‘Swiss emigrants are gifting their money to Swiss health insurers’

© Keystone / Gaetan Bally

The Swiss Abroad should be able to take their Swiss health insurance abroad with them – that’s the aim of a proposal that will soon be put before parliament.

When Swiss citizens living abroad fall ill, they are often forced to return to Switzerland to get healthcare. A political initiative wants to put an end to this.

SWI swissinfo.ch previously reported on the proposal:

The man behind this 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: Josef Schnyder, you are the author of the demand that the Swiss Abroad be able to take out voluntary insurance with Swiss health insurers. How did you come about this?

Josef Schnyder: I live in Thailand. The number of Swiss Abroad has risen from about 9,000 to 10,000 in the last three years. Many of them are pensioners – I reckon about 6,000, including many early retirees. It is a trend. Life in Switzerland is expensive; Thailand is much cheaper [and] the climate is healthier. The problem is that if you emigrate to a non-EU/EFTA country at retirement age, you have paid health insurance premiums in Switzerland all of your life, but by law you have to give up this insurance.

Josef Schnyder is the delegate for Thailand on the Council of the Swiss Abroad. zvg

SWI: Is this not part of a free decision?

J.S: I am concerned with justice, and this is an injustice. It’s clear: when you’re young, you get sick less. But the Swiss system does not reflect this. There is no breakdown according to age. All age groups pay the same premiums.

SWI: This ensures that pensioners can still afford Swiss health insurance. 

Yes, it is a redistribution system. As a young person, you actually make advance payments to the Swiss health insurance funds towards old age.

SWI: What bothers you about that?

J.S: The Swiss health insurers’ calculation only works for people insured in Switzerland. It’s disgusting if you’ve paid into the insurance for 35 years and then have to give it up when you emigrate and you may already have heart problems or diabetes. It’s almost impossible to get private insurance, let alone at a fair price. If you emigrate, you give your money to the Swiss health insurance companies.

SWI: How does the problem manifest itself in Thailand?

J.S: There are many Swiss here who have no insurance or insufficient insurance. This is a fact, even though Thailand now only allows people to stay if they have health insurance. I estimate it is about one in four.

SWI: That would be over 1,000 people. Who steps in when they need care?

J.S: Then it becomes a challenge. We run an aid organisation in our Swiss Society. From time to time, we receive requests from compatriots who have to go to hospital and have no insurance. I also know that the Swiss embassy in Bangkok goes to great lengths to find relatives in Switzerland who can pay.

SWI: What do you think of the fact that many pensioners return to Switzerland for treatment?

J.S: That’s another matter: medical tourism happens everywhere, even among guest workers whose families join them. Among the 800,000 Swiss Abroad, there are also people who have never paid into the system, and they too could return at any time.

But yes, there is this typical case of the Swiss who emigrates at 60, stops paying in and then comes back to Switzerland at 80 for expensive cancer treatment. But he could just as well be treated in Thailand, if not better. It would therefore be wiser if these people could stay in the basic insurance system and be treated here, where it is much cheaper. That would also be in the interest of Swiss health insurers.

SWI: How much cheaper would this be?

J.S: That depends on the clinic. State clinics are very cheap. I once looked after a compatriot who needed a stent. In a private clinic it would have cost the equivalent of CHF10,000 [$11,448]. Because he had no money, we arranged treatment in a state clinic, where it cost CHF2,000. In Switzerland, health insurance companies pay between CHF12,000 and CHF15,000 for such an operation.

SWI: As a rule, however, Swiss citizens living abroad do not pay taxes in Switzerland. Yet tax money is an important pillar of the Swiss health system.

J.S: Yes, that should be taken into account. Depending on the canton, 30 to 50% of the health system is financed by taxes. If we want to create a fair system, we could reduce the benefits of the health insurance companies by this percentage.

Translated from the German