In 1890 the constitution was changed by popular vote to give the federal government the authority and duty to establish a health care system, either voluntary or mandatory.
A project for mandatory accident and health insurance passed the parliament in 1899, but a referendum was requested and the proposed law was rejected by popular vote in 1900.
A new law was passed in 1911, keeping the mandatory accident insurance but leaving the states free to make health insurance voluntary or mandatory. This law survived a referendum in 1912.
Attempts at revising the health insurance law failed in the 20's, 40's and 50's.
A popular initiative for mandatory health insurance failed the vote in 1974. A counter-project submitted by the government, with mandatory coverage for large risks only, also failed the vote.
Finally, another popular initiative for mandatory health insurance is deposited in 1986. The government prepares an indirect counter-project, resulting in a law that includes mandatory health insurance. The law is adopted by the parliament in March 1994, but a referendum is requested. Both the initiative and the referendum on the law are submitted to a popular vote in December 1994. The initiative fails by 76.6% "no" while the counter-project passes by 51.8% "yes".