Political theories of the modern state describe a rise of the regulatory healthcare state, balancing the imperatives of cost control and quality assurance and welfare norms such as solidarity. This paper analyses the unique case of Switzerland, where the rise of the regulatory healthcare state occurred late and incompletely, with the adoption of the Federal Health Insurance Law in 1994. The Swiss federal state pursues the social objective of universal access to healthcare through social health insurance regulation. This paper demonstrates that economic efficiency has not been the primary goal of healthcare coverage within the Swiss regulatory healthcare state despite rising costs. As another exceptional feature, Switzerland has diverged from the traditional path of judicial behavior in the regulatory state. This paper critically dissects how the Swiss Federal Court has become a crucial actor, imposing limits on access to healthcare and shaping decision-making criteria for social regulation, such as cost-benefit and cost-impact analysis. Through this judicialization of limit-setting, the judiciary engages in an ongoing constitutional dialogue on the limits of the regulatory welfare state and its sustainability for the future.

中文翻译：

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瑞士监管医疗保健国家的崛起：在追求更好（或更便宜？）的过程中维护正义

现代国家的政治理论描述了监管医疗保健国家的兴起，平衡了成本控制和质量保证的必要性以及团结等福利规范。本文分析了瑞士的独特案例，该国在 1994 年通过《联邦健康保险法》后，监管医疗保健国家的兴起较晚且不完全。瑞士联邦国家追求通过社会健康普遍获得医疗保健的社会目标保险监管。本文表明，尽管成本不断上升，但经济效率并不是瑞士监管医疗保健国家医疗保健覆盖的主要目标。作为另一个不同寻常的特点，瑞士已经偏离了监管国家司法行为的传统路径。本文批判性地剖析了瑞士联邦法院如何成为一个关键角色，对获得医疗保健的机会施加限制，并为社会监管制定决策标准，例如成本效益和成本影响分析。通过这种限制设置的司法化，司法机构就监管福利国家的限制及其未来的可持续性进行了持续的宪法对话。