At least one country already has a health-care plan roughly similar to the one President Obama and the Democrats have proposed, with universal coverage, a mandate that everyone buy insurance, and a major role for private insurance companies: Switzerland.

Here’s how the Swiss system works: Everyone is required to buy basic health insurance from one of several private companies; the government subsidizes the cost for low-income families. Consumers can choose any insurer and go to any doctor — more choice than most Americans now enjoy. The government prescribes what the policies will cover, sets the price, and tells doctors what they can charge for every medical procedure. Doctors are free to do whatever they feel is called for, order any test, and prescribe any approved medication. But if a doctor’s billings exceed the regional median by too much, he or she will get a “blue letter” — a bill from the government demanding the return of some of those fees.

By world standards, Swiss medicine is very good. The average infant born in Switzerland can expect to live to almost 82, more than three years longer than the average American baby. Swiss patients don’t wait long for treatment, either. And they pay a lot less than Americans do. Approximately 11 percent of the Swiss Gross National Product goes to health care, against about 16 percent of the U.S. GNP.

The unrelenting rise in costs has been the single biggest disappointment in the Swiss universal coverage system, which was created by landmark reform in 1994. The basic reason is evident: The well-insured Swiss use a lot of medical care — too much, in fact. They visit their doctors more frequently than Americans do. They often ask for tests or pharmaceuticals that they’ve heard about from friends. And nobody wants to tell them no.

The average general practitioner in Switzerland makes around $150,000 a year, but cardiologists and other specialists can make $300,000 or more said, Dr. Jean-Oscar Meile, who runs a tidy one-man practice in Melide, a suburb of Lugano in Switzerland’s Italian-speaking south.

One lesson of Switzerland’s experience is that near-universal coverage is possible without a government-run “public option.” Swiss health insurance is provided entirely by private companies, even for the elderly. (In that sense, it’s less “socialized” than U.S. medicine: There’s no government-run Medicare.) By law, the basic insurance plans are nonprofit, but companies use them to attract customers to their for-profit lines of business.

Another lesson: Cost containment is very, very difficult — especially if, like Obama and his Swiss colleagues, you’ve promised voters that they’ll still get all the care they want.

A third lesson: Don’t expect miracles. The Swiss are still working the bugs out of their system 15 years after it was enacted. They still haven’t covered everyone, and illegal immigrants are a continuing problem.

Still, they get medical care as good as or better than that of the United States, at a cost that’s significantly smaller. They must be doing something right.

Doyle McManus is a syndicated columnist. A version of this commentary appeared in Sunday’s Los Angeles Times.