Swiss Saturday: Medical Care

Lately, my family has had more than it’s fair share of events resulting in doctor’s visits. And I probably should have gone for stitches last week when I sliced my finger open, but I didn’t, and now it’s healing very weirdly. Good thing I’m not a hand model.

It always makes me laugh when people talk about European health care systems because every country is different. Switzerland doesn’t have socialized medicine–we buy our own policies. The law requires that you have health insurance and that the insurance meets certain standards, but beyond the minimum, you can pay for what you want. And insurance isn’t tied to your job, so if you change jobs, get fired, or want to start your own business, your health insurance isn’t affected. If you can’t afford insurance, the government will subsidize you.

It’s a nice system. We pay a bit more than strictly necessary, but the insurance company deals with us in English–written and spoken and, frankly, that’s worth some extra money. We pay about 1400 francs a month for a family of 4, so it’s not cheap but it is cheaper than what a lot of my friends in the us pay. (The dollar is generally equal to the franc.)

You are also (generally) responsible to pay your own bills and then submit directly to the insurance company for reimbursement. This cuts costs because doctor’s offices don’t need people to do battle with the insurance companies. Hospitals and pharmacies tend to bill the insurance companies directly but every doctor and dentist that I’ve seen bills me and then I submit.

My husband and I each have 2000 CHF deductibles so I don’t even bother to submit bills for us unless it’s going to hit that limit. (I do submit for dental cleanings and gym memberships as those don’t count against the deductible–and yes, we get up to 500 CHF for gym memberships. The kids have 0 deductibles so they get everything submitted.

It’s a good system and I like it but there are some super weird things about the Swiss medical system as well. For instance:

No paper gowns. Going to the gynecologist for the first time is freaky. “Just take off your pants,” the doctor says and then sits there while you do so. Uhhh, yikes. I haven’t had a full body scan at the dermatologist yet but my friends assure me that you stand there completely naked, from head to toe. Awkward for Americans. Europeans reading this are probably like, “how else would you do it?”

We don’t believe in pain medication. By we, I mean Swiss people, not me. You can buy Ibuprofen, Aspirin, and Acetaminophen at the pharmacy, but you have to ask for it. And, more often than not, the pharmacist will ask you why you want it. If your answer isn’t acceptable, they’ll hold back. My husband had surgery last year and didn’t get any of the “good” drugs. Just ibuprofen. When I’m in the states, I go to Target and buy a 500 count bottle. That way I don’t have to deal with judgy pharmacists.

We don’t believe in anti-depressants. I do. And my doctor does, thankfully. She’s actually from New Zealand. But, I’ve had friends who have had difficulty getting help. The doctors tend to say, “drink a cup of tea! go for a walk!” Because I’m open about my depression, people are willing to come to me and tell me this and then I send them to my doctor. They very much like nature here and I’m all for it, but sometimes you need medication.

We do believe in homeopathy. This drives me absolutely crazy. Rudolf Steiner, the founder of anthroposophy movement lived in Switzerland, just a couple of towns over. His movement has some weird ideas including their opposition to right angles, but the one that is dangerous is homeopathy. You have to be careful even in the pharmacy when you ask for something for a specific ailment that they don’t hand over some expensive water.

Well-child checks last an hour. In the US, there was always a checklist where the doctor would ask questions like, “can he take a toy from one hand and put it in the other?” and I always felt dumb because I never knew what to watch for. Here, the pediatrician hands the kid a toy and watches. Even with my 10-year-old at his last well child check, she made him jump around the room, kick a soccer ball, and throw things. She has him draw pictures and do simple puzzles to check his development. It’s so much better than asking mom, “How is his development?”

Emergency room fun. I had to take my daughter to the emergency room a few years ago, when she got hit by a tram. We handed over our insurance card and later received a bill for 300 francs. Not our part–that was the total. But, a few months ago my sister-in-law and nephew were visiting and her son got sick. Instacare won’t see you until you are 3, so to the emergency room, we went. Because she didn’t have a European insurance card, they required a 500 franc deposit to be seen. But, because that’s crazy and the toddler just had a fever, the nurse took his temperature in the waiting room, told her how to dose alternating acetaminophen and ibuprofen and sent her to the pharmacy across the street without charging anything.

Titles aren’t common. I’ll always ask to speak to Dr. Whatever, but they’ll introduce themselves as Herr (Mr) or Frau (Ms) and speak of each other like that as well: “I see you met with Mrs. Kindler.” It’s weird to me. I  kind of like the idea of doctors not being equal to me–I want them to be superhuman or something. Even the bills from the pediatrician say “Frau Doctor ” instead of just “Doctor.” Also, while they taught us in German class that the word for nurse is “Krankenschwester” (literally sickness sisters, so named because the original nurses were nuns), no one uses that and the name badges all say Pflegerin (someone who takes care of). I can pronounce Krankenschwester more easily, so I’m kind of bummed about that.