As Swiss interior minister in charge of health, Dreifuss oversaw the health insurance law reform which entered into force in 1996. Earlier this month she participated in a debate on US health reform at Harvard Business School.

swissinfo.ch: What is your reaction to Sunday’s vote?

Ruth Dreifuss: It’s a historic vote, like the Swiss one concerning the health insurance law reform. It represents a decisive step in a battle that has gone on for decades since the first initiatives by US presidents Franklin Roosevelt and then Harry Truman.

The bill is very complex and the result of all kinds of deals. And coverage is not universal, so some people will still be ruined by healthcare costs or be unable to afford them. But it’s a huge step forward and any law can be improved…any law has to be improved when its implementation has negative side effects.

swissinfo.ch: What parallels can you draw between this vote and the Swiss reforms?

R.D.: There are numerous [parallels]. We have a similar mentality to the Americans concerning our fear of excessive state intervention and a high regard for individual responsibility and freedom.

Like the Americans, the Swiss took a long time to find ways of surmounting the scandalous situation in which people lived without medical healthcare.

Ruth Dreifuss (Keystone)

swissinfo.ch: Republican and industry critics said the $940 billion bill was a heavy-handed intrusion in the healthcare sector that will drive up costs, increase the budget deficit and reduce patients' choices. What’s your view?

R.D.: People who find it’s too expensive always remind me of that famous comment by [former US President] Thomas Jefferson, “If you think education is expensive, try ignorance.” You could say the same here: if you think the Obama plan is expensive, then simply continue to condemn people to not receiving healthcare, not being able to work and being wracked by illness.

The hardest thing now – and it’s also the case in Switzerland - will be to see what rationalisation measures can reduce rising health costs. As lots of observers have said, “It’s over, but it’s just begun.” Things will now have to be clarified in the medical world and cost-control tools will have to be developed. But this problem is common to all countries, linked to issues of demography and the evolution of medical technology and knowledge but also to the permanent battle involving medical lobby groups.

swissinfo.ch: Is the US moving towards a “Swiss-style” healthcare system?

R.D.: There are still very big differences between the two systems, but as New York Times columnist, economist and Nobel Prize winner Paul Krugman said a few months ago, Switzerland is the European system that most resembles the Obama health plan.

swissinfo.ch: The US rejected the public healthcare system option. What about possibly introducing it in Switzerland?

R.D.: Since the multi-party compromise that allowed us to introduce universal coverage under the healthcare reform, with a large number of private companies the issue of a single health insurance company arose several times… and will certainly be on the table again soon.

It’s clear that in the Swiss system, which is slightly different from the US system, the competition between various companies did not bring the expected results in terms of cost control.

In Switzerland competition is much more restricted than in the US. The real competition is over the quality of services to the insured person, including managed services, while the catalogue of services and tariffs are unified by law or negotiation in Switzerland. Under such conditions, the alternative is not competition between public and private insurance schemes but a single health insurance system.

swissinfo.ch: The Republicans say they will seek to repeal the new bill, challenge its constitutionality and try to block its implementation. Does it have a solid future?

R.D.: This ongoing political battle is distressing. But I don’t think the public likes this battle or Fox News’ climate of brutal politics, contempt for opponents and lies. The individual citizen expects solutions.

I share the line of a recent Washington Post editorial that said that it’s easier to scare the population about a project than about the reality. The majority of Americans will realise that this is an extremely important positive step that has been taken. And I’m sure they won’t want to return to the former discriminatory, cruel situation.

Simon Bradley, swissinfo.ch