France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.
In recent months, France imposed American-style "co-pays" on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. "A hospital doesn't need to be money-losing to provide good-quality treatment," President Nicolas Sarkozy thundered in a recent speech to doctors.
It's often pointed out that France's health care system was ranked #1 (in 2001) by the WHO. And they have a better record of saving lives than the U.S. does. But in the meantime, the system is under water.
French taxpayers fund a state health insurer, Assurance Maladie, proportionally to their income, and patients get treatment even if they can't pay for it. France spends 11% of national output on health services, compared with 17% in the U.S., and routinely outranks the U.S. in infant mortality and some other health measures.
The problem is that Assurance Maladie has been in the red since 1989. This year the annual shortfall is expected to reach €9.4 billion ($13.5 billion), and €15 billion in 2010, or roughly 10% of its budget.
And this in spite of the fact that France's health care system got to where it is today via a very different path than the one Democrats are planning to drag the U.S. along. For one thing, France did it incrementally, over decades. And then there's this:
In France, "If you are in medical care for the money, you'd better change jobs," says Marc Lanfranchi, a general practitioner from Nancy, an eastern town. On the other hand, medical school is paid for by the government, and malpractice insurance is much cheaper.
Is that where we're heading? Government (i.e., the taxpayers) paying for medical school? As for med mal insurance, suffice it to say that France's legal system in general is very different from ours. In addition, France had its own version of "tort reform" several years ago that's, well, just downright alien.
Here's another difference.
Patients can choose their own doctors, and -- unlike the U.S., where private health insurers can have a say -- doctors can prescribe any therapy or drug without approval of the national health insurance.
So much for cost containment. Yes, the French are pretty happy with their health care system, they pay through the teeth for it and it's been bankrupt for more than a decade.
Anyway, read the whole thing. Compare and contrast. It's an interesting profile.
Hey, the distinguished panel on Fareed Zacharia's show this morning was bemoaning the fact that, while Europeans realistically "expect to die," Americans are less eager to capitulate to that particular reality (hence our wasteful spending in keeping people alive who by all rights ought to be out of our hair). This is exactly the mindset that's going to inform our health care decisions under Obamacare. Get ready to capitulate.
