Small Changes, Big Impact

Story by David Taylor

Switzerland is a small country, Felix Gutzwiller reminds people—so small that it doesn’t have full-time politicians. That can be an opportunity.

That’s how Gutzwiller, MD, DrPH ’80, MPH, came to straddle two worlds: politics and public health. As head of Public Health at the University of Zurich’s medical school, he ran for a seat in the lower house of the Swiss legislature in 1997. He won, and in 2007 won again, this time gaining a seat in the Senate, where he’s the only physician.

“It’s great fun to introduce small changes in legislation that have great impact, greater than my academic papers,” says Gutzwiller.

For example, he introduced a law banning smoking in public indoor spaces, and felt great satisfaction when it passed. His work combines public health issues with legislative nuts-and-bolts, with a portfolio in three main areas: a standing committee on Health and Social Affairs; foreign affairs; and science and culture.

Besides tobacco use, public health issues in Switzerland include drug abuse and mental health problems. Gutzwiller says that the country also faces a rising epidemic of overweight young people. The rate is not as high as in the U.S. but there’s been a marked increase in recent years.

Then there’s the systemic issue of health reform. Like other countries, Switzerland faces a rising tide of health care costs and institutional choices. Gutzwiller discusses these with health professionals in other countries, and watches with interest U.S. health reform efforts.

Gutzwiller points to his years at the Bloomberg School as the time when he first encountered public health mixing with government. “The interaction between Hopkins and Washington was quite new for me,” he says, noting the policymakers who gave talks on campus, and professors who taught from policy experience.

Now his background helps to get laws passed. “I tend to think I have a certain amount of credibility on health issues,” he says. Fellow legislators listen when he advances arguments based on his expertise. On the smoking rule, for example, some were unconvinced, so Gutzwiller marshaled health evidence strong enough to demand action. “It benefited that I knew both sides,” he says. Since passage of the indoor smoking ban, he adds, smoking rates for Swiss men have begun to fall.

Gutzwiller’s senate term will keep him busy until 2011. Then he’s up for re-election.