Many Swiss people abroad have no or only insufficient health insurance. © Keystone / Gaetan Bally
The Swiss abroad should be able to take their Swiss health insurance abroad with them. That is what an initiative that is going to Parliament wants. We spoke to Josef Schnyder, the man behind the idea.
This content was published on August 11, 2023 – 11:00 am August 11, 2023 – 11:00 am
Balz Rigendinger
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If Swiss abroad fall ill, they often return to the Swiss healthcare system. Central National Councilor Elisabeth Schneider-Schneiter wants to stop that.
We reported about it here:
The initiator of the idea is Josef Schnyder. He is Vice President of the Swiss Society in Bangkok and a member of the Council of the Swiss Abroad.
SWI swissinfo.ch: Josef Schnyder, you are the initiator of the demand that Swiss abroad should be able to voluntarily insure themselves with Swiss health insurance companies. How did you get into it?
Josef Schnyder is the delegate for Thailand on the Council of the Swiss Abroad. zvg
Josef Schnyder: I live in Thailand. The number of Swiss abroad here has risen from around 9,000 to 10,000 in the last three years. Many are retirees, I assume 6000, including many early retirees. It’s trending.
Life in Switzerland is expensive, Thailand is much cheaper, the climate is healthier. The problem now is: Anyone who emigrates to a non-EU/EFTA country towards retirement age has paid health insurance premiums in Switzerland their whole life, but by law they have to withdraw from this insurance.
Isn’t that part of a free decision?
I want justice, and this is an injustice. It’s clear: when you’re young, you get sick less often. Disease comes with age. However, the Swiss system does not reflect this. There is no breakdown by age. All age groups pay the same premiums.
This ensures that pensioners can still afford Swiss health insurance.
Yes, it is a rearrangement system. As a young person, you actually make advance payments to the Swiss health insurance companies when you get old. For young people, Swiss health insurance is correspondingly more expensive than international private insurance. The latter calculate differently, they adjust the premiums to the age. It’s cheap for young people and expensive for those over 65.
But both insurance models work. What bothers you about it?
The calculation of the Swiss health insurance companies only applies to insured persons in Switzerland. It’s annoying when you’ve been paying in for 35 years and then have to leave when you emigrate, even if you already have heart problems or diabetes. It is then almost impossible to get a place with a private insurance company, especially not at a fair price. Those who emigrate donate their money to the Swiss health insurance companies.
How does the problem manifest itself in Thailand?
There are many Swiss people here who have no or only insufficient insurance. This is a fact, even if Thailand now only allows you to stay there if you have health insurance. I guess it’s about one in four.
That would be over 1000 compatriots. Who steps in when they need care?
Then it becomes a challenge. We maintain one in our Swiss Society Aid organizationExternal link. From time to time there are inquiries from compatriots who have to go to the hospital and have no insurance. I also know that the Swiss embassy has always had to go to great lengths to find relatives in Switzerland who can pay.
There are hospitals that only treat the insured, or for cash payments. But that can get expensive. I know a Thai woman who had to go into debt to get her Swiss husband treated.
How do you assess the fact that numerous pensioners are returning to Switzerland for treatment?
That’s another thing: medical tourism occurs everywhere, even among guest workers whose families are moving to Germany. Of the 800,000 Swiss abroad, there are also those who have never paid in, and they too could come back at any time.
But yes, there is, this typical case of the Swiss who emigrate at the age of 60, no longer pays in and then come back to Switzerland at the age of 80 for expensive cancer treatment. But he could be treated just as well in Thailand, if not better. It would therefore be wiser if these people could stay with basic insurance and be treated here, where it is much cheaper. That would also be in the interests of Swiss health insurance companies.
How much cheaper would this be?
That depends on the clinic. You don’t necessarily have to go to one of the expensive private clinics. State clinics are very cheap. I once looked after a fellow countryman who needed a stent. In a private clinic, that would have cost the equivalent of CHF 10,000. Because he didn’t have any money, we arranged treatment in a state clinic, where it cost 2,000 francs. In Switzerland, health insurance companies pay between 12,000 and 15,000 francs for such an operation.
Incidentally, this patient had no idea that government clinics were cheaper. Information is also necessary. If you are a foreigner, the ambulance will almost always take you to a private clinic. Apparently there are commissions, but not with state ones.
But would the Swiss also be treated in Thailand?
I am convinced of that, many are really at home here. And there are good doctors here.
However, Swiss abroad generally do not pay any taxes in Switzerland. Tax money is an important pillar for the Swiss healthcare system.
Yes, one would have to take that into account. Depending on the canton, 30 to 50 percent of the healthcare system is financed by taxes. If we want to create a fair system, the health insurance benefits for Swiss abroad would have to be reduced by this percentage.
How do you assess the chances of your claim in politics?
It will not be easy, the health insurance companies are very well networked in Parliament. There will be a lot of lobbying. It is of course good business for the health insurance companies if someone pays premiums up to the age of 65 and then leaves the insurance company. It’s not fair.
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