Alongside old age provision (AHV and pension funds), mandatory health insurance is one of the main areas of social security (F2). Healthcare is also a key part of public expenditures (F3).

At the beginning of the 20th century, those covered by health schemes were predominantly male workers (F12). Health schemes were able to gradually increase their membership over the course of the 20th century with the introduction of federal subsidies in 1914 as well as local and cantonal laws mandating the affiliation of an ever-growing fraction of the population (such as children and low-income workers, followed by the entire adult population). In 1960 – a generation prior to the introduction of mandatory health insurance (1994-1996) – 80 per cent of the population were already affiliated to a health fund.

More than 1,000 health funds of various sizes operated in Switzerland until well into the 1960s (F13). Despite this wide variety, the largest funds always played a decisive role in the expansion of insurance provision (F14). Of the 1,154 funds active in 1950, only a dozen boasted over 100,000 members. Altogether, their memberships accounted for almost a third of all people insured. This process of concentration further intensified in the 1960s due to a number of health fund mergers. In 2010, five health funds (from a total of 86) had more than 500,000 members. Half of all people insured were covered by these five funds.

Figures

F2 Expenditures of key social insurance programs as a percentage of gross domestic product, 1925-2010

F3 Social security expenditures as a percentage of public spending (Confederation, cantons and municipalities), 1913-2000

F12 Number of members of a health fund by sex and as a percentage of the population, 1914-1960

F13 Federally approved health funds, 1914-2010

F14 Memberships of various types of federally approved health funds, 1920-2010

(12/2015)