Invariably, social security also means bureaucracy. Laws stipulating benefits have to be drafted, and their implementation organized and overseen. In Switzerland, this process not only involved state authorities, but also often private organisations too. This section will explore these administrative and legal-historical aspects. It describes how the most important classes of social insurance are organized and explains the development of major state stakeholders and private welfare institutions.
Many early social insurance organizations, including the charitable ones and societies working for the common good (gemeinnützige) belonged to what we now refer to as civil society. They were increasingly replaced, over the course of the 20thcentury, by public authorities and governmental institutions that administered social insurance programs. Initially, meaning in the first half of the 20thcentury, these were the Federal Social Insurance Office and SUVA; by the second half, they included the AHV, disability insurance, and other social insurance branches. Even today, private organizations perform tasks, which supplement welfare state services, such as caring for those with disabilities or chronic illnesses. The health insurance and pension funds have also exerted significant influence on the Swiss welfare state. Such organizations, which can be either commercial or non-profit, have successfully defended their role in a publicly regulated system of old-age care and health insurance.
Generally speaking, there has been a shift in responsibility in the provision of social security away from the municipalities and towards the cantonal and national levels. Poor relief and hospital care were originally organized at the local level; later, the cantons were given important decision-making powers over these domains. Social insurance systems have been coordinated at the national level since they were introduced, albeit in a partly decentralized manner and implemented by lower-level organizations.