Commonwealth Fund cites European models for U.S. healthcare reform

A new Commonwealth Fund report finds that policies in Switzerland and the Netherlands that achieve near-universal healthcare coverage and low administrative costs can help inform the U.S. healthcare reform debate.

According to The Swiss and Dutch Health Insurance Systems: Universal Coverage and Regulated Competitive Insurance Markets, both countries have effectively covered all but 1 percent of their population - compared with 15 percent uninsured in the United States- by putting in place both an individual mandate to purchase health coverage and premium assistance for people with low incomes.

While the United States spent $6,700 per capita on healthcare in 2006, Switzerland spent $4,300 and the Netherlands just $2,800. Even while spending less, both countries ensure health coverage for most of their populations and also enjoy better health outcomes than the United States.

Administrative costs in the Netherlands and Switzerland average about 5 percent of total healthcare costs, compared with 7 percent in the United States.

The study, which was prepared by a team of researchers led by Robert E. Leu of the University of Bern in Switzerland, also notes that the Dutch and Swiss systems feature patient choice, broad access to care and low rates of disparities in care.

"These countries can serve as idea labs for health reform in the U.S. , and we should seek to learn from their successes and failures, just as we learn from the experiences of states like Massachusetts," said Karen Davis, the Commonwealth Fund's president. "There are examples of universal, comprehensive, high-quality, efficient healthcare systems that can show us the path to high performance."