Why aren't we talking about the French Healthcare system?

[Peregrinator]

Here's my entry into the debate. I figured we needed yet another healthcare thread.

This is an article from the Boston Globe from 2007:

France's model healthcare system

By Paul V. Dutton | August 11, 2007

MANY advocates of a universal healthcare system in the United States look to Canada for their model. While the Canadian healthcare system has much to recommend it, there's another model that has been too long neglected. That is the healthcare system in France.

Although the French system faces many challenges, the World Health Organization rated it the best in the world in 2001 because of its universal coverage, responsive healthcare providers, patient and provider freedoms, and the health and longevity of the country's population. The United States ranked 37.

The French system is also not inexpensive. At $3,500 per capita it is one of the most costly in Europe, yet that is still far less than the $6,100 per person in the United States.

An understanding of how France came to its healthcare system would be instructive in any renewed debate in the United States.

That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.

Their freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled US counterparts envious. However, the average American physician earns more than five times the average US wage while the average French physician makes only about two times the average earnings of his or her compatriots. But the lower income of French physicians is allayed by two factors. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free. Thus, French physicians enter their careers with little if any debt and pay much lower malpractice insurance premiums.

Nor do France's doctors face the high nonmedical personnel payroll expenses that burden American physicians. Sécurité Sociale has created a standardized and speedy system for physician billing and patient reimbursement using electronic funds.

It's not uncommon to visit a French medical office and see no nonmedical personnel. What a concept. No back office army of billing specialists who do daily battle with insurers' arcane and constantly changing rules of payment.

Moreover, in contrast to Canada and Britain, there are no waiting lists for elective procedures and patients need not seek pre-authorizations. In other words, like in the United States, "rationing" is not a word that leaves the lips of hopeful politicians. How might the French case inform the US debate over healthcare reform?

National health insurance in France stands upon two grand historical bargains -- the first with doctors and a second with insurers.

Doctors only agreed to participate in compulsory health insurance if the law protected a patient's choice of practitioner and guaranteed physicians' control over medical decision-making. Given their current frustrations, America's doctors might finally be convinced to throw their support behind universal health insurance if it protected their professional judgment and created a sane system of billing and reimbursement.

French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new healthcare funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

The French system strongly discourages the kind of experience rating that occurs in the United States, making it more difficult for insurers to deny coverage for preexisting conditions or to those who are not in good health. In fact, in France, the sicker you are, the more coverage, care, and treatment you get. Would American insurance companies cut a comparable deal?

Like all healthcare systems, the French confront ongoing problems. Today French reformers' number one priority is to move health insurance financing away from payroll and wage levies because they hamper employers' willingness to hire. Instead, France is turning toward broad taxes on earned and unearned income alike to pay for healthcare.

American advocates of mandates on employers to provide health insurance should take note. The link between employment and health security is a historical artifact whose disadvantages now far outweigh its advantages. Economists estimate that between 25 and 45 percent of the US labor force is now job-locked. That is, employees make career decisions based on their need to maintain affordable health coverage or avoid exclusion based on a preexisting condition.

Perhaps it's time for us to take a closer look at French ideas about healthcare reform. They could become an import far less "foreign" and "unfriendly" than many here might initially imagine.

Paul V. Dutton is associate professor of history at Northern Arizona University and author of "Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France," which will be published in September.

What do you think? It seems to make sense to me.

 

[where]

I keep seeing this figure of $6,100 per capita spending on public health in the USA. How can you NOT have universal health care for that figure? I don't understand. Someone explain please.

 

[busybody..]

I dint read NO SHIT from WHO, a political organization of teh UN

whatever you do

dont get sick in France during the summer,

THE DR's AND NURSES are ALL ON VACATION and the HOSPITALS dont have AC

 

[Peregrinator]

I keep seeing this figure of $6,100 per capita spending on public health in the USA. How can you NOT have universal health care for that figure? I don't understand. Someone explain please.

That's a good question. I also heard it broken down that we have enough physicians here that we could assign each one of them (I think it was 15) a certain number of families to be responsible for, and every single citizen would have a personal doctor who wasn't overwhelmed. And with that kind of money, those docs would be paid quite well. If each of those families only had two people in it (deliberately lowballing), their doc would still make $183,000 a year. I could live on that.

 

[Peregrinator]

I dint read NO SHIT from WHO, a political organization of teh UN

whatever you do

dont get sick in France during the summer,

THE DR's AND NURSES are ALL ON VACATION and the HOSPITALS dont have AC

Read the article. It makes some excellent points, whether WHO is right or not.

All of Europe is on vacation in August. So what? That wouldn't happen here.

 

[where]

That's a good question. I also heard it broken down that we have enough physicians here that we could assign each one of them (I think it was 15) a certain number of families to be responsible for, and every single citizen would have a personal doctor who wasn't overwhelmed. And with that kind of money, those docs would be paid quite well. If each of those families only had two people in it (deliberately lowballing), their doc would still make $183,000 a year. I could live on that.

that's roughly what UK GPs make.

so where does all the money go?

 

[great lover]

Very interesting article Perg. Thanks for posting.

 

[Sean]

I keep seeing this figure of $6,100 per capita spending on public health in the USA. How can you NOT have universal health care for that figure? I don't understand. Someone explain please.

Because there are these wonderful organisations in the US called HMO's. Set up under the Nixon administration. Basically, they gouge the American public for every cent they can to provide health coverage, then do everything they can to deny treatment. These same HMOs have done such a fantastic PR job over the decades that any attempt to encroach on their obscene profiteering from others' misery is called Communism and scares the horses. Horses, in this case, being fucking retard American sheep.

 

[koalabear]

that's roughly what UK GPs make.

so where does all the money go?

The British Health Care System is the third largest employer in the world, only exceeded by the Red Army and Indian Rail. That is where all the money goes, to pay for the massive bureaucracy.

 

[Peregrinator]

that's roughly what UK GPs make.

so where does all the money go?

Because there are these wonderful organisations in the US called HMO's. Set up under the Nixon administration. Basically, they gouge the American public for every cent they can to provide health coverage, then do everything they can to deny treatment. These same HMOs have done such a fantastic PR job over the decades that any attempt to encroach on their obscene profiteering from others' misery is called Communism and scares the horses. Horses, in this case, being fucking retard American sheep.

There you go, Kyb. Our insurance system is insane. It's almost as bad as our pharma system. Both have gigantic well-funded lobbies.

Very interesting article Perg. Thanks for posting.

My pleasure.

 

[busybody..]

All of Europe is on vacation in August. So what? That wouldn't happen here.

when EVERYONE gets PAID the same, regardless of work effort

THEY WILL

DONT BE A DUMMY!

Pick up an ECONOMICS FOR DUMMIES book

 

[revelator]

I keep seeing this figure of $6,100 per capita spending on public health in the USA. How can you NOT have universal health care for that figure? I don't understand. Someone explain please.

Take my brother-in-law as an example. As the article mentioned, he graduated with quite a bit of student loan debt, and started earning $500,000 per year as an anesthesiologist.

Of course, that was 20 years ago. Today, due in large measure to pressure by the insurance industry, he makes 'only' $250,000.

He was pretty vocally against 'Hillarycare' in 1993. He's a lot more open to reform this time, because he realizes that the problem is the insurance industry, not the government.

 

[Peregrinator]

when EVERYONE gets PAID the same, regardless of work effort

THEY WILL

DONT BE A DUMMY!

Pick up an ECONOMICS FOR DUMMIES book

Why would everyone get paid the same?

 

[where]

Because there are these wonderful organisations in the US called HMO's. Set up under the Nixon administration. Basically, they gouge the American public for every cent they can to provide health coverage, then do everything they can to deny treatment. These same HMOs have done such a fantastic PR job over the decades that any attempt to encroach on their obscene profiteering from others' misery is called Communism and scares the horses. Horses, in this case, being fucking retard American sheep.

thank you

The British Health Care System is the third largest employer in the world, only exceeded by the Red Army and Indian Rail. That is where all the money goes, to pay for the massive bureaucracy.

I was talking about US health spending and your figures are out of date anyway.

 

[HB1965]

My guess is because we are too busy in this country worrying about becoming socialized rather than actually looking at real healthcare reform

 

[Sean]

The British Health Care System is the third largest employer in the world, only exceeded by the Red Army and Indian Rail. That is where all the money goes, to pay for the massive bureaucracy.

Source?

 

[where]

Source?

he googled it. Walmart has usurped em all.

Plus, we are talking about a service employing 1.3 million people to look after what... 66 million? How is that a bad thing?

 

[islandman]

Counter-point from a recent WSJ article

http://online.wsj.com/article/SB124958049241511735.html

France Fights Universal Care's High Cost.

Excerpt: The French system's fragile solvency shows how tough it is to provide universal coverage while controlling costs, the professed twin goals of President Barack Obama's proposed overhaul.

 

[Sean]

he googled it. Walmart has usurped em all

I Googled it as well. I got one article in a personnel mag and an unattributed answer on wikianswers.

 

[koalabear]

Source?

he googled it. Walmart has usurped em all.

Plus, we are talking about a service employing 1.3 million people to look after what... 66 million? How is that a bad thing?

I Googled it as well. I got one article in a personnel mag and an unattributed answer on wikianswers.

http://blogs.telegraph.co.uk/news/d...cans_Dont_copy_the_British_healthcare_system/

 

[Nigel]

when EVERYONE gets PAID the same, regardless of work effort

THEY WILL

DONT BE A DUMMY!

Pick up an ECONOMICS FOR DUMMIES book

Perhaps it is you who needs to read an Economics for Dummies book.

Everyone in Europe doesn't get paid the same. Now you're just being silly. Well...not just now. Most of the time. And it won't happen here.

For instance, do you know that doctors in England get paid a bonus when their overweight patients lose weight? When their patients who smoke, stop smoking? In other words, when preventative care is stressed and achieves results.

 

[Sean]

http://blogs.telegraph.co.uk/news/d...cans_Dont_copy_the_British_healthcare_system/

Ah, a blog from a right wing Tory MP.

 

[koalabear]

Ah, a blog from a right wing Tory MP.

I know Brits, who can you trust.

 

[where]

http://blogs.telegraph.co.uk/news/d...cans_Dont_copy_the_British_healthcare_system/

ermmmm... says nothing about the NHS being the third largest employer in the world...

here however... a PCT claims it having over 1 million employees.

http://www.newhampct.nhs.uk/detail.asp?ID=75

see? that's how you find creditable sources.

 

[busybody..]

Simple question

Knowing how the government works

On other projects and what not

WOULD YOU TRUST EM TO DO IT WELL?