Skip to comments.Vive Le French Care? (IBD Exclusive Series: Government-Run Healthcare: A Prescription For Failure)
Posted on 08/26/2009 5:33:10 PM PDT by Kaslin
Health Systems: Health care in France is often held up as a model the U.S. might follow. Yet the French have their own problems that show there's no such thing as a free lunch or a free doctor's visit.
As City Journal contributing editor Guy Sorman notes, the French would also love to have the low-cost, high-service system some Americans gush about. Unfortunately, they don't. France's system isn't that cheap and is financed by high taxes on labor that have heavy economic consequences.
Sorman notes that a Frenchman making a monthly salary of 3,000 euros has 350 of them deducted for health insurance. Then the employer throws in an additional 1,200 euros. This raises the cost of labor to prohibitive levels and puts a brake on economic growth. This helps explain why French unemployment hovers around 10%.
France imposes an additional tax levy to cover the constant deficits that national health insurance runs.
The French Parliament raises this levy, which applies to all forms of income, every year. Altogether, Sorman writes, "25% of French national income goes toward what's called Social Security, which includes health care and basic retirement pensions for all."
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I saw on CBS news that French doctors earn between $50,000 and $100,000.
Can’t see that happening here unless we want the worst of the worst.
Thanks for posting
A left-wing retired history professor in my town recently wrote a letter to the editor of the local newspaper extolling the supposed advantages of French health care. Thanks to you I now have some info I can use when I respond with my own letter.
The French Health Care System has been in a downward spiral for many years.
There does, exist, however, a parallel system of private health care, private physicians, and private hospitals.
*** FRENCH POLITICS AND CULTURE PING LIST *** FREEPMAIL ME IF YOU WANT TO JOIN ***
I’ll know America, ‘land of the free, home of the brave’, is toast when I get my next checkup performed by a civil servant.
It’s hard to believe this is happening in my country.
I think of all the boys that died for American freedom. What a waste it will be.
I’m probably the only person here on FR who has used, heavily,
- the best Private health plan in the US
- socialized medicine in France (I’m French also, and live in Paris)
- private clinics here in Paris
- public HMOs and private under-the-table pediatricians and obstetricians in the Middle East
Obviously all my anecdotes are highly personal, and I wouldn’t share many of them on FR (even though I love the rough and tumble of the forum here.)
My bottom-line feeling is that there is a certain discipline and education that makes each system work for its population.
In France, for example, most private doctors do not have any staff! That means, that when they are taking care of you and the phone rings, they answer it! They type or hand write their own letters of referral, and they take your ‘Carte Vitale’ for payment. (only paying around 65% of the visit, and either out of pocket or a PRIVATE health insurance add-on covering the rest!) No Frenchie is going to get all huffy when the doctor takes a call during his examination. (like that plastic bag event, all Frenchies shop with their own shopping bags, in the US people stormed out of stores, offended that bags were no longer provided!)
The waste in time, staff, paper-work is shocking for me when I go back to the States. Example: The requisite nurse entering the examination room to avoid lawsuits of sexual impropriety in the States! (I was actually a bit shy when I first visited my first French doctor, and there is no big separate dressing room, etc.) You’re just supposed to take off whatever clothing necessary and climb on up!
That said, their training is AMAZING, their cross-knowledge, their national competitive exams excluding the moneyed and only allowing the most qualified...
Of course, the cutting edge medicine is to be found in the States, due to the financial winnings and private enterprise, although, sometimes the simple answers are the right ones, and they are often overlooked in the US.
Another topical personal story. Under-performing nursing infant. Not gaining, etc. So, the French doctor takes the baby, down to the diaper, weighs her, tells me to go nurse and come back in 15-20 minutes, weighs her again and tells me that despite my best efforts, I don’t have enough milk and forget about exclusively nursing, I must supplement with bottles. This back-to-basics is typically French.
My personal, almost 30 years of experience as a customer leads me to diagnose:
In the US, forget about nationalizing, just get the job-provided health insurance revoked and have the populace negotiate directly with private health insurers. The market works.
In France, (obviously absent real numbers, as the national budget is beyond my knowledge), nationalization works, people don’t expect champagne service on a beer budget, Sarkozy has made many co-pay provisions, ie: generic incentives, that affect demand. People are just too used to the State providing, and they still perform absent the personal fear of failure. Life is slow, a pleasure. People get up for work, do their best, have State mandated (!) continuing education in their field, and love to do their jobs well. There is a PRIDE in doing ones job well. Even waiters! (required reading: 60 million French-men Can’t All Be Wrong.’)
What can I add?
Hi there! Thanks for the ping!
Here I am, back in Paris for the ‘Rentrée Scolaire’, and going to all the pre-rentrée dentist, Optomotrist, doctor visits,etc. and you ping me!
Please read my above post, and I’d love to continue this discussion. I have stories to tell!
Isn't it astounding that 'average people', aka town hall attendees all over America, can see this obvious solution but our elected representatives cannot see it!
I once had to see a professor at a hospital here. He is the head of the department, and it is true that I had to wait months. (not emergency, elective.)
Anyway, we were talking about the US, and he says that he loves to visit, especially Chicago where he has family.
Then, knowing his celebrity clientele I asked him why he doesn’t move to the States. And he said that he is very happy with his situation with the hospital and the extra money doesn’t appeal to him. He has generous vacations and a nice enough house in the suburbs of Paris.
There really is this feeling of good is good enough, and life-style is more than income. I am not advocating one over the other, as I think you can tell I love both!
And did this head of the department make the average $50,000 to $100,000?
I have an acquaintance, a woman in Montreal. She had to wait 3 months for a gynecological exam. I can see that going over big in the US. I wonder how long the French wait for a cat scan. I needed one last month. I had an appointment the next day.
I can see GP’s being more accepting of this socialist style of medicine but I have a hard time thinking specialists would be thrilled about it. Or that the best and the brightest would go into medicine to make the salary of a teacher.
Well, really it’s more complicated than that.
First of all, no US medical student could, you’re right.
In France, medical school is free. Entry is very difficult and students must pass a national competitive exam. Thus, no student loans.
Ditto with the lawsuit issue. There is just no lottery win/ malpractice suit culture here.
Now as for this professor, I agree he probably makes more, but not much. It is very difficult to compare quality-of-life scales between two countries. Much of what Americans need a high income for are available for the masses here.
For example, in Paris the public parks are STUNNING. Sundays are often a trip to a park and a family picnic. Very cheap.
Additionally, I’ve been following Mark Steyn for years, and his telling of Canada’s health-care system is nightmarish, granted. I will say though that this is not the situation in France. I’ve had top notch CAT scans, X-Rays, etc. on a moment’s notice. Some of the periphery stuff is not the same, like for example, your results are simply handed to you, with an initial diagnostic of the lab doctor. Then you take your own scan/x-ray to whichever doctor you’d like.
As I said originally, I really have decades of experience with both, and absent the full budget of France’s ‘Securité Sociale’ it’s impossible to know the real cost, but I can say that there is little to no waste, great realistic care, comprehensive care... stuff like, after childbirth the woman is covered for ‘re-education’ of muscles. Nothing like this AT ALL is offered in the US.
Also, it’s odd to say, but there was a time when I had a great private insurance in the States, but still qualified for Medicaid. (overlap)
Anyway, I found the medicaid clinics much more efficient for vaccinations. The time-waste and ‘tra-la-la’ in private pediatrician’s offices was annoying. The city clinics wouldn’t make you go through this big complicated ceremony, you just handed in your vaccination record and voilà! Ten minutes!
I’ll have to go back to my first point, and that is that I’m the LAST person to want to see socialized medicine in the US. There is just something about the French culture that has government functionaries really educated. There must be ‘death panels’ here, I’m not stupid. My husband had an uncle who had cancer, and he was not initially offered all the cutting edge treatments. He also did not follow up on all the possibilities of treatment, but like everywhere the family has to get involved and educate themselves.
How many people in the US really have top-notch care? I went the HMO route also! This isn’t rationed care to you?
Abortion (IVG) is legal in France only during the first trimester of pregnancy.
If that were the case in the US, thousands of babies would be saved, and abortion would no longer be such a hot political football issue.
I saw on a CBS summary that you have to be a French citizen to get the free care. And like you said the doctors can’t be sued for obscene amounts like they were a lottery ticket.
The CBS report also said they are working with a 10 billion dollar deficit (I think I remember the figure correctly).
The French population is much smaller and less diverse than ours. Our social problems are not theirs. So I don’t see how it would be possible to use them as a model.
Thanks for sharing your experience.
I lived in France for 12 years, and observed that everyone who had the means went to private doctors, private clinics, or the American Hospital in Paris.In many cases, they fly to the US to see our doctors, who are the best trained in the world, and have access to the latest in technology and treatments.
In a doctor’s office, which is usually very nicely done up, there is always a nurse in uniform, to assist you and be with you during an exam.
France has many wonderful attributes, but mass, impersonal and shabby national health care is not among them. Their use of handwritten whatever in this age of advanced technology is a disgrace.
Ditto for dental care. If you need root canal surgery, the non-private dentist will pull the tooth, not save it, as is done in the US. The dentists I used in France were all French, and specialists who did their advanced training in the US. The Secu (national health service) only reimburses you as if the dentist worked on you for 20 minutes, the time it takes to extract a tooth, instead of the 4 plus hours it takes to do root canal surgery.
In America, getting into Medical School, and completing the four years (after completing a four year university degree) is an intensely competitive process, which accepts only the highest grades and scores on the MCAT. This idea you have that it is somehow limited to the rich and privileged is just not true. If a qualified student cannot pay the fees, loans and scholarships are available.
In NYC the guy who sells Metro Cards in the Subway makes $50,000 a year. Most doctors don’t even start to earn a living until they are 32, having put in four years of university,four years of Medical School, a one or two year internship, and a 2-5 year residency. I believe they should be compensated accordingly.
In France, they also expect you to bag your own groceries at the the supermarket, and there is no service with a smile as there is here in the US.
We are not France, and by he Grace of God, I pray it stays that way.
One must then pose this question:
It is obvious that the American people, by a large margin, do not want ObamaCare. Why, in the face of this obvious rejection, do the Dems keep pushing ahead to ram through their plan, without bi-partisan support, and totally without support of the American people?
The role of the government is to respond to the will of the people, not the other way around.
“In France, medical school is free. Entry is very difficult and students must pass a national competitive exam”
There are many states like New York that do have Medical School which are free. All Medical Schools in the US are of an excellent level.
All prospective students must take the Medical College Admission Test (MCAT), a highly competetive, long, extensive exam. Passing ther MCAT is not good enough. It is only the top 10-15 % who are accepted into Medical School. Medical School is the most highly competitive, most difficult professional school to get into.
You are correct. The french system, Securite Sociale is going broke, and has been running at a deficit for the last 20 years.
You don’t have to be a French citizen, but you do have to have a Carte de Sejour, the equivalent of a Green Card here. ie, you can’t be an illegal resident and get free medical care. Studcent from abroad are also eligible, but have to buy a Mutuelle, an sort of supplement that you pay for
Doctors can’t be sued, which alsdo means you have no recourse if a doctor or hospital screws up or is negligent.
IMO Tort Reform is absolutely essential to bringing the cost of health care down for all. Texas has done very well with capping the amounts in malpractice lawsuit
Tort Reform in the US must try and eliminate the frivolous and baseless lawsuits. But as a consumer of medical services, one has to have recourse.
The will of the people gets to speak every two years. We are not a democracy, but a representative republic, and our elected representatives are tasked with voting in the best interests of their constituents and the country. That may not necessarily be what their constituents want on any given issue.
To answer your question: the Dems are Socialist. They want Power over the ‘little’ people.
I am watching the Clarence Thomas hearings on old videotapes - because there is nothing interesting on tv this week.
It is fascinating to see Biden, Kennedy, and Leahy were just as snarky then as they have continued to be for decades. The dialogue, however, is much better than today’s farces of congressional hearings. Clarence Thomas talked circles around them.
Why did the whackos want CO2 declared a pollutant?
You seem to have soured on your France-memories since the last time we spoke!
I’m so surprised about your post, I mean I hope it’s clear that I’m the last person to want socialized medicine in the US.
That said, almost nothing you write in your post fits with what I’ve personally experienced since 2001.
Perhaps things have changed since you lived here?
I only know ONE person who gave birth in the American Hospital of Paris, and that was a friend of mine who had recently married and moved to France and didn’t speak French yet. My daughter is now due to give birth and has registered in Hopital Tenon (20ème). My other daughter will also give birth in a hospital in the 19ème.
I have such experience with dentists here, and ONLY the emergency office SOS DENTISTS have ever pulled a tooth! What on earth are you referring to? Root Canals!? I’ve had two here (they took 45 minutes, not 4 hours!, and they are fast, painless, and crown are 1/5 the price! If I move back to the US, I will come HERE for dental work! (I once asked my dentist here how is it that in the US a root canal takes multiple visits, and she answered that they probably bill per visit, not procedure, so they drag it out.) In any case, perhaps my US dental anecdote is dated, because I’ve been in France since 2001. (I think your first-person French info is also dated...)
Also, what’s that with avoiding the real issue of heavy student loans needed to pay for medical school?
Anyway, please re-read my TWO posts. You’ll see that I’m not advocating changing the US system, (besides taking employers out of the middle-man role!), I’m just saying that there is really amazing medical care here too. Fast, efficient, complete.
Of course, in the US, doctors should be able to earn a living in relation to the expertise and training they invest.
It’s true, you must be part of the European Union.
I DIDN’T SAY THAT WE SHOULD USE THE FRENCH SYSTEM AS A MODEL!
I said the opposite.
Of course there is a ‘deficit’, it is a government program, not a money-making business. This is one of the COSTS of government in a Socialized system, duh.
My only point is that it is GOOD, not horrible like we read about in Canada.
What happened here in FR, subtle points can no longer be made?
I didn’t think I said anything that deserved caps.
Nice talking to you.