Swiss healthcare system

What is the Swiss healthcare system?

The “healthcare system” means everything in Switzerland that serves to prevent, treat and care for illness and the consequences of accidents: the facilities, the people who work in them, the rules and the flows of money. It includes hospitals and clinics, doctors’ and dentists’ practices, pharmacies, care homes, home care organisations (Spitex), therapy practices, laboratories and rescue services. On the funding side are the health insurers, the other social insurance schemes, the Confederation, the cantons and the municipalities, and households themselves.

As an insured person, you mainly deal with one part of it: compulsory health insurance under the Federal Health Insurance Act (KVG), also called basic health insurance. Everyone resident in Switzerland must take it out. According to the Federal Statistical Office (FSO), it funded 39.5% of all costs in 2024. Alongside it there is voluntary supplementary insurance under the Insurance Contract Act (ICA), accident insurance under the Accident Insurance Act (UVG), invalidity insurance, military insurance and supplementary benefits.

The Swiss system is neither purely state-run nor purely private. The Confederation sets the framework, the cantons are responsible for provision, and basic health insurance is run by several competing health insurers. You choose your health insurer freely, but the list of benefits is the same with all of them. Your choice of insurer therefore mainly determines the premium and the service, not the scope of basic benefits.

How it works

The roles

• Confederation: It passes the laws on health and accident insurance, decides through the Federal Department of Home Affairs (FDHA) and the Federal Office of Public Health (FOPH) which services basic health insurance pays for, approves the premiums and supervises the health insurers.
• Cantons: They plan hospital care and keep the hospital list, authorise doctors, therapists and other service providers to bill basic health insurance, pay at least 55% of the remuneration for inpatient treatment and subsidise the premiums of people on modest incomes.
• Health insurers: They accept anyone into basic health insurance, collect the premiums, check the invoices and pay for the services.
• Service providers: Doctors, hospitals, pharmacies, nurses, therapists and other professionals treat you and bill according to tariffs agreed with the insurers or set by the state.
• Insured persons: You pay premiums, bear part of the costs through the deductible and the retention fee, and choose your health insurer, insurance model and deductible.

The flow of money

Outpatient treatment, for example at a doctor’s practice or in a hospital outpatient department, is currently paid for by the health insurer alone, in other words through your premiums. Inpatient treatment in hospital is shared between the health insurer and your canton of residence; the canton pays at least 55%. This difference in funding has consequences: if an operation moves from a hospital bed to a day clinic, the total cost falls, but premium payers bear a larger share. With uniform financing (EFAS), outpatient and inpatient services will be paid for according to the same allocation key from 01.01.2028, and long-term care will follow from 2032. According to federal figures, the cantons will then bear 26.9% and premiums 73.1% of net costs.

Costs in 2024 at a glance

What the money is spent on is shown by the breakdown by service provider: according to the FSO, in 2024 hospitals accounted for 36.2%, socio-medical institutions such as care homes for 16.3% and doctors’ practices for 15.8%. Retail, which includes pharmacies, came to 9.2% and dental practices to 4.1%.

Legal basis

• Art. 117 Federal Constitution: The Confederation legislates on health and accident insurance and may declare them compulsory.
• Art. 117a Federal Constitution: Within the scope of their powers, the Confederation and the cantons ensure sufficient, high-quality primary medical care that is accessible to all, and promote general practice.
• Art. 35 KVG: Lists who may provide services at the expense of basic health insurance, from doctors and pharmacists to hospitals and care homes to transport and rescue companies.
• Art. 39 KVG: Hospitals are only authorised if they meet the cantonal hospital planning and are on the hospital list.
• Art. 49a KVG: The canton and the insurer share the remuneration for inpatient services; the cantonal share is at least 55% (para. 2ter).
• Art. 65 KVG: The cantons subsidise the premiums of insured persons in modest financial circumstances, and those of children from low- and middle-income households by at least 80%.

The amendment to the KVG introducing uniform financing was accepted in the popular vote of 24.11.2024. The new provisions apply to outpatient and inpatient services from 01.01.2028; until then, Art. 49a KVG applies in its current version.

Example: Who pays the CHF 97 billion?

The FSO figures for 2024 show which pots fund the healthcare system (financing schemes, total CHF 97,210 million).

In the table, AHV stands for old-age and survivors’ insurance, IV for invalidity insurance, UV for accident insurance and MV for military insurance. The table explains why premiums can rise faster than total costs: if the share of services paid for by basic health insurance alone grows, for example because treatment shifts to the outpatient setting, more of it ends up with premium payers. You will find more on the cost side under healthcare costs.

What this means for you

The system is complex, but there are three points where you can make a difference yourself:

1. Choose your health insurer and model. The benefits of basic health insurance are the same with every insurer, the premiums are not. The premium calculator shows you the official FOPH premiums for 2026 of all health insurers for your municipality. You will find the key data on each insurer under health insurers.
2. Choose the right deductible. If you rarely have medical costs, a higher deductible saves you premium; if you need regular treatment, a low deductible is often the better choice.
3. Check whether you qualify for a premium subsidy. The cantons support individuals and families on modest incomes. Your canton of residence decides whether you are entitled.

You can switch health insurer for the end of the year. Your notice of cancellation must reach your current insurer by 30 November; all the steps are explained under switching health insurer.

Common mistakes

• Treating basic and supplementary insurance as the same thing. Basic health insurance is compulsory and identical with every insurer; supplementary insurance is a voluntary contract under the ICA with its own rules.
• Thinking the premium covers all healthcare costs. In 2024, premiums funded just under 40% of the costs; the cantons, households and other insurance schemes bear the rest.
• Believing an expensive insurer pays more. The benefits covered by basic health insurance are set by law and are the same for every insurer.
• Mixing up years. FSO cost statistics are published with a delay; the figures here relate to 2024, the premiums to 2026.

How we handle data and sources is explained under how we calculate.