So Why Don't We Steal the French Healthcare System?

rubegoldberg
This is my healthcare plan. It is much better than your stinky French one
(from here)

In a previous post, I wondered why we don't just steal someone else's healthcare system instead of inventing some untried and untested system. In TNR, Jonathan Cohn asks the same question (italics mine):

A closer model for the United States would be France, which doesn't have that problem and which--thankfully--also merits considerable screen time in Moore's movie. As Paul Dutton explains in a new book called Differential Diagnoses, the French prize individual liberty, so they created an insurance system that, today, allows free choice of doctor and offers highly advanced medical care to those who need it....

All of this does cost money, naturally, and Moore acknowledges what many assume is the French system's big drawback: its high taxes. But Moore also provides the same answer that any good policy wonk (including yours truly) would: They pay more in taxes but less in private insurance. In fact, the French system, like every other one in the rest of the developed world, costs less than ours overall.

The French like their system a lot--more than the citizens of any other country, including the United States, if you believe the opinion polls. The World Health Organization likes it a lot, too: It has ranked France's system tops in the world. But that isn't stopping critics from attacking it. In a pre-buttal of Sicko that appeared in the New York Post, the Cato Institute's Michael Tanner warned last week that Moore missed the real problem in France: its shortage of high-tech care.

This was news to me. I spent a lot of time researching France when I wrote my book, and I never heard anything about shortages of high-tech care. I asked Victor Rodwin of New York University, this country's leading expert on the French health care system, if he had ever heard of such shortages. He hadn't, either.

In the interest of fairness, I decided I would ask Tanner himself: What was his evidence? He said the French government was starting to tighten access to specialists. Well, sure--but it's still a far cry from what managed care has done in this country for years. He also said that France has fewer MRIs and CT scanners than the United States, which is very true and very irrelevant. Most experts think we have far more than we need here. If there were real shortages in France, there would be long queues to use them, and there's no evidence of this, either.

Well, that wouldn't be the first time a professional conservative makes something up to fit a preconceived notion. It still seems like the French are doing it better.

an aside: If playing the exceptionalism card is what it takes to get national healthcare, then, to steal Dan Rather's phrase, where do I sign up?

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Yes, we spend more on healthcare than most other first world countries. But it isn't because it necessarily costs more to get the minimum care people need.

If you went to a country where the only food was government issued rations, and you were only allowed a certain amount of food, then yes, you would spend a lot less money on food. (These rations are all that is necessary to keep you at a normal health and weight. No skimping, but no excess, either)

But then you look at the US, and you say "boy, people spend a lot of money on food! Their feeding system must suck!"

Of course, people are spending money on expensive foods, luxury foods, etc. They eat out. There's a huge diversity in food. And yet, the poorest people seem to getting food alright, and basics such as bread and dairy products are much cheaper than anywhere else in the world. So it isn't that food is more expensive, it's that people are buying more than they need, or at least more than the gov't says they need.

It's a similar thing for healthcare here. People spend a lot of money on a lot of procedures that aren't approved in other countries, and they have routine procedures like cancer screening earlier and more frequently (which is why the rate of death for prostate cancer is 60% higher in than in the US). Of course we spend more.

Of course, I'm not saying that our healthcare system is anywhere close to as good as our food system. It
needs a lot of fixing. But saying that Americans spend a greater percentage of their GDP on healthcare than any other first world nation is not nessecarily indicative of a problem.

"US" should be "UK". Death rates for all cancers in the UK are much higher, because they screen less frequently and later. Sometimes too late.

I hope Renee understands what the poverty stricken of America actually eat on a daily basis. For a few years we got a box of food from a local charity once a month. As a child I went hungry over a 3-day school weekend, and didn't realize it until I started to dry heave Sunday afternoon. We ate the last can of creamed corn with a packet of saltines (corn casserole) a week or so before that, and all I had during that time was free school lunches. But that would be the definition of 'alright'.

That is the issue here, that the basic health care needs are not being met for all of us, certainly not in the same way. The idea is for taxes to support the necessary checkups and procedures for all people, and leave the wealthy to pay for their plastic surgery and quintuplet preemies.

My younger brother lost his job mopping floors at a chemical plant recently. He had a bad cut on his ear that needed stitches. They gave him time off while the wound healed, because he couldn't go to the plant with the stitches in. Since he didn't have $70 to go to the doctor and get them removed, he did it himself. Without a release from the doctor, he couldn't be allowed back on the job. That's how impoverished Americans pay for basic health care.

If cancer death rates are higher in other developed countries, why are their life expectancies higher than the US's? There are several ways to address the national healthcare problem in the US. One is to tax food; most likely "unhealthy food". How that is determined I will leave to the FDA as an exercise, and they will most likely botch it. Anyway, you can then use the taxes to pay for healthcare. Another way is to have the gov't pay for front end care aka preventative medicine in full, in hopes that people take advantage of it and are less ill down the line. Of course, there are always injuries from car accidents and such, so mandatory insurance would be the law, but it should be cheaper, since insurance companies only have to worry about catastrophic injury. The third would be to have the gov't pay for back end, or imperative corrective medicine, such as surgeries. That will be expensive, and the gov't will have to decide which procedures they will and won't cover. Someone will have their taxes raised. Unfortunately, people will not take advantage of preventative care since they will have to pay for it out of pocket, so more problems later.

"But saying that Americans spend a greater percentage of their GDP on healthcare than any other first world nation is not nessecarily indicative of a problem."

I'm not sure this is exactly what is meant by the French spending less on health care than us. I seem to remember reading some comparison of what the US and other nations GET for the amount of money spent (somewhere in this blog maybe). and that we're getting less for what we spend (because a lot of it is going to having an army of people in insurance companies arguing with an army of billing people at clinics about what will be paid for).

By Michael Schmidt (not verified) on 29 Jun 2007 #permalink

Bottom line on USA's health care:

We spend nearly twice as much as do Canada, France, or Germany, and more than twice as much as the UK, Japan, Sweden, New Zealand, or Australia.

We don't cover more than 10% of our population.

We spend over 30% of our healthcare dollars on administration; while single payer systems spend less than 10%. This means that right off the top we throw away over 20% of our healthcare dollars.

Any problems the other systems have could rather easily be taken care of by doubling their spending, putting them where our spending is. And by the vast majority of measures all those other systems (esp. France and Germany) do better than the USA. All have less infant mortality, longer livespans.

Why are we satisifed paying twice as much and getting less? It's like paying going to a card dealer, paying for a Porsche and getting a Hyundai; would you stand for that? Why stand for it when it's your health?

From my experience French doctors are generally excellent. They also seem to have very good specialists. If you go privately the cost is often about 40% of what you would pay in the USA.

I know this may sound contradictory to many of you, but I am a staunch Republican who has always believed in the need for universal health care in our country. I am so glad that Michael Moore and all of the Democratic candidates for President in 2008 are raising the level of discussion once more about this need.

I would very much like to join a group of fellow Republicans who support the need for univeral health care, however, I have been unable to locate any such group through internet searches. If one doesn't exist, then I would be happy to help create one! Please let me know if anyone reading this posting knows of such a group, or would like to create one.

By Tom Jones (not verified) on 01 Jul 2007 #permalink

Jane Galt explains what is wrong with comparisons between American and French and Canadian systems.

Of course, people are spending money on expensive foods, luxury foods, etc. They eat out. There's a huge diversity in food. And yet, the poorest people seem to getting food alright, and basics such as bread and dairy products are much cheaper than anywhere else in the world. So it isn't that food is more expensive, it's that people are buying more than they need, or at least more than the gov't says they need.

I know this may sound contradictory to many of you, but I am a staunch Republican who has always believed in the need for universal health care in our country. I am so glad that Michael Moore and all of the Democratic candidates for President in 2008 are raising the level of discussion once more about this need

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