ANITA'S INTERESTING HEALTH INSURANCE

Anita is 34 and works for the government in a clerical position.  Her husband is a mechanical engineer.  Her salary is approximately $24,000 a year and she has health insurance.  Last year she delivered her first child, a girl, and to witness her husband’s protective ways you would think the baby was literally
delivered by God himself from on high.  They are both beside themselves with joy over their first child.

Anita’s personal share of her private health insurance premium is 8% of her salary which comes to $160 per month. Her employer kicks in the remaining portion. Her deductible is zero -- $0.00. She has none.  The total amount deducted from her biweekly paycheck for social security and taxes is 11% or $220.  Stay with me!

In other words her gross paycheck is $1,000 per biweekly check, with her take-home pay being $780 every two weeks ($1,000 less $220).  

She chose, of course, the same obstetrician she’s been seeing for 5 years to deliver her baby at the hospital which is located 8 miles from where they live.  She made a total of 6 visits to her doctor, paid no Copay or anything at each visit.  But during her pregnancy last year when she entered her third trimester she was required to inform the office as to whether or not she would be taking leave from her job after she delivered her baby.  This is so her doctor could validate her medical condition (pregnancy) to her employer which in turn allows him/her to hire a replacement, depending on her option.  Her private health insurance policy, which is regulated by the government, allows her the option of
taking 2 months off work with full-pay and returning to work thereafter.  Or, she can opt to stay at home for 2 years to care for the baby and still receive 80% of her paycheck ($624 every two weeks).  Since this was her first child, Anita chose to stay at home.  Her postpartum “paycheck” is actually a benefit of her health insurance policy and her “paycheck” during this time is drawn from her insurance policy -- not her employer.

When Anita and her husband first told me about her insurance options, I listened in disbelief.  But I understood, because Anita, and her husband Jochen, live in Lucerne, Switzerland, and by way of marriage, she’s my sister-in-law.

What I find most interesting about her health insurance is the fact that she has the option to choose which private insurance company she wishes to purchase her insurance.  There is a free market in which wage earners can choose from among qualified insurance companies which in turn profitably operate within a  framework of regulations established by the government, a government which is obviously aware of the companies’ need to make a profit but with a view towards fairness and benefits to the Swiss taxpayer in mind.

Also, the societal benefit, apparently desired by the Swiss people themselves through their leaders, is to allow a mother to bond with her baby during the most important part of an infant’s development -- a benefit and luxury of which American women and families don’t have -- and probably never will.