Sunday, February 06, 2011

America could learn a lot from the French health care system

Even when (or if) the Affordable Healthcare Act is implemented, it will not solve all of America's problems of providing health care to the population in an affordable way. But Bloomberg Businessweek writes approvingly of the French health care financing system.
In Sicko, [Michael] Moore lumps France in with the socialized systems of Britain, Canada, and Cuba. In fact, the French system is similar enough to the U.S. model that reforms based on France's experience might work in America. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self- employed, are free to prescribe any care they deem medically necessary. "The French approach suggests it is possible to solve the problem of financing universal coverage...[without] reorganizing the entire system," says Victor G. Rodwin, professor of health policy and management at New York University.

France also demonstrates that you can deliver stellar results with this mix of public and private financing. In a recent World Health Organization health-care ranking, France came in first, while the U.S. scored 37th, slightly better than Cuba and one notch above Slovenia. France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.

That's not to say the French have solved all health-care riddles. Like every other nation, France is wrestling with runaway health-care inflation. That has led to some hefty tax hikes, and France is now considering U.S.-style health-maintenance organization tactics to rein in costs. Still, some 65% of French citizens express satisfaction with their system, compared with 40% of U.S. residents. And France spends just 10.7% of its gross domestic product on health care, while the U.S. lays out 16%, more than any other nation.

To grasp how the French system works, think about Medicare for the elderly in the U.S., then expand that to encompass the entire population. French medicine is based on a widely held value that the healthy should pay for care of the sick. Everyone has access to the same basic coverage through national insurance funds, to which every employer and employee contributes. The government picks up the tab for the unemployed who cannot gain coverage through a family member.
This is, of course, a report from a business publication rather than a political publication. Most of what we political wonks on-line look at are political publications and they focus on the he-said - he-said of party politics. The business publications have a focus on the bottom line, so they can sometimes report that one side or the other in an argument is right and the other is wrong. Providing health care to the population and to the workforce may be one of those situations. Read the rest of this report for a very interesting view on health care.

One more point - will the five conservative Catholics on Supreme Court vote to declare the mandatory buy-in required by the Affordable healthcare Act (ACA) is unconstitutional if the business community objects? Especially the health care companies who expect to get an additional 45 to 50 million paying customers under the ACA?

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