The word “socialized” freaks out a lot of people who right away associates it with government-control, no freedom of choice, and basically bordering if not entirely to the communist annotation. When it comes to health care coverage, it is not quite so. Indeed, Americans tend to compare their health care with Canada’s or Great Britain’s, and the Democrats laud it whereas the Republicans criticize it. A better comparison would be France’s health care coverage, which is number one worldwide, with 62 millions citizens healthier than in the rest of the world, with Britain’s rating at 18 and the U.S. graded number 37 with 47 millions Americans without health care coverage.
To set the record straight, French detest and distrust socialized medicine, as it is understood by many, and demand patient’s choice, independent physicians and medical practice freedom, just like their American counterparts. For them “socialized medicine” is what Britain and Canada offer to their citizens, where they cannot choose their doctors, they cannot obtain certain medications and are oftentimes refused certain procedures because they are too expensive. In Britain, for example, there is an annual quota that doctors and dentists must reach after which they cannot see any more patients because the National Health Service will not pay them for extra work.
Just like in the U.S., France healthcare system relies on both the government, - where both the employers and the employees contribute to it via the payroll and income taxes - and the private insurance (police complementaire purchased by 90% of the French.)
The NHI (National Health Insurance) pays 70% of health care and the private insurances the remainder of 30% not covered by NHI. “A May 15, 2007 study from the Commonwealth Fund found that the U.S. ranks last in quality, access, efficiency, equity and healthy lives.”(1)
French healthcare system provides a wide choice of general practitioners and specialists.
They all have access to basic health –preventative – care. Their emergency health care system is the swiftest and most efficient: you can be in and out within 90 minutes with no paperwork, no forms, no third degree interrogation regarding your insurance coverage and no signature required at all. Their main concern is to see you, evaluate the emergency, treat you and send you home. All they ask is your name.
It is a fact that French taxes are higher than in the U.S., but if you compare our tax rates with the level of expenses for health care per capita, you will find that the U.S. spends $6,400/person whereas France spends only $3,300. Indeed, 20% of a French worker salary goes toward the health care funds but look at what he gets in return for him and his family. If you do the math, you will see that you get much more for your money in France than in our country. Granted we have the HMO, PPO and so on, and they are great, up to a point. If you need a special medication and it is not on their list, you will have to pay full price which oftentimes comes in the 3 digits or even 4; your co-pay increases as your medical needs increase. Surgical procedures are sometimes refused. The sicker you are the less you get and forget about private insurances which all have waivers for pre-existing conditions.
In France, the sicker you are the more you get and the less you pay. For those who have one of the 30 chronic and/or acute illnesses, such as diabetes, cancer and heart disease, and for those that require long-term care, they do not have to spend a penny. They are 100% covered. Even new mothers have paid help by visiting nurses and pediatricians. Nursing care at home is covered at 70%. One caveat though is that the patient must pay up-front at the time of visit and the NHI reimburses according to their breakdown. And here is a short summary of these coverage rates:
| GP/Specialists: |
70% |
| Major surgery: |
95% |
| Minor surgery: |
80% |
| Pregnancy/childbirth: |
95-100% |
| Medications vary: |
15-35-65% |
As of January 2008 though, President Sarkozy has made some changes in an effort to revert the $9 billion deficit (even though it is lower than last year) and patients will start being charged for some of the drugs, the ambulance costs and other services.
I am not saying let’s copy the French healthcare system, but it wouldn’t be a bad idea to emulate some of it even it means raising the taxes in exchange for “universal health coverage” as our presidential candidates call it, and give complete access to all avenues of care and treatment for each and every one American throughout the whole economical spectrum.
(1): Capell, Kerry. Business Week, June 13, 2007
WOULD SOCIALIZED HEALTHCARE BE AN ANSWER?
By Johana Nadler