similar terms in another language (Italian azione used not only as act but also as discount from German Aktion). Swiss French, while generally close to the French of France, also contains some Helvetisms. The most frequent characteristics of Helvetisms are in vocabulary, phrases, and pronunciation, although certain Helvetisms denote themselves as special in syntax and orthography. Duden, the comprehensive German dictionary, contains about 3000 Helvetisms. Current French dictionaries, such as the Petit Larousse, include several hundred Helvetisms; notably, Swiss French uses different terms than that of France for the numbers 70 (septante) and 90 (nonante) and often 80 (huitante) as well. Learning one of the other national languages is compulsory for all Swiss pupils, so many Swiss are supposed to be at least bilingual, especially those belonging to linguistic minority groups. Because the largest part of Switzerland is German-speaking, many French, Italian, and Romansh speakers migrating to the rest of Switzerland and the children of those non-German-speaking Swiss born within the rest of Switzerland speak German. While learning one of the other national languages at school is important, most Swiss learn English to communicate to Swiss speakers other languages, as it is perceived as a neutral means of communication. English often functions as a lingua franca. Health Swiss residents are required to buy health insurance from private insurance companies, which in turn are required to accept every applicant. While the cost of the system is among the highest, its health outcomes compare well with other European countries; patients have been reported as in general, highly satisfied with it. In 2012, life expectancy at birth was 80.4 years for men and 84.7 years for women – the world's highest. However, spending on health at 11.4% of GDP (2010) is on par with Germany and France (11.6%) and other European countries, but notably less than the US (17.6%). From 1990, costs steadily increased. It is estimated that one out of six Swiss persons suffers from mental illness. Culture Swiss culture is characterised by diversity, which is reflected in diverse traditional customs. A region may be in some ways culturally connected to the neighbouring country that shares its language, all rooted in western European culture. The linguistically isolated Romansh culture in Graubünden in eastern Switzerland constitutes an exception. It survives only in the upper valleys of the Rhine and the Inn and strives to maintain its rare linguistic tradition. Switzerland is home to