What is this LAMal, the mandatory health insurance?

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Let’s open this topic with a small historical introduction… 

If you were in Switzerland and that time, you can probably remember these never-ending controversies about basic healthcare. Should the system remain as it is or should we opt for a single fund model? 

In this political brouhaha where lobbies were just fighting each other, we end up not even understanding what LAMal really is. Let’s have a closer look at all of this. 

What is the point of the LAMal?

The LAMal, basic insurance or mandatory healthcare insurance, is, just like its three names indicate, a mandatory insurance that aims to give access to care to the entire population, in case of an illness, an accident or a pregnancy. 

Entered into force on the very first day of 1996 (the same year the Macarena came out, to give you a historical fun-fact), it is the successor of the LAMA of 1912. Long time ago! 

Because the basic insurance is governed by a federal law, its service catalogue is the same for every service provider.  

However, when taking out a mandatory insurance, we do so with a private insurance, which can appear to be quite contradictory. 

Thereby, you get to choose freely your healthcare provider. The premium amount fluctuates depending on the age, the deductible and the insurance you choose. It can greatly vary, as you can see in this other article

This tension between public and private is the root of all criticism towards the healthcare insurance system. Consumer organisations are asking for more transparency when it comes to costs. 

In 2014, Swiss citizens rejected at 61.9% the popular initiative in favour of a public fund for the healthcare insurance. 

After reading this, you probably are starting to familiarise yourself with this healthcare insurance but so many questions remain unanswered: What does the mandatory healthcare cover?, How does the LAMal reimbursement system work?and What are the gaps of this healthcare insurance?

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