Due to cultural and blood ties, we usually look to the English-speaking world for political and social models for consideration and possible adoption. But the World Health Organization today rates the British 13th and the Canadians 30th in quality of health care, while the French system is ranked number one. Overall life expectancy is higher in France, and the life expectancy of French women is the second highest in the world, just behind Japan. Although it more closely approximates our own health care system than any other, probably because of cultural bias and linguistic barriers, we have largely ignored the French system for study and consideration.
French health care has some important features that are absent in the British and Canadian models, such as office-based medical practice, fee-for-service billing, freedom of choice in selecting health care providers regardless of the individual’s personal income level, a public, private and not-for-profit hospital mix, private health insurance companies and patient copayments. The not-for-profit hospitals were formerly denominational institutions and make up 14 percent of all French hospitals. Performance indicators as well as public opinion surveys that measure patient satisfaction rate French health quality care higher than ours, substantially higher in some areas.
The major differences in the two systems mostly favor the French. In France, national health care covers practically everyone (more than 99 percent), while we still leave 50 million Americans without coverage. The prices for most elements of health care are lower in France — office visits, diagnostic and surgical procedures, hospital stays, prescription medicines, etc. But the volume of office visits, the number and length of hospital stays, procedures performed and medications dispensed per patient is higher over there. While France’s health care costs are the fourth highest in the world, they are substantially lower (26 percent) than ours, although the French population is on average older.
An important feature of French health care is the sharing of patient records among providers, public and private. This dramatically reduces the mountains of paperwork and costs involved each time a patient sees a new provider or is referred to a specialist. The reported long waiting times for services in other countries with national health care systems — and not exactly uncommon, I might mention, in the U.S. — are reportedly rare in France.
The private sector of French health care is particularly active in surgery, performing 50 percent of all procedures, and in treating 60 percent of all cancer cases. France is definitely not the exclusive domain of “socialized medicine.”
The French system has been in place and evolving for more than a century now and is funded by taxes on incomes of various kinds and levies on tobacco and alcohol.
Does all of this sound too good to be true? It might well be, but isn’t it worth at least investigating? It is high time we ignore the protestations of the American Medical Association, GOP and American health insurance companies, cast aside our Gallic phobias, prejudices and cultural biases and evaluate the French national health care system with a dispassionate, objective eye.
What have we to lose?
George B. Reed, Jr. is retired from AT&T and a former history teacher in the Hamilton County school system. He lives in Fort Oglethorpe and can be reached at firstname.lastname@example.org or 706-858-3501.