The State System
Only citizens who are permanently resident in Liechtenstein are compelled to contribute to the healthcare fund. Many of Liechtenstein’s employees come from neighbouring countries, but they are not obliged to contribute, if they do not have a permanent address in the country. Employers have to register their staff with the health insurance fund when a new employee starts work. Employees and employers pay into the healthcare fund. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave do not have to pay healthcare contributions. Self-employed persons must make their own contributions.
The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth and rehabilitation.
Citizens who belong to vulnerable groups of society e.g. pregnant women, war veterans, diabetics and tuberculosis patients do not have to pay any charges. Appointments with a doctor and referrals to a consultant are free.
Doctors and Health Centres
There are only around 64 GPs and consultants to serve the entire population. You can see any doctor, so long as he or she is covered by a contract with the state-funded healthcare scheme. A doctor is called an Artzt and he is the first point of contact with the Liechtenstein health system. Citizens can register with the doctor of their choice; however, people seeking state medical care must make sure that their doctor is contracted into the Liechtenstein scheme. If you are treated by anyone other than a state funded doctor, you will have to pay the fees yourself.
GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education.
Health centres only provide outpatient care but they do offer a wide variety of specialist services. Medical services provided by health centres include, general practice, maternity care, child healthcare and dental care. They also provide emergency medical aid as well as laboratory, radiology, and other diagnostic services.
Health centres are staffed by qualified doctors and nurses.
Out of surgery hours, doctors run a service roster, which is advertised each day in the national press.
Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a Consultant if he or she believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in Liechtenstein like gynaecology, oncology, paediatrics and dermatology. There is often a waiting list to see Consultant doctors.
Liechtenstein only has one hospital, The National Hospital, situated in the capital Vaduz. It is common for patients to receive medical treatment from neighbouring Austria or Switzerland, where the Liechtenstein government has a number of contracts. Outside of the capital, care facilities exist in each district and they are part of the Liechtenstein Senior Care and Nursing Foundation.
Patients are admitted to hospital either through the emergency department or through a referral by their doctor or consultant. The hospital is run in conjunction with private doctors specialising in internal medicine, surgery, gynaecology, obstetrics, and psychiatry.
Emergency care is available free for everyone including those without state health insurance. However, once your condition is stabilised they will want proof of your insurance status. Emergency treatment is provided at the emergency room of the National Hospitals and is known as the Notaufnahme. The emergency department is open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.
Outside of the capital, there is an emergency service in each town operated by GPs and specialists. Each of the country’s two national daily newspapers publishes the details of each duty doctor. The National Hospital in conjunction with the Liechtenstein Red Cross has arranged for a doctor, who is trained in emergency medicine, to travel with the ambulance service.
Private practices exist alongside the state system in Liechtenstein and they are staffed and managed by independent doctors and specialists. The premises, equipment and personnel are funded by the doctors themselves and from private insurance contributions.
Around 26 dentists provide outpatient care in the country. However, some citizens use the dental facilities of neighbouring countries. All dental treatment is private and citizens must pay the full cost of their treatment themselves. Dentists also operate emergency treatment facilities in the same way that doctors in the country do.
Dispensing chemists known as Apotheke sell medicines in Liechtenstein. Only doctors and consultants can prescribe medicine in Liechtenstein. Prescription medicine is only available from a qualified and registered chemist, dispensing doctors’ private pharmacies or from the hospital pharmacy. Non-prescription drugs are priced higher than prescription drugs. Under this system, you may pay less for a packet of aspirin if it has been prescribed by your doctor. Liechtenstein permits the sale of medicine, which has been approved in neighbouring Switzerland and the European Economic Area.
More information is available at www.liechtenstein.li