http://www.examiner.com/x-6665-Liberal-Examiner~y2009m8d8-Health-Care-Reform-Series-The-French-health-care-systemAccording to the American Journal of Public Health, “In France, the commitment to universal coverage is accepted by the principal political parties and justified on grounds of solidarity – the notion that there should be mutual aid and cooperation between the sick and the well, the active and the inactive, and that health insurance should be financed on the basis of ability to pay, not actuarial risk.”
In the United States, our system is the exact opposite. If you get sick in America, there are people who will search your medical records in search of a reason to deny you coverage – sometimes retroactively. In America, insurers rely on the premiums of their healthy customers to subsidize their profits and advertising costs, as well as the administrative burdens behind their intense denials of care – indeed, we all pay more, so that the profit sector is able to withhold, delay, or deny payment in order to satisfy shareholder demands. The system is designed to deny care to those who need it the most, which is an inherent failure that the free market cannot, or will not address on its own.
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The French system offers extraordinarily comprehensive prenatal and early childhood care. In France, mothers and their children receive basic preventive care through a network of community-based health care facilities called Protection Maternelle et Infantile. Children are cared for by a team of pediatricians, nurses, midwives, psychologists, and social workers, and if a parent neglects to take their children in for regular checkups, a social worker will visit the family at home. Expectant mothers receive monetary rewards for attending their pre- and post-natal visits. Child care is also subsidized and affordable for working parents. As Daniel J. Pedersen, president of the Buffett Early Childhood Fund, notes “It’s based on the practical idea that high-quality investments made at the start of a child’s life will pay huge dividends to both the child and society in the future.”
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The NHI typically covers about 70 percent of health care costs. There are no deductibles, but moderate co-pays. In addition, more than 90 percent of the population subscribes to supplementary health insurance to cover these costs, as well as other benefits not covered under NHI. Chronic diseases and other critical ailments are reimbursed in full and cancer patients are treated for free. As mentioned above, in France, the more care you need, the less you pay.
In order to achieve such laudable results, the French pay more in taxes than Americans – about 21 percent of their income (employers pay half of that) – but they also receive far more for the tax dollars they pay. Beyond taxation, France has held down costs by negotiating far lower rates with physicians than their American counterparts receive – they earn about one-third of what US physicians do; about $55,000 per year. However, as Business Week points out, French doctors’ medical school is paid for by the state, malpractice premiums are a fraction of what they are in the U.S., and the government pays two-thirds of the social security tax for most physicians – a tax equivalent to 40 percent of income.
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