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The centerpiece of the case against Obamacare is the requirement that everyone buy some kind of health insurance or face stiff penalties – the so-called individual mandate. It is a way of moving toward universal coverage without a government-run or single-payer system. It might surprise Americans to learn that another advanced industrial country, one with a totally private health care system, made precisely the same choice nearly 20 years ago: Switzerland. The lessons from Switzerland and other countries can’t resolve the constitutional issues, but they suggest the inevitability of some version of Obamacare.Switzerland is not your typical European welfare-state society. It is extremely business-friendly and has always gone its own way, shunning the euro and charting its own course on health care. The country ranks higher than the U.S. on the Heritage Foundation’s Index of Economic Freedom.

Twenty years ago, Switzerland had a system very similar to America’s – private insurers, private providers – with very similar problems. People didn’t buy insurance but ended up in emergency rooms, insurers screened out people with pre-existing conditions, and costs were rising fast. The country came to the conclusion that to make health care work, everyone had to buy insurance. So the Swiss passed an individual mandate and reformed their system along lines very similar to Obamacare. The reform law passed by referendum, narrowly.The result two decades later: quality of care remains very high, everyone has access, and costs have moderated. Switzerland spends 11% of its GDP on health care, compared with 17% in the U.S. Its 8 million people have health care that is not tied to their employers, they can choose among many plans, and they can switch plans every year. Overall satisfaction with the system is high.

Under Britain’s National Health Service (NHS), the patient doesn’t pay a thing. … Compare that to the U.S., where an estimated 137,000 people died over seven years because they were uninsured. Of course, the Brits do pay for their health care in another way – with taxes. their sales tax is a whopping 20% and income taxes are as high as 50%.All of that money feeds a health care behemoth. The NHS is Europe’s largest employer, with well over 1 million people on the payroll. So you’d think it would be inefficient.T.R. Reid, a former overseas bureau chief with The Washington Post toured the world’s health care systems for his recent book, The Healing of America. Reid says:”That seems sensible, right? The private sector can do things more efficiently? It doesn’t work in health care. The least efficient payers in the world are the American private insurance companies. They have administrative costs of 20 to 30%. That’s a 30% tax on every dollar you spend on health care.Britain is totally socialized medicine [and its] administrative costs [are] 5%. Canada is private doctors and public payers – 6% administrative costs. So it turns out, for some reason in health care, governments are doing this more efficiently than our private sector.”