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US takes a look at Swiss and Dutch health care systems

The Swiss and Dutch health care systems are suddenly all the rage. They have features similar to proposals by at least two presidential hopefuls, and next month the US' top health official will visit Switzerland and the Netherlands to kick the tires.

Health and Human Services Secretary Michael Leavitt will visit Switzerland next Wednesday and then fly to The Hague for two days. His schedule is filled with meetings with ministers and technocrats, hospital officials and insurance executives and patients and their advocates.

His visit arose, health department officials said, because policy experts here have promoted Swiss and Dutch changes as models.

In Switzerland and the Netherlands, all people have to obtain health insurance or pay a penalty. Employers are exempt from the mandates, and private insurers and hospitals provide care.

"We have been hearing a lot of people in the health policy community talk about how those two countries had been doing new things in health access, and the secretary wanted to get a closer look at what they're doing," a department official said.

The trip is not a sign, however, that the administration of US President George W. Bush is considering major health initiatives, officials said.

"We don't have anything cooking that we haven't announced," the department official said. "We would not endorse a system like the Netherlands or Switzerland's. But if there's something we could learn about their system, we should learn about it."

Other experts, however, are endorsing the two countries' health systems.

The proposals of Senator Hillary Rodham Clinton and John Edwards borrow heavily from changes in the two countries. Mitt Romney's changes when he was governor of Massachusetts were in part modeled on those in Switzerland.

The Healthy Americans Act, introduced by Senators Ron Wyden and Robert Bennett would largely adopt the Dutch reforms.

Wyden said Leavitt's trip was part of growing Republican support for proposals for universal health care through individual mandates and private providers.

"I think Mr. Leavitt's trip is a really positive development," Wyden said.

A spokeswoman for America's Health Insurance Plans, Susan Pisano, said she was struck by Leavitt's timing.

Today, Pisano's trade group will be the host of a luncheon at which Dutch and Swiss insurance executives will discuss the changes in Europe.

The event is meant to dispel the myth that every nation that provides universal health care does so through government-run systems.

"The only models we seem to focus on here are those in Canada and Great Britain, which both have government-run systems," Pisano said. "We thought it made sense to look at two countries that have universal coverage but rely on the private sector to get there."
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