The U.S. health care system has increasingly been the topic of every household for almost two decades, since Bill Clinton’s promise to do something about the rising health care costs in the early 1990s. The World Health Organization (WHO), in a comprehensive study carried out in 2000, ranked the U.S. health care system as the highest in cost. Today, the U.S. system is still expensive for many citizens; according to The U.S. Census Bureau, approximately 47 million Americans are without medical coverage (Rayski, 2010). This paper seeks to take a critical view of the U.S. health care system by comparing it with the French system. In addition to health care costs, other issues have been identified, such as
The French Health Care system was chosen because of the increasing interest from a majority of health care experts who regard the French health care system as the model for United States. In addition, the French model has been on the limelight following the results of the 2000 World Health Organization’s ranking of the world’s health systems.
According to the WHO, France has the best health care system in the world, while the U.S. was ranked at number 37. The brilliant performance by France in the WHO rankings was because of various fronts, mainly: provision of universal coverage, responsive health care providers, patients’ freedom of choice, and the health of the population (Guilloton, 2009).
There are various similarities between the United States and the French health care systems. Both systems rely on private insurance as well as government insurance. This is despite the fact that complementary private insurance funds in France are very koosely regulated, in lower rates than in the U.S. In addition, in both systems, the insurance is provided through the employer.
In the French health care system, physicians are private, although patients are registered in national health insurance. The system is also government financed. This resembles the US system, taking the form of Medicare for all. Although in the French system the whole resident population is covered and the benefit package is greater, the system resembles Medicare and Social Security, because it is funded by enforced payroll taxes in addition to a number of income tax contributions. However, doctors work for the most part in private, office-based practices, and there is a mix up of public and private hospitals.
Physician Compensation is another subject that shows significant similarities between the French and the U.S. healthcare systems. The national health insurance system is in charge of paying French doctors, who are paid according to a centrally planned fee schedule, although doctors can charge their price. Notably, the fees are founded on an up front treatment scale, a similar method to DRGs in the United States system. The patient must structure the difference between the amount paid for by the universal health care system and the fee charged by the doctor.
Just like Americans, the French are against restrictions on patient choice. Some Americans consider the French to practice “socialized medicine”, which is not the case. The French system depends on independent private practitioners as opposed to a British-style national health service, a system regarded to as “socialized medicine.”
In France, everyone has health care. However, unlike in Britain and Canada, there are no waiting lists to get elective surgery or see a specialist, Dutton says. There is no explicit health care rationing in France. There are no waiting lists for specialized hospital treatments. There is very easy access, perhaps too easy, to specialized services. A
The French system has increasingly been moving towards control of the government. In France, there have been a variety of attempts in recent years to broaden government control of health care costs. In 1991, for example,the French government enlarged its Health Map system whereby it is in charge of the capital construction of all health care facilities as well as their budgets, the acquisition of medical equipment, and even the price of drugs. This resembles the US system, whereby the government has been rallying for total control of health care.
A major difference between the French health care system and the US is the fact that everyone in France has access to health insurance. Every legal citizen of France has the right to use health care, which is covered by the law of universal coverage called la Couverture maladie universelle. In the United States, access to health care is a challenging concept; according to a Consumer Reports study of the U.S. health care system, a total 40 percent of the citizens in the United States do not have adequate health insurance. This is because in America, as opposed to France, the federal government does not guarantee universal health care to all its citizens.
The issue of waiting times raises significant differences between the France and the US systems. Waiting times are a major concern in the United States, whether for a specialist, specialized treatments, or major elective surgery, for example hip replacement. One of the primary determinants of access to health care in the United States is accessibility to funding to pay for treatment and the availability of services in the area. These factors, in addition to the willingness of the health care provider to deliver service at the insurer’s set price, as well as rationing, have significantly increased waiting times. In France, however, the health care system has successfully managed to avoid waiting lists, because of , for example, the fairly high coinsurance charges.
There are significant differences in the reimbursement of doctors in both systems. In France, the government reimburses its physicians at a much low rate compared toU.S. physicians, while many doctors in France are free to prescribe any care they consider medically necessary. Nonetheless, French physicians do not have to pay back their crushing student loans since the state pays medical school. The average yearly net income for French physicians is $55,000, approximately a third of what the US physicians earn.
Technology also has notable differences between both systems. The United States, compared to France, spends more on technology. The French government does not fund new technologies as generously as is the case of the U.S. government. This is because of fee restrictions as well as global budgets, which provide little incentive to invest generously in medical technology. Besides technology differences, there is a significant difference in the way both systems control health care costs. It is important to note that the investor-owned insurance sector of France is much smaller compared to the United States sector. This is the same trend in the French system’s medical-industrial complex, which is much less powerful compared to the U.S.’s system.
The issue of universal coverage has made the French health care system a favorite. The French system should be on an upward trend away from centralized government control. Moreover, health care providers should consider introducing more market-oriented methods. This is an invaluable lesson to the health care problems of the United States; by considering the success of the French system, it is evident that centralized command and control is bound to lead to more problems. There are numerous benefits to be obtained from developing consumer incentives and choice.
A noteworthy feature of the French system is that the more serious one’s condition is, the more coverage one gets. Expensive illnesses such as cancer, mental illness and diabetes are efficiently covered by the government, an aspect which is uncommon in the United States. The high prevalent cases of Cancer in the U.S., particularly to the African Americans, are increasingly leading to condemnation of the health care system, because of the complications in providing for insurance coverage.
The issue of maternity benefits of the U.S system, compared to the French, makes the French system affordable and much welcome. In France, women take up to 16 weeks of mandatory, remunerated maternity leave from work, in addition to benefits such as financial supplements for homes with more than two children, nanny services as well as single parent allowances. These are important lessons for the U.S. to learn from. There should be a universal maternity benefits policy, which should counter the current system of unique company policies regarding maternity leave.
A French System That Would Work For Americans
In the recent past, health care has advanced in considerable ways. From progression in medical knowledge, to investment in equipment and drugs, the 21st century has set health care on a new level.
Today, treatments are more effective and quality of life and life expectancy have been enhanced. As a result, doctors and other health care providers have been faced with the challenge of keeping up to date. At present, in almost every country in the world, government policy plays a central role in health care. In regard to medical treatments and insurance, governments, either actively or passively, offer special legislative favor to interest entities.
Most Americans need a health care system that will unite the nation, in spite of gender, racial, religious, cultural, or political backgrounds. In relation to the U.S. system, the French health care system covers everyone, and its costs rise at a lower rate. see graph.
Both rely on private insurance as well as government insurance. In both systems, the insurance is provided through the employer-government financed. This resembles the US system, taking the form of Medicare for all
I think that the employer-based health-care system is good. However, it would be good if citizens who make too much money to qualify for Medicaid but cannot afford insurance, could get insurance. Maybe the government could raise the maximum wage requirements so these people would qualify. And the additional costs could be paid for by cutting the waste in the current Medicare and Medicaid systems.
I feel that it is good that America is the leader in technology (MRI scanners and etc) and that physicians and researchers are not limited by the government and that they have financial incentives.
Here are some sources that I found on the Internet. Thanks!