August 14, 2007

Look to the French?

This may not go over well with Bill O'Reilly, but this description of the French health care system seems like a good fit for us here in the old U.S. of A. (IHT)

Many advocates of a universal health care system in the United States look to Canada for their model. While the Canadian system has much to recommend it, there's another model that has been too long neglected. That is the health care system in France.

Although the French system faces many challenges, the World Health Organization rated it the best in the world in 2001 because of its universal coverage, responsive health care providers, patient and provider freedoms, and the health and longevity of the country's population. The United States ranked 37.

[...]

An understanding of how France came to its health care system would be instructive in any renewed debate in the United States.

That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.

[...]

National health insurance in France stands upon two grand historical bargains - the first with doctors and a second with insurers.

Doctors only agreed to participate in compulsory health insurance if the law protected a patient's choice of practitioner and guaranteed physicians' control over medical decision-making. Given their current frustrations, America's doctors might finally be convinced to throw their support behind universal health insurance if it protected their professional judgment and created a sane system of billing and reimbursement.

French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new health care funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

The French system strongly discourages the kind of experience rating that occurs in the United States, making it more difficult for insurers to deny coverage for pre-existing conditions or to those who are not in good health. In fact, in France, the sicker you are, the more coverage, care and treatment you get. Would American insurance companies cut a comparable deal?
More at link.

See also this New York Times editorial published on Sunday regarding the current state of American health care. It compares many facets of our health care system with other countries and ends thusly:
With health care emerging as a major issue in the presidential campaign and in Congress, it will be important to get beyond empty boasts that this country has “the best health care system in the world” and turn instead to fixing its very real defects. The main goal should be to reduce the huge number of uninsured, who are a major reason for our poor standing globally. But there is also plenty of room to improve our coordination of care, our use of computerized records, communications between doctors and patients, and dozens of other factors that impair the quality of care. The world’s most powerful economy should be able to provide a health care system that really is the best.

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