HEALTH CARE: France Does It Best
Everybody tuning into the health care debate knows the U.S. is the only wealthy, industrialized nation that does not ensure that all citizens have medical coverage, and by no coincidence, ranks below all the other advanced nations in overall performance and level of health. What is not so well known is that France, ranked as the number 1 health system by the World Health Organization (WHO) in 2000 (the last time they issued such rankings), spent $3,554 per person on health care in 2006, compared with $6,714 in the United States, the highest in the world, according to WHO.
For all the money the U.S. spends on healthcare, it only manages to rank 37th in the world (between Costa Rica and Slovenia) in overall performance, and 72nd by overall level of health (among 191 member nations included in the WHO study). France spends 11.2% of GDP on health care, far less than the 15.2% spent in the U.S.. Yet Frenchmen live on average two years longer than American men do, and Frenchwomen live four years longer. The adult mortality rate in 2006 (probability of dying between 15 to 60 years) was 9.1% in France, 10.9% in the U.S. in 2006, a difference of nearly 20%. The infant mortality rate in France is 43 percent lower than in the United States, which has the highest rate of all developed countries. The U.S. has 26 physicians for every 10,000 people, France has 34, proportionately 30% more.
I’m willing to bet that if the same end-result comparisons were made between the French population, all of whom are covered by national health service, and the segment of the U.S. population covered by adequate health insurance, the results would be much closer. Whether the U.S. would come out ahead is still unlikely, given the French system's greater emphasis on preventive care and the largely unproductive allocation of 31% of U.S. health care expenditures to administrative costs (compared to about 3% for Medicare). I understand that within the U.S. health care system there are more workers providing administrative services than are providing health care. (Does anyone have the statistics on this?) The main function of administrators in private insurance companies seems oriented toward boosting the company’s bottom line through policies calculated to “delay, deny and deceive.” If profit and, not incidentally, outsized compensation of top insurance company executives, are the organization’s driving motivations, then these objectives are most readily achieved by maximizing the price of coverage and minimizing the claims paid. Hmm. What's wrong with this picture? Check out http://www.brasschecktv.com/page/321.html for a sobering assessment of the U.S. health-care insurance industry.
The major difference between the French and the U.S. health care systems, of course, is that the French provide universal, government-run (horrors ‘socialized’) health care whereas the U.S. offers government paid care only to individuals over the age of 65 or disabled through Medicare, to qualified military veterans through the Veterans Administration, to Native Americans from recognized tribes through the Indian Health Services, and to indigents through Medicaid and companion state programs. In France, the national healthcare system accounts for 80% of total health care expenditures, with the remaining 20% expended on private medical services. Health care paid for by the government in the U.S. accounts for nearly half the country’s medical expenses covering 83 million individuals, 27.8% of the population, in 2007, mostly about equally divided between Medicare and Medicaid, according to the Census Bureau (http://www.census.gov/hhes/www/hlthins/hlthin07/hlth07asc.html). Medicare and Medicaid are “single payer” (the Government) and not “socialized medicine” inasmuch as the care providers are private, rather than government employees, as in France.
The remaining 72.2% of the American population is left to fend for itself, including 202 million covered by private health insurance and about 47-50 million uninsured, roughly one in five of those not covered by the government.
With Americans always ready to adopt “best industry practices” in order to maintain their competitiveness, why don’t they do so in health care and borrow from the French?