France Fights Universal Care's High Cost

Source: WSJ

When Laure Cuccarolo went into early labor on a recent Sunday night in a village in southern France, her only choice was to ask the local fire brigade to whisk her to a hospital 30 miles away. A closer one had been shuttered by cost cuts in France's universal health system.

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Doctors, trade unions and others have called national protests against French health-care cutbacks this year. One petition signed by prominent physicians said they feared the intent of the reform was to turn health care into a 'lucrative business' rather than a public service.
. Ms. Cuccarolo's little girl was born in a firetruck.

France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.

In recent months, France imposed American-style "co-pays" on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. "A hospital doesn't need to be money-losing to provide good-quality treatment," President Nicolas Sarkozy thundered in a recent speech to doctors.

And service cuts -- such as the closure of a maternity ward near Ms. Cuccarolo's home -- are prompting complaints from patients, doctors and nurses that care is being rationed. That concern echos worries among some Americans that the U.S. changes could lead to rationing....


Read more: http://online.wsj.com/article/SB124958049241511735.html#mod=whats_news_free?mod=igoogle_wsj_gadgv1

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This is why I believe the Swedish system is where we should look.

.

:thumbsdown:

I suggest you actually read it.

"The quasi-monopoly of Assurance Maladie makes it the country's largest buyer of medical services. That gives it clout to keep the fees charged by doctors low. About 90% of general practitioners in France have an agreement with Assurance Maladie specifying that they can't charge more than €22 (about $32) for a consultation. For house calls they can add €3.50 to the bill.

By comparison, under Medicare, doctors are paid $91.97 for a first visit and $124.97 for a moderately complex consultation, according to the American College of Physicians."

:eyes:

I am always surprised that people are wary of actually looking into anything. Is it better than ours, yes. Can it be improved, of course.

We've used the hospitals. The above figures are correct. that from personal experience. The only co pay for medicines, is the standard 3 euros. Carte Vidale is consistant with the 3 euros charge. No surprises.
Medicines must be regulated in some manner. go to the pharmacy, pick up 18 tabets of Advils. 2 euros, 50.

is free or nearly so in comparison to ours, where doctors may emerge with six figure debt that they must pay off.

Often doctors must be paid enough to entice them to study medicine and that includes paying off their student loan "mortgage" in a reasonable amount of time.

While difference in educational expense certainly does not account for the entire difference in payments per service, it may account for a decent percentage.

We should try that.

which affects other businesses in the aggregate.

US
Per capita expense: $6,096 (2007)
WHO Rank: 37
Lifespan (M/F): 73/79 (1996 birth)

France
Per capita expense: $3,040 (2007)
WHO Rank: 1
Lifespan (M/F): 74/82 (1996 birth)

"France Fights Universal Care's High Cost" - costs that are 2/3 of our costs, with universal coverage and better outcomes. The 'problem' as far as your 'excellent WSJ article' and Sarkozy are concerned, is that the French consider healthcare a right and don't want to hear about having their system Thatcherized. Universal health care in France and elsewhere is less costly than our bullshit system.

it is a misleading headline.

Lower costs, better outcomes, everyone is covered. Meanwhile....

the French system isn't perfect and about its flaws a lot can be said. It's still vastly superior to the US system.

I don't know exactly what they mean with co-pays. But if it has to do with prescription drugs, fact is that there has been a vast abuse (and still is) of the system. In the old system you could go to the doctor, get your pills and get reimbursed (100% with private insurance). But you always have a bunch of hypocondriacs that the go to the next doctor (even 3 etc...) and get more pills, reimbursed too. I am not talking here about drug abuse even it is a minor part of the scheme. Anyway the French were the most pill-popping people in the world and probably still are. New regulations make that you have to choose (repeat choose) a doctor and design him/her to the local authority as your "treating doctor" (he fills the form for you, you have only to sign). You can choose a new doctor whenever you want. His presciptions are fully reimbursed. Then if you want to go to a second one the reimbursement will be less or none. This is easily checkable since you have to use an electronic chip card to get out the stuff. Frankly I think it's a good measure. The ones most whining are old ladies because they might have to pay more to get pills which are medically unjustified.

Anyway co-pays are a little part in the financing problem. Roughly 50% of the money goes into financing the public hospital facilities and management and there is plenty of administrative pork that could be cut, but of course it's very impopular and the unions are against it. The cost for minor sicknesses is minimal and that's the part most people come in contact with. The cost for heavy care for severe cases like cancer is the big part (20% or more) but it affects only a minority and of course nobody is against it. If I can find a pie chart for the exact costs, I'll post it.

Despite its flaws the French system costs less than HALF/inhabitant compared to what the US system costs his own. And everybody is covered, NO QUESTIONS ASKED (unless of course if you are male and want to have a pair of free boobs). And the only time you cannot choose your doctor or hospital is when you are unconscious in an ambulance because of a trafic accident and they rush you to the next facility

I was really hoping you would comment.

Got a link?

is entirely tax based and completely goverment run. It leaves very relative little room for private ward. So the choices are more limited. The French system is based on mixture of public service and private service. The doctors are mostly private practicioners (covering the vast majority of MINOR ailments, which is the majority of the cases), except in the public service hospitals. Since every kind of ward is reimbursed, the French system has a flexibility that few other systems have. The Swedish system is still very efficient and covers everybody. It means a higher tax burden too. The Swedish system doesn't cover optics and dentistry unless you are on complete welfare.

Thanks.

But are Americans prepared to pay those taxes ? And have little choice, practically change doctor all the time, you never know who you are going to meet. This system wouldn't be viable in France for it's lack of privacy and flexibility. In the US it's impossible.

Who would they choose? How would they decide? People to go who their employer or insurance company recommends, or whoever's local. It's not as if they have some greatly funded body which ranks doctors in various ways from which they choose.

she said (check http://www.huffingtonpost.com/2009/08/07/palin-obamas-death-panel_n_254399.html)

"The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil."

my answer

all industrialized Western countries except the USA have single-payer government run healthcare .

As a result of that, all babies are aborted and all over 75 are euthanazied in those countries and people love it... How the population grows in those countries is a mystery for science. Some suspect covert stem-cell cloning in secret military facilities....

In reality the truth is :

Doctors DECIDE about what care has to be given, based on scientific experience but patients can choose their doctors or clinics or public hospital.
Government PAYS the bills, and its civil servants fill in reimbursement forms. This is tax financed and costs half of what it costs in the US.
Private insurances cover the COMPLEMENTARY bill for all that isn't directly necessary and make a shitload of money, for a relative small fee from the insured who has a free choice.
Goverment MIGHT DECIDE according to the highest medical authorities advice in what areas it must invest money to improve healthcare through prevention and better equipment.

This system is of course evil.
:sarcasm:

and even more frustrating to hear people just eat it up and accept it all as fact. To be fair though, I also find it annoying when people reject any and all criticism of such a system. While it seems clear to me that the good outweighs the bad, it shouldn't be taboo to identify problems that will arise, and ideally, discuss ways to mitigate them. I think that actually applies to any topic, not just health care... ehnnn.

Anyway, your postings on this thread have been very insightful. Curious though, are there people in France who are against the health care system in place?

people can be critical though, if they find out that money has been used improperly (administrative costs, deficit etc...) but they don't want to touch to the system as such, only improve it. The US system is perceived as absolute horror all over Europe. Some bigots are complaining that the system is covering "forinners" but they are quite few. People abusing the system through fraud are seen with utmost contempt. The idea that a system could be run solely on private basis without governmental regulation and warranting is outlandish for the overwhelming majority of the French. "Privatisation" is seen as a threat and "nobody" would elect a President on such a basis. If a President tried to implement a privatisation for whatever ideological reason during his mandate, the government would rapidly fall after massive popular outrage, people would take to the streets. They have already done that for simple propositions of privatisation of peripheral elements.

they should see what it is in Sweden, if you don't live in a major town. It's a country of the size of France with only 9 millions inhabitants. So you cannot have a top maternity in every village.

The problem with small maternities is that, even if they are very convenient for the locals due to proximity, they go half of the time empty on the countryside. Which means less trained personal for emergencies and most of all lack of high-tech modern equipment for the severe emergency cases, which the big ones have. So it's better to have the inconvenience to make 50 km extra and be hospitalized in a facility with huge ressources. Because if your kid dies at birth for an unusual complication that the local maternity cannot handle, you will regret your whining, Ms. Cuccarolo for the rest of your life.

Besides Ms Cuccarolo is lying

The firemen function as ambulance service when for some reason ambulances are not available immediately. And she hasn't been paying a shit for that. Her case is a curiosity.

But not as good as Sweden where they don't fool around with public services.

If in Sweden at 11 in the evening you have a terribly sore throat and 39° fever and feel terrible, you put yourself into a taxi (20 bucks in town) which is not reimbursed and go the emergency room and wait two hours. If you need to stay it's free.And if you have a throat angina with bacterial complications that go down into the lungs and must be checked upon, you might see 3 different doctors in the same hospital before you're cured. Then you take the bus home. I know, been living there 30 years.

In France when my American wife had the same symptoms, a doctor showed up home 15 min after call at five in the morning, checked her and decided hospitalisation after that a required paramedic communicated very negative blood tests with a portative lab. An ambulance showed up after 5 minutes. Another doctor followed her under her 3 days hospitalisation. They placed her in room with an English patient so she could "chat" and delegated a nurse that could speak English since her French isn't so good. Costs ? Zero. Except the flowers and ice-cream. They offered an ambulance back (we lived 3 miles from the hospital) but we refused and took the tramway instead.

choose your system.

Or you mistook "better" to mean "better service" and not "better costs"?

But frankly, either one sounds way the heck better, cost or service, than what you get here.

but regarding costs it's still better in France (despite flaws) because the invidual has to put relatively less money. What we call Social Security reimburses (most of the time you don't even have to put the money in advance while using an electronic card) 70% and your private insurance (which you can choose and compare) reimburses the rest up to 100%. The private insurances seldom refuse you covering (BTW they are flourishing and don't want to lose their customers for some bucks) and cost for a good standard round $100 a month. With such an insurance optics and dentistry are practically covered to 100%. If you can't afford a private insurance (income for a couple under 900€/$1300/month), you are totally covered anyway by the State.

In Sweden everything is free, but your tax burden will get up to 35% of your income, when in France it is 28% (for the part that pay any). At the same time, dentistry and optics will be reimbursed only if you have practically no revenue at all (welfare), that is to say if you make 500€ a month, you'll have to start filling forms and ask for deferred payments, tax exemption etc...

the society cost per inhabitant for healthcare (all kinds) is roughly $2100/year in France, $4800 in the US and something $1900 in Sweden. Those costs include what society has to finance. But the burden by citizen (what they have to pay in reality from their wallet) is somewhat lower in France for a far better service than in Sweden. And even if it was somewhat higher, it still would be worth it.

But the service is not as good as in France.

And both are cheaper and provide better service than in the USA.

Thank you for your testimony.

Voila!


ces la vie

if it had been a boy would have been Hose.

just kidding

What a bunch of fucking right-wing douchebags: "That concern echos worries among some Americans that the U.S. changes could lead to rationing...." FUCK YOU!!! This just goes to show what happens when you move away from universal health care, not what happens when you move toward it. Ass hats.

Health services are brutally rationed now in this mean-spirited country.

20,000 die of neglect here every year, while Arlen "No Public Option" Specter gets free brain surgeries at taxpayer expense.
If that's not rationing, I don't know what is.

it is usually better to ask some one from that country.

with Sarkozy?

Remember what Margaret Thatcher did do Britain's NHS.

they are crypto-communists...

If countries, and I know France may not do this but other countries do, can spend oodles of money on defense, we sure as hell can do it for health care.

How will we show the world that we are the best killers. And besides if we leave health care alone we will show them even more that we know how to kill our own.

Is everyone posting about this because 1 healthcare system versus another will mean no babies are born before the mom goes to the hospital? The whole point of this article is invalid and everything then becomes invalid. Let's try some logic for a change.

By the way, that's in-VAL-id not IN-va-lid.

big-time hit jobs on cash for clunkers and healthcare reform in the same week...

When he expects evil, he wants evil.
:puke:

...but that's a headline you won't read in the WSJ.

Privatize, privatize, privatize. Of course.

if not the German, if not just plain single payer

:rofl:

'Sarkozy, who is right-wing by French standards, is trying to weaken and partially privatize their healthcare system.'

He won't succeed, or even try, to damage it completely - but he may weaken it to a degree, as happened in the UK.

Do you ever take a day off? I mean, seriously - the WSJ? Here?