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DIGITAL HEALTH STARTUP STORY
DIGITAL HEALTH START-UP STORY
Switzerland has an increasing number of start-ups in the field of digital health. They focus primarily on technology-orientated offerings and on doctors, hospitals, insurance companies and pharmaceutical companies as customers. This is the conclusion of a new study by ZHAW and Health-Trends
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Switzerland has a dynamic, rapidly developing startup landscape in the digital health sector. Of the current total of around 180 to 200 start-up companies, the majority are active in the “data health” and “tech health” segments: they offer, for example, digital solutions for the evaluation of health data or digitally controllable medical technology products. More than half of the start-ups included in the survey are located in the Zurich area and employ a maximum of five people. These are the findings of a survey conducted by the ZHAW School of Management and Law and Health-Trends, a Swiss think tank for digital health. The survey is based on an online survey of 42 Swiss start-ups that was conducted between July and December 2019. FURTHER GROWTH EXPECTED
“We assume that the digital health sector and the associated start-up scene will develop rapidly in the coming years. The COVID-19 Pandemic is likely to accelerate this trend even more,” says Alfred Angerer, head of the Department of Management in Healthcare at the Winterthur Institute of Health Economics at the ZHAW School of Management and Law. “The high proportion of start-ups in “tech health” and “data health” also illustrates how important high-tech skills are for innovations in the digital health environment. Many start-ups use forward-looking technologies such as artificial intelligence, cloud computing and the internet of things.
WIDE RANGE OF SERVICES
Around three-quarters of the startups offer digital products and services in core medical areas, such as prevention, symptom recording, information search, diagnosis and therapy. These can be digital symptom testers or online information platforms, for example, for searching for doctors and therapists. In terms of content, the solutions are often aimed at chronic illnesses like diabetes or cancer, or at psychological complaints.
As the survey further shows, 80 per cent of the start-ups are active in the B2B sector and focus on hospitals, doctors, health insurance companies or pharmaceutical companies as customers. “This is mainly due to the fact that the willingness of private customers to pay for digital health offers in Switzerland has been rather low to date,” explains Matthias Mettler, coinitiator of Health-Trends and expert on the digital health and innovation scene in Switzerland.
Around half of the start-ups already have a well-developed product or service offering. Another quarter has at least one offer in the form of prototypes, whose market demand is currently being validated by the companies concerned. Almost 85 per cent of the start-ups have entered into cooperation agreements with academic partners to develop their offerings.
BY GEORG E. RIEKELES / PROJECT SYNDICATE
SWITZERLAND’S BREXIT MOMENT
Many in Switzerland have failed to recognise that their exorbitant privileges vis-à-vis the European Union could not continue. The Swiss government’s recent withdrawal from talks on an EU framework agreement could reduce the country’s single-market access and prompt a fundamental rethink of its relationship with the bloc
The Swiss government’s recent withdrawal from negotiations on a framework agreement with the European Union has triggered a deep crisis in bilateral relations. For the EU, the fallout is manageable: economic relations will erode, but the Union will carry on. For Switzerland, the consequences could be more dramatic. With Switzerland’s future access to the EU’s single market in jeopardy, its walkout might now require a Swiss rethink of its relationship with the bloc almost as fundamental as the United Kingdom’s after the 2016 Brexit referendum.
Switzerland is not an EU member state, but in many respects it comes close. Through some 120 bilateral agreements, Switzerland is a member of the border-free Schengen Area, is closely integrated with the EU in areas such as transport, research, and the Erasmus student-exchange programme, and enjoys full access to the single market in sectors from finance to pharmaceuticals. All told, Switzerland probably benefits more from the single market than any other European country, and pays little in return. A 2019 Bertelsmann Stiftung study found that the single market boosts Swiss annual per capita income by €2,900 ($3,515) per year – well above the EU average of €1,000
– whereas Switzerland’s corresponding financial contribution (when it is paid) in effect cost the Swiss less than €14 per capita per year.
Switzerland’s free lunch is not only economic. The main problem with the “bilateral way,” cherished by the Swiss since they voted “no” to the European Economic Area (EEA) in a 1992 referendum, is the lack of continuous updating of single-market law in Switzerland. Swiss public opinion has long held that “foreign judges” should have no role in interpreting the country’s laws. Yet, this clashes with the single market’s requirement of uniform application of supranational rules.
The Institutional Framework Agreement (IFA) that the EU and Switzerland reached in 2018, after five years of negotiations, was a belated attempt to put bilateral relations on a sustainable footing and pave the way for further Swiss access to the EU market. To secure it, the EU again made significant concessions in the face of Swiss sovereignty concerns.
Rather than requiring automatic incorporation of single-market law, the EU allowed for three years of internal Swiss procedures to adopt it (including possible referendums). And instead of insisting on sole jurisdiction for the Court of Justice of the European Union, the EU agreed to an arbitration-based dispute-settlement mechanism that would seek the CJEU’s intervention only for interpreting concepts of EU law.
Significantly, the EU also conceded that the IFA would cover only five market-access agreements, from transport to the free movement of persons. The 1972 bilateral free trade agreement remained off-limits, with the two sides issuing only a statement of political commitment to its future modernisation.
But despite these concessions – which would place at risk the single market’s level playing field – the Swiss government never signed the IFA, or even defended it. On the contrary, the Swiss strategy was always to come back for more – until they walked away.
The talks had been made difficult because of disagreements over state-aid rules. Under the IFA, the EU offered a two-pillar arrangement whereby the EU rules would apply in Switzerland but would be implemented through an autonomous Swiss surveillance mechanism with powers equivalent to the European Commission’s. But when the EU negotiated its post-Brexit relationship with the UK, some in Switzerland thought that the UK received a “better” state aid deal.
The even bigger thorn in the EU’s side has been Switzerland’s remonstrations against EU citizens’ freedomof-movement rights to Swiss social security benefits, and its concerns about downward pressure on domestic wage levels. Here too, the Swiss have a weak case.
Following the Swiss 2014 referendum “against mass immigration,” the EU conceded that Swiss law could require Swiss employers to give priority to domestic job seekers. The IFA grants exceptions – provided these are non-discriminatory and proportionate – to protect Swiss wage levels. And the CJEU has recognised that freedom of movement is not absolute and that economically inactive EU citizens may be excluded from other member states’ social benefits.
The EU could not concede more. Precisely because these tricky issues are not unique to Switzerland, the EU cannot give the Swiss a free pass. Treating all countries alike matters not only for the integrity of the single market, but also for the EU’s political viability. If the EU were to give non-members privileges that even members don’t have, more might head for the exit. The EU and Switzerland must find solutions within a common framework of rules, not outside them.
Many in Switzerland fail to recognise their exorbitant privileges vis-à-vis the EU, and that this cherry-picking cannot continue after Brexit. All in all, the Swiss government has shown little interest in a fair single-market settlement with the EU, and, having broken off talks, now faces some immediate economic consequences.
For starters, future single-market access in electricity and health is off the table. And on 26th May, Switzerland lost access to the EU market for new medical devices, because the EU-Swiss Mutual Recognition Agreement was not updated. Machinery and chemicals are next in line. Bit by bit, the two economies will decouple in these sectors, at an estimated cost to Switzerland of up to €1.2 billion per year.
The EU must soon make other hard choices, not least concerning Switzerland’s participation in the bloc’s Horizon Europe research programme. Research cooperation is obviously mutually beneficial. But with the Swiss holding up their financial contributions and spurning efforts to find viable institutional solutions, the EU seemingly has little choice but to put its foot down.
The EU-Swiss rupture comes as the UK government is also brazenly confronting the Union by stepping away from key provisions of the IrelandNorthern Ireland protocol and asking the EU to adapt. With Norwegian support for the EEA increasingly unstable, several of the EU’s wider economic partnerships are in play.
But it is the Swiss who face the most difficult choices. A recent opinion poll showed that more than 60% of Swiss are in favour of the IFA. But similar majorities support the EEA model, or even the model of EU-UK and EUCanada agreements.
As the Commission reminded the Swiss government after it broke off the talks, the bilateral relationship urgently needs modernising. Instead, it is now entering the unknown.
THE 12 BEST SWISS WATCH BRANDS FOR MEN
By Leena Kim and Sam Dangremond
From Baume & Mercier to Vacheron Constantin, here are the top Swiss watch brands worthy of any timepiece enthusiast’s collection
As James Bond creator Ian Fleming once said, “A gentleman’s choice of timepiece says as much about him as does his Savile Row suit.” While the best suits may come from England, the best watches, without a doubt, are Swiss. Any timepiece enthusiast should have at least one (preferably more) exquisitely crafted watch in his arsenal. So, whether you’re shopping for the most important man in your life, or are simply adding to your own growing collection, below are the best Swiss watch brands on the market.
REVERSO CLASSIC Jaeger-LeCoultre $6,450.00
As the story goes, the Reverso was developed in 1931 after a British army officer, who had broken the glass of his watch during a polo match in India, challenged Jacques-David LeCoultre to come up with a watch design that could survive a similar athletic endeavor. LeCoultre came up with this model, whose face flips over to protect the front of the watch from, among other things, errant polo mallets. It’s become one of the brand’s signatures, and this one features a small second dial and a calfskin strap from Casa Fagliano, the celebrated Argentinian bootmaker.
As one of the thinnest automatic watches in the world, Piaget’s Altiplano Ultimate 910P is just 4.3 mm thick (the watch’s movement is visible through its case). The brand, of course, is no stranger to setting records—its Altiplano 900P is the world’s thinnest mechanical watch.
CLIFTON BAUMATIC 10399 Baume & Mercier $2,850.00
For an automatic movement, Baume & Mercier offers a great price point. The Clifton Baumatic 10399 features a 40 mm case with a date window and a smooth black dial. The black alligator strap is interchangeable, and the stainless steel bezel and rhodium-plated hands of the dial make this model a sleek choice.
SEAMASTER AQUA TERRA 150M CO‑AXIAL MASTER CHRONOMETER Omega $5,700.00
Tributes to Omega’s maritime heritage abound in this Seamaster Aqua Terra, from the waveedged design on the back to the elegant blue dial, which has a unique horizontal “teak” pattern inspired by the wooden decks of luxury sailboats. Plus, any watch that’s good enough for 007 (namely, Daniel Craig’s Bond) is certainly good enough for you (or your man).
GMT‑MASTER II Rolex $9,700.00
Perfect for the jetsetter, Rolex’s GMT-Master II is designed to tell time in two different time zones during intercontinental flights. The blue and red dial lends a patriotic flair.
PORTOFINO CHRONOGRAPH IWC $16,800.00
Be transported to the dolce far niente lifestyle of the Italian Riviera with IWC’s Portofino Chronograph collection. This particular model has been given quite the luxurious upgrade, with its gold case (the applied indices and Roman numerals are also of solid gold) and hand-painted black alligator strap.
CARRERA AUTOMATIC CHRONOGRAPH TAG Heuer $5,750.00
With its sleek black dial and ceramic black tachymeter bezel, Tag Heuer’s Carrera watch strikes a fine balance between being both sporty and elegant, an accessory that would look just as good on the racetrack (for which this collection was made, in 1963) as it would paired with that aforementioned Savile Row suit.
LONGINES SPIRIT Longines $3,100.00
The glory days of aviation were the inspiration behind Longines’s Spirit collection. It’s the best of both worlds: the watches have an appealing vintage aesthetic, but are made for the 21st century.
PILOT TYPE 20 TON UP Zenith $7,200.00
This watch is dedicated to the café racer motorcycle community, also known as Ton-up boys, which originated in the United Kingdom in the 1950s. The case is black stainless steel and the strap is black nubuck leather with a rubber lining designed to protect it from anything, including any dirt and grime that might result from a motorcycle ride.
ROYAL OAK OFFSHORE DIVER Audemars Piguet $21,300.00
The legendary Audemars Piguet Royal Oak is given the rubber treatment in a chic beige color, perfect for summers in the Hamptons.
GOLDEN ELLIPSE Patek Philippe $50,460.00
Inspired by the “golden ratio” of great works of art, Patek Philippe’s Golden Ellipse design was a significant departure from everything else available on the market when it launched in 1968. This model includes a striking blue dial and band with a platinum case.
FIFTY SIX SELF‑WINDING Vacheron Constantin $12,000.00
This model is part of a collection for Vacheron Constantin inspired by vintage timepieces. The most notable factor here is its material—steel— offering a previously unheard of price point for coveted entry into the Vacheron owners’ club.
THE BEST SCENIC TRAIN RIDES IN SWITZERLAND
There really is no better way to explore the incredibly beautiful country of Switzerland than by train
All of the country’s best natural sights - from verdant valleys to dramatic waterfalls and sheer mountain peaks - are train accessible, with a number of these journeys considered the most scenic in the world. So come along for the ride!
THE BERNINA EXPRESS
Connecting Chur to Poschiavo in Switzerland, and to Tirano in Italy by crossing the Swiss Engadin Alps, the Bernina Express features breathtaking views from its panoramic, red carriages. The two main lines on the Bernina Express route - the Bernina line and the Albula line - were jointly declared a World Heritage Site in 2008. The Bernina line through this site is a spectacular four-hour journey across 196 bridges, through 55 tunnels and across the stunning Bernina Pass at 7,391 feet above sea level. The first section of the Bernina Express, from Chur to Pontresina, also crosses the famous Landwasser Viaduct, a dramatic, curving single-track viaduct made of limestone and featuring six massive arches. This iconic journey continues to be one of the most popular in the country.
THE GLACIER EXPRESS
The Glacier Express - known as the ‘Slowest Express Train in the World’ (and arguably the most scenic) - connects the mountain resort towns of Matterhorn adjacent Zermatt, and St Moritz in the Swiss Alps. Much of the train’s spectacular journey passes through the same World Heritage Site as the Bernina Express and boasts equally as impressive views, including the Matterhorn and the Matter Valley, the massive rock walls through the town of Visp, and the sparkling river Rhone, just after departure from Brig. Because the train routes feature similar, but different vistas, many visitors make it a point to ride both the Glacier and Bernina Express during their time in Switzerland.
THE GLACIER EXPRESS
JUNGFRAU RAILWAY TO JUNGFRAU MOUNTAIN
JUNGFRAU RAILWAY TO JUNGFRAU MOUNTAIN
The historic Jungfrau railway line takes visitors to Europe’s highest railway station, a whopping 3,453 metres above sea level. The snow-capped Jungfrau Mountain is sandwiched between the huge peaks of the Monch and Eiger Mountains, and part of the Jungfrau railway line tunnels through these two mountains, with spectacular views through windows carefully carved into the mountainside. Once you reach the top, marvel in awe at the amazing views, which can extend as far as the Black Forest of Germany and France on a clear day. The mountain peak features an ice sculpture gallery and the opportunity to take a walk on a glacier, as well as a restaurant and what is believed to be the world’s highest chocolate shop. On the way back down the mountain, the route descends through the village of Lauterbrunnen and boasts gorgeous waterfall views.
COGWHEEL RAILWAY TO MOUNT PILATUS
The cogwheel railway to Mount Pilatus in Switzerland boasts the title of the ‘Steepest Cogwheel Railway in the World.’ The 30-minute journey begins in Alpnachstad and has an average gradient of 35%. The Cogwheel Railway operates between May and November, while at other times the top can be reached via a spectacular aerial gondola and cableway. At the top, you’ll find the historic Pilatus Kulm Hotel and restaurant where you can enjoy refreshments, or discover one of the numerous walking trails with stunning views of the surrounding area.
GORNERGRAT COG RAILWAY
The Gornergrat cog railway is considered a marvel of modern engineering, climbing from 1,603 metres above sea level near the town of Zermatt, to 3,089 metres at the top in just 33 minutes. From the top, visitors experience one of the most spectacular panoramas in all of Switzerland - the iconic outline of The Matterhorn as well as the surrounding peaks and glaciers. Enjoy a stroll at the top through the nature reserve and sample a fondue in one of the lovely, panoramic view restaurants. Take the same route back down to Zermatt where you can enjoy the numerous small bars and restaurants on the car-free roads of this beautiful village.
COGWHEEL RAILWAY TO MOUNT PILATUS
