Ethicist says solidarity can strengthen personal responsibility

Solidarity and personal responsibility can reinforce each other, ethicist Jean-Daniel Strub told SRF, arguing that Switzerland’s health insurance system contains incentives that can discourage people from seeking care or encourage unnecessary treatment.

Debate over rising health costs often asks whether treatments such as weight-loss injections should be funded collectively or left to individuals to pay for themselves. Strub said that framing risks turning a structural problem into an individual one. The injections suppress appetite, he noted, which can help create the conditions for someone to take responsibility for their health.

Personal responsibility involves both the willingness and the ability to care for one’s health and understand the effects of one’s actions on oneself and the community, Strub said. People cannot always simply choose to change their behaviour. The causes of illness are complex and may include factors such as work-related stress and a person’s social position.

Strub also criticised the option to choose the size of the deductible in Switzerland’s health insurance system. He said the choice was introduced to encourage personal responsibility but can produce opposing incentives. A higher deductible may lead people who cannot afford treatment to delay seeking it, while a lower deductible can make it easier to use more services, sometimes more than necessary.

Strub is a member of the National Ethics Commission for Human Medicine and heads the Neumünster Institute. The interview was conducted by Eveline S. Kobler.