Health Care: France spends less, does better

France spent $3,464 per person on health care in 2004, compared with $6,096 in the United States, according to the World Health Organization. Yet Frenchmen live on average two years longer than American men do, and Frenchwomen live four years longer. The infant mortality rate in France is 43 percent lower than in the United States.

Statistics like these are often used to condemn the U.S. healthcare system as both wasteful and less effective than its French counterpart. However, if we were to get behind these statistics we might learn that the U.S. health care is not so much wasteful or less effective as mal-distributed.

I suspect what we would find is that French expenditures on health care through their universal health care system are fairly evenly distributed across the population, while U.S. expenditures on health care are wildly skewed in direct proportion to income. With a disproportionate share of the U.S. $6,096/person going to the insured higher income earners, low-income earners receive a far lower amount and quality of health care if any. According to the Census Bureau, 36% of the families living below the poverty have no health insurance. Overall, some 45 million U.S. residents have no health insurance (13/2% of U.S.-born residents and 33.8% of foreign-born residents), producing a higher incidence of fatal diseases and infant mortality within the uninsured segment of the population, which, in turn, shows up in the unfavorable overall comparisons with the French system.

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 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. 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.

Can anyone provide statistics to shed more light on the subject?