An overwhelming majority of 71.2% of voters have thrown out a left proposal for creating a single health insurance company in Switzerland (through the abolition of the current 87 private insurers), with premiums based on income and wealth.

71.2% said no to a de facto nationalization of the health sector and the single health insurance company. Turnout was close to 46 per cent, slightly above average. As expected, voters in the main German-speaking part of the country turned down the planned reform, which was supported by the centre-left but opposed by the centre-right as well as the business community, parliament and the government. Opposition in the French- and Italian-speaking regions was less pronounced. Two cantons, Jura and Neuchâtel, even came out in a slight favour of the proposal. On average health insurance premiums are higher in western and southern Switzerland than in German-speaking areas. Interior Minister Pascal Couchepin said a majority appeared to be opposed to "a revolution" in the health sector but wanted to continue the reforms under discussion in parliament. He called on all sides, notably health insurers and the cantonal authorities, to make renewed efforts to reduce spending and abuse, and aim for more cost efficiency.

There are currently 87 private insurers providing mandatory basic health care coverage for Swiss residents under a 1996 law. But health premiums have soared over the past decade. Opponents argued a single insurance system would lead to complacency and create a two-tier system, where only the wealthy could afford to take out additional private insurance coverage. They dismissed claims that the initiative could help reduce rising health expenditure.

For their part proponents said a single health insurer would boost the efficiency of the system and allow annual savings in administrative costs which was assumed nevertheless to be only marginal. The current funding system is unbalanced, since many clients on low incomes claim state subsidies to pay their premiums, according to the Social Democratic Party and the Greens. The proposal to merge the insurance companies and introduce premiums based on wealth and income was the latest in a series of attempts over the past ten years to rein in spending on health care. A similar proposal to change the funding system of the health insurance companies was rejected in 2003 by 73 per cent of voters. Switzerland has the most expensive health system in Europe, according to an international comparison. It spent 11.6 per cent on health in 2005, ahead of Germany and France but behind the United States.

A failure of the initiative committee was to renounce of details. The proposal was very vague and in the first place, nobody had an idea about how the proposal would be enacted into law (since the proposal was on constitutional level). Thus, claims by the proponents about cost reductions were not based on facts, but on vague forecasts of possible models.

Prevention against an ill single health insurance did work!

The Young Liberals Switzerland (jungfreisinnige schweiz) are delighted about the distinct NO on the ill single health insurance as proposed by the left. With an own campaign (http://www.jungfreisinnige.ch/einheitskasse) the jungfreisinnige contributed that more market-based solutions can now be discussed.

The Swiss citizenry did say NO to the ill single health insurance. It is a NO to less freedom of choice and NO to more bureaucracy. The people said once again clearly NO to income-based premiums and shot down another leftist try to enhance redistribution in all imaginable areas of our society.

The jungfreisinnige are not just happy about the outcome of the popular vote. We are also proud of our own contribution. With their own campaign "NO to the ill single health insurance", the jungfreisinnige have distributed material in nearly all Cantons in order to warn the public of the risks and side effects of the initiative. The public showed its inclination towards competition and market solution in the health sector and its refusal of a state-run monopoly. With this experience, the jungfreisinnige are optimistic about the upcoming general elections of October 21^st. At least, after the KOSA initiative last september, another left proposal has been shown as unqualified.

Swiss Politics is now challenged to solve the problems in the health sector with a liberal approach – e.g. through improving the risk compensation, the abolition of the contract-coercion, flexible performance assignments for hospitals, more self-responsibility for clients – in brief: the implementation of the jungfreisinnige position paper. Only with the necessary reforms done, future generations could count on a working system.