying innovative approaches to overcome these challenges. Again, Switzerland's challenges are similar to those in the United States.

Although Swiss healthcare is not cheap, it is growing at a slower rate than in the United States. According to the Commonwealth Fund, Swiss healthcare costs grow annually at 2.0%, whereas US costs grow annually at 2.5%. The cumulative impact is that by 2013 the United States healthcare costs were 17.1% of GDP, compared with 10.1% for Switzerland. At the current rate, Switzerland's health care costs will not reach US levels until 2060. Zeltner indicated that this puts the U.S. economy at a disadvantage compared with other countries.

Healthcare in the United States faces a unique challenge in that the Affordable Care Act is facing a third challenge before the United States Supreme Court. Arguments for California et. al. v. Texas, et. al., will begin in early November and Dr. Eliot Sorel is a co-signatory in an amicus brief filed in this case. The case questions the constitutionality of the individual mandate which could unravel the framework of the Affordable Care Act. A U.S Supreme Court decision to unravel the Affordable Care Act could deeply damage millions of Americans already suffering economic and health challenges of the pandemic. The Medical Society plans to host another healthcare forum in early November to explore the Supreme Court case and its potential impact.  The forum will include Eliot Sorel, MD, F of the George Washington University School of Medicine and Health Sciences and School of Public Health and Sara Rosenbaum, JD, of the George Washington University School of Public Health. Details will be forthcoming at www.msdc.org.