Content
Table of Contents
A “Swiss Model but Better”: Affordable Universal Healthcare for America
Disclaimer: Dr. Dawn Francis does not endorse or support any political candidate. She provides independent expertise on healthcare issues. Readers are encouraged to follow her work on Substack for her full analysis and insights. https://substack.com/@drdawnfrancis
Mark Heggestad is a Democratic Congressional candidate from Jacksonville, Florida’s CD‑5, bringing the grounded perspective of a longtime football official and a seasoned healthcare IT project manager. His career includes leading complex initiatives at Medtronic, Blue Cross Blue Shield Nebraska, Vatica Health, and most recently at Mayo Clinic in research and individualized medicine. Across these roles, he has focused on supporting teams that deliver accessible, affordable healthcare. He’s driven by the belief that families deserve an affordable life, and that dependable, equitable healthcare is essential to that promise. Heggestad for U.S. Congress | CD - 5 | Florida Democrat
The World Cup Healthcare Scoreboard
The countries we watch on TV, including France, Germany, Spain, England, Brazil, Argentina, Japan, South Korea, Australia, the Netherlands, Switzerland, Denmark, Sweden, Croatia, Portugal, Mexico, and Canada, all guaranteed healthcare. They do it with different systems, but they do it.
Some use national health services. Some use social insurance. Some use regulated private insurance.
But they all share one thing: universal coverage is normal.
Among these systems, Switzerland’s stands out as the one Americans could realistically adopt.
The Swiss Model but Better
Healthcare expert Dr. Dawn Francis offered some insights.
Dr. Francis: “I really like the sports comparison; it resonates right now with the World Cup…The Swiss model is an evolution of other European models. It is the newest of the models, and it is the second most costly (we are the first) but quite a bit cheaper than ours. For this the Swiss have the longest life expectancy, the lowest maternal mortality, and the shortest wait times for primary care and for elective surgical procedures.”
Dr. Francis pointed out the gaps we must address if we as a country want a “Swiss model but better.”
1. Universal Coverage Without Employer Dependency
In Switzerland, your insurance belongs to you, not your job. You choose your insurer, your deductible, and your supplemental coverage. If you change jobs, retire early, or start a business, your coverage stays with you. A U.S. version would finally end the era of job‑locked healthcare, a system that punishes entrepreneurship, mobility, and family transitions.
2. Employer Premium Credits and Payroll-Based Subsidy Funding
Dr. Francis: “Other than employer credits, how is this funded? If it is all personal responsibility, then there needs to be some coverage for people that cannot afford it and that needs to be funded somewhere. A viable option is with payroll tax, since employers do not have to provide insurance any longer, they are taxed and the money is pooled.”
Here is how it works:
Employers no longer sponsor health plans.
Instead, they pay a payroll-based contribution into a national subsidy pool.
Employers may optionally offer premium credits as a benefit.
Employees apply credits to any regulated plan they choose.
Credits follow the worker, not the job.
This creates predictable costs for employers, portable coverage for workers, and a stable funding base for subsidies. It is the best part of employer involvement without the worst part of employer dependency.
3. Safe, Smart Incentives, plus “Provisional” Research Incentives
Safe, non‑Controversial Incentives (Core System)
Blood Donation Credits: A small annual premium reduction for residents who donate blood regularly, supporting hospital supply stability.
Community Health Participation Credits: Premium credits for CPR training, first aid certification, or disaster response volunteering, strengthening community resilience.
Preventive Care Engagement Credits: Discounts for completing annual checkups, screenings, and chronic care management, reducing long-term system costs.
These reflect an emphasis on population health, early intervention, and shared responsibility.
Provisional Research Incentives (Optional and Subject to Review)
Included in the initial rollout, but carefully regulated:
Clinical Trial Participation Credits: A modest premium credit for voluntary enrollment in approved trials, recognizing their role in accelerating medical innovation.
Genomic Data Sharing Credits: A small credit for contributing anonymized genomic data to certified research repositories, supporting precision medicine research.
These incentives must remain voluntary, privacy-protected, transparent, publicly debated, and scientifically justified. But scientific breakthroughs could unlock cures for major diseases, extend healthy lifespans, and transform how humanity powers, feeds, and heals itself.
4. “Share Your Data, Not Your Identity” — A Privacy-First Preventive Care Framework
Dr. Francis: “Americans will not share health data unless privacy is guaranteed”.
So instead, we adopt a simple principle: Share your data, not your identity.
Residents can opt into anonymized health data sharing, including steps, sleep, glucose, blood pressure, and heart rate. Insurers receive risk signals, not personal identities. Preventive care algorithms flag early warning signs. Participants earn premium reductions for engaging in preventive care.
This protects privacy while unlocking the power of early detection. It is voluntary, secure, modern, and exactly the kind of innovation Dr. Francis argues is necessary for a 21st‑century system.
5. Not for Profit Basic Insurance, The Swiss Secret Sauce
Insurance companies must offer basic care in a non-profit model, which is fundamental for the success of private insurance in the systems that maintain private insurance.
This is the backbone of the Swiss system. A “Swiss model but better” keeps this structure. It is the only way private insurance can remain affordable in a universal system.
6. Price Caps, The Tool Every Peer Nation Uses
Price caps for the medical supply chain, including pharmaceuticals, which will be fundamental to cost control and is what the Swiss and all other peer countries do.
Every peer nation uses price caps. They cap hospital procedure prices, specialist fees, pharmaceutical prices, and medical device costs.
A “Swiss model but better” includes national price ceilings, transparent pricing, annual cost reviews, negotiated drug prices, and limits on surprise billing. This is how you contain costs without sacrificing quality.
7. The United States Can Lead the World in Precision Healthcare
This is where the American advantage becomes undeniable.
We already lead the world in genomics, biotech, AI-driven diagnostics, personalized medicine, clinical research, and pharmaceutical innovation.
A “Swiss model but better” does not just guarantee coverage. It supercharges precision healthcare by encouraging anonymized data sharing, supporting early detection, integrating preventive analytics, creating optional provisional pathways for research participation, and building a system that learns from population-level trends.
A “Swiss model but better” is neither a government takeover, single-payer, nor employer-based healthcare, but rather a practical hybrid approach.
Universal coverage is not the ceiling. It is a launchpad.
A healthier nation is a stronger nation. Let's build a Healthcare solution that we are proud of.
Mark Heggestad
Congressional Democratic Candidate - FL CD-5