Intended for healthcare professionals


Swiss experience of managed care

BMJ 1997; 314 doi: (Published 07 June 1997) Cite this as: BMJ 1997;314:1695
  1. Thomas V Perneger, Medical epidemiologista,
  2. Jean-François Etter, Social scientista
  1. a Institute of Social and Preventive Medicine, University of Geneva, Centre Médical Universitaire, CH-1211 Geneva 4, Switzerland

    Editor—Chris Ham's editorial on managed care in Europe ignores the Swiss experience.1 Traditionally, Swiss citizens could see any doctor they wanted, paid the doctor on a fee for service basis, and were reimbursed by the health insurance company to which they belonged. In 1990, in an attempt to curb healthcare expenditure, the federal government authorised “health insurance contracts with limited choice of doctor” (which means health maintenance organisations minus the political marketing wrapping), and this option remained in the new Law on Health Insurance, adopted …

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