"I'll probably get flamed for this, but, having experienced both, I prefer the health care system in France. People back home are truly surprised when I tell them how efficient and patient-friendly it is."
No flame intended, but you're missing the point. If the medical system in France is just terrific, wonderful. But it has to be paid for one way or another. Either the individual pays for it out of his own pocket or the government picks said pocket-taxes-and pays for it. The disadvantage of the latter is that the individual who takes care of himself has to help bear the burden of those who don't. There is no free medical care any more than there is a free lunch.
I understand that. But I'd always heard horror stories about "socialized medicine" and wasn't quite sure of the quality of health care that I would receive after I moved to France.
Incidentally, it's a combination of the government picking our pockets and us paying for it ourselves. The government pays a portion of most things and the rest is paid by the patient. Well, we pay the doctor and the government reimburses us via direct deposit into our bank account within several days of the doctor visit. We have supplemental insurance that reimburses us for almost everything (if not everything) that the government does not pay for, including vision and dental.
"No flame intended, but you're missing the point. If the medical system in France is just terrific, wonderful. But it has to be paid for one way or another. Either the individual pays for it out of his own pocket or the government picks said pocket-taxes-and pays for it. The disadvantage of the latter is that the individual who takes care of himself has to help bear the burden of those who don't. There is no free medical care any more than there is a free lunch."
This is true, but there are ways to compare the costs of medical systems. France has a private health care provider system, with universal public health insurance. America has a private health care provider system, with partial public health insurance for retirees (Medicare), partial public health insurance for the poor (Medicaid), private health insurance, and 40 million uninsured.
The direct comparison of quality can be made by comparing results, such as infant mortality, or life expectancy, or survival rates from major illnesses. France has better infant mortality and life expectancy than America does, and comparable rates of survival. So, the two systems are of comparable quality, or the French system is better at some things, the American, at others, depending on how finely one wishes to screen it. Given relatively equal outcomes overall, one can then look straight to the PERCENTAGE OF GDP SPENT ON HEALTH CARE.
And here, it is not close.
The French and American systems have approximately the same standard of care.
But France's system of health insurance finance causes French health care costs per capita to be 10% of GDP.
The US spends 16% of GDP for a comparable or lower standard of care.
Alors: the conclusion one can draw is that the French are much better businessmen, and have much greater economic skill and understanding when it comes to medicine, because they do the same thing the Americans do, at less than half the costs.
Yes, there is a price to be paid for health care.
And in France, that price is smaller than the US.
So, should the US adopt the French system?
Logically, yes.
But America CAN'T.
Structurally and psychologically, Americans cannot tolerate that sort of massive concentration of power and money into government. Also, there is no particular reason to believe that the American government health care agencies would be as competent as the French government agencies are, again for cultural reasons.
In France, the very highest and most prestigious positions in the society are...the top jobs in the Civil Service! And so, in France, the best and the brightest in the country actually aspire and compete for the Civil Service School (ENA - the Ecole Nationale d'Administration). In France, "Harvard" is like a French "Annapolis" for Civil Servants.
So, those who, in America, would be aspiring to be hired by Goldman Sachs out of Harvard Business School, are instead dreaming of one day being the Minister of Health, or the Minister of Finance.
Wherever you concentrate your best intellectual capital you have the best results, and France concentrates its intellectual capital very heavily into government.
America, um, DOESN'T.
What that means, in a nutshell, is that the French Minister of Health is someone who would be, in America, the equivalent of a graduate of the Wharton Business School and Harvard's John F. Kennedy School of Government who runs Goldman Sachs, something like that. But the head of the American Health Care Financing Administration and his staff are, no doubt, well-meaning people, but they are not the elite intellects of society.
This is another reason why the two systems are not translatable. France has a royal monarchical tradition. Service to the State is the highest and most prestigious service, and the French routinely trade higher incomes for greater prestige in the civil service. Americans are the opposite.
In America, health care finance is largely done by senior doctors who have moved up to the role of administrators of hospitals and programs. To the French, this would be exceedingly strange. A senior doctor is the most skilled surgeon. Surely, he should be doing MORE operations, not less, and spending his time in the operating room with students, so he can pass along his superior skills. What the hell does he know about running financial programs and negotiating business contracts for equipment and janitor services. Indeed, why the hell would he even WANT to do that, given that he chose to be a medicine man and not an administrator or businessman.
But that is French thinking, where everyone is a specialist.
Anyway, the bottom line is that I don't think the original poster was missing the point. The French health system is terrific, and has the same or better results across the board than the American system, and it costs 55% LESS than the American system. It's simply better.
Now, can the AMERICANS learn from the French here?
I am skeptical. I think that giving American civil servants that sort of power would be a recipe for calamity. America is not France, and France is not America, and it's not simply a difference in money, but in mindset. Now, if the American MILITARY were to run things, yes. Because that is comparable. The American professional military out of Annapolis and West Point have that level of professionalism and non-economic committment that the French out of the Civil Service School have. But could the Civil Service mindset be transplanted to America? God no! It's contrary to the American people's whole ethos. Can American-style employment-at-will doctrine be transplanted to France? God no! French bosses would turn the workplace into the tyranny that it used be in France before the labor laws.
"East is East, and West is West, and ne'er the twain shall meet." - Rudyard Kipling.