Why The French Can Afford To Get Sick
Sunday Morning: Medical Care In France Is Efficient, Quick, And Costs Half What Americans Spend On Health Care
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With state-supported health care, this doctor mused, many come to France for free medical care "and they don't pay." (CBS)
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This summer in Paris my friends Matt and Noemi had twins. Matt's British so they ended up naming their sons George and Alistair. But Noemi's French - and that's what's important here, because the entire family is covered by the French Social Security system.
So, even though the boys were delivered by Cesarean section and Noemi spent nine days in a private room, after leaving the hospital they paid …
"19 euros, for the TV," Matt said.
That's around twenty-five dollars.
Well, they also paid a $165 for the first night, but for twins delivered by Cesarean, and nine days in a private room, and the cost was about $190?
Maybe we could learn anything from it.
"All the people coming to our emergency department are treated equal," a doctor told Turecamo. "We can't say to a patient, 'Oh, you don't have money or the right kind of insurance.'"
In fairness, emergency rooms in the United States are obliged to treat and at least stabilize everyone - but because of the cost many Americans never see a doctor until it's an emergency.
If anything the French go to doctors too much simply because they can afford it. You see, a typical office visit will cost them 22 euros. That's about $28.
"Obviously that would make an American laugh," the doctor said.
But don't laugh - 65% is covered by the national health system. The rest is picked up by private insurance which is available to everyone at a nominal cost. But even with that, one doctor in private practice told me, "If a patient has a big problem - no job, nothing - I say 'Okay - don't pay.'"
You should know French doctors make a lot less than their American counterparts - roughly $50,000 to $100,000 a year - because the French government (not doctors or pharmaceutical companies) sets the prices for everything - prices they feel are reasonable.
While critics argue that's socialized medicine, some doctors argue it's what we call managed care.
"Most of the time it doesn't cost anything for the patient," said the doctor.

Sound good?
Well, eight years ago the World Health Organization released a study ranking France as having the best health care system in the world.
"Well, even the French tend to roll their eyes when they hear that," David said, "and the study itself has been criticized for its methodology.
"But it's not just the quality of health care this country offers, it's the fact that it's offered to everyone. Every man, woman and child who is a legal resident in France is covered by national health care."
It's a comprehensive system that's innovative as well. When you call the emergency number (SAMU is like our EMS, or emergency medical services), first you talk to a doctor ...
"Oui, bonjour c'est le docteur du samu."
… who decides whether or not your case is an emergency. It's a time- and cost-effective measure because out of every thousand calls they receive, only about fifty turn about to be real medical emergencies.
"That means in more than 95% of the case we can deal with the call without using the full team," the SAMU medical chief said.
Because the full SAMU team in France includes a doctor, nurse, technicians and a battery of equipment and drugs, including drugs you will not see in an American ambulance. "These are drugs for general anesthesia," the SAMu staffer said. "We have all the monitoring; we have the possibility to give the drugs with infusion with a computer. It's like having a small part of the emergency room in the street."
See, in the U.S. ambulance teams are paramedics whose job is to get a patient to the nearest hospital quickly. Here the idea is to bypass the emergency room altogether. The patient is treated at the scene (on average for about 45 minutes), and when she is moved to a hospital it's one chosen not for its proximity but for its specialty
"We think this hospital is the better place for this type of disease," the SAMU doctor said.
Because treatment has already begun, the patient is taken directly to the specialized ward where the specialist is waiting for her.
Are there failures? Of course … case in point: the death of Princess Diana, which some say was caused because SAMU spent more than an hour and a half treating her at the scene before moving her to a hospital.
But overall, doctors agree the system is pretty effective.
"If you have some paramedics that is allowed to do some procedures that's good," SAMU medical chief said. "But where is the diagnosis? To go in the hospital and to save time we need a precise diagnosis."
But what if it's not an emergency? What if it's, like, well, during this January blizzard a few years back, my daughter ran a fever and …

They respond to about 2 million calls a year across France and can have a doctor at your home or hotel generally within an hour of your call.
They receive no state support and charge 52 euros, or about $65 for a visit - which generally is fully reimbursable.
Of course, all this comes with a price tag.
On a per capita basis it costs the French about $3,400 a year for health care, most of which, they complain, comes from taxes.
But in the U.S., per capita spending for health care is almost double that figure
And there are still roughly forty six million Americans who are uninsured.
And while the French are determined to preserve their system (it's currently running a 12 to 14 billion dollar deficit), most agree something's got to change.
"People come to France just to have free care and they don't pay," one doctor said.
So, is their system really better than ours?
Well, the only thing I can really say definitively is, in France you can go to the hospital without going broke.
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See all 58 CommentsWilliam Vogler, LPN
The United States has the resources and ability to do something simular to what the french are doing much better--including pay received by our healthcare professionals.
For all the conservative out there who push pro-life issues,doesn''t everyone have the right to live? Medical care should be a right, not a luxury!!!
Posted by rmherbst at 10:56 AM : Oct 26, 2008
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Excellent point.
Being French, I particularly enjoyed the comments from AHMTK. Immigrants are taken care of in France too. One thing I find particularly telling is the state of one''s teeth don''t necessarily tell one''s income - many of our U.S. friends couldn''t afford braces for their children - unheard of here. And whre does he get the "only work 4 days a week" stuff? We work 35 hours a week, have 5 - 6 weeks vacation per year and are still more productive than Americans. Quality of life is indeed very important - eg time spent with family. I''d heard about people from Texas and you have confirmed the stereotype.
Posted by rmherbst at 10:56 AM : Oct 26, 2008
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Absolutely!!!
Protection against sickness and injuries are every bit as important as protection against military attacks, and socialized health care would be viewed no differently than our socialized military defense.
Will trade for decent health insurance.
I would take France over Texas any day. They also have more visitor arrivals than any other country in the world. To all you dimwits living in our red states that says alot. If France is such a joke why does everyone want to visit there. And if you haven''t had the chance or opportunity I feel really sad for you because the French know how to live..
From an American in Hawaii
(For those interested, I''ve actually done some looking into the pre-existing conditon issue in both the McCain and Obama plans. I''ve also done some statewise research for each state on the current (usually risky) situation with pre-existing conditions, posted at: http://www.nastechservices.com/HealthInsuranceUSAPolicy.html )
Lets hope the country can stop the medical bankruptcies and deaths due to uninsurance. Most ridiculous--this is the only industrialized country where this happens, and we spend about double what the others are spending. (Last industrialized country to abandon our system was Switzerland in 1994.)
as a car manufacturer, because of our medical system. Consider that medical insurance and benefits costs for American car manufacturers add about$6500
dollars annually for each employee. Because we have socialized medicine, the employee benefits package costs less than $800 annually. Do the math. Most industrialized countries have some form of socialized medicine, which makes them highly attractive to employers. I also agree with Aladdin49, in that countries such as France, and to a less extend, Canada, put more value on the quality of life than on dollars and cents. Wouldn''t you rather live and work in a country that allows you optimum time with your family without subtracting from your standard of living? Americans have to work so very hard for so very little.
There are no free lunches. Universal coverage will increase costs. Historically, government is not an efficient mechanism to deliver services; look only at the cost increases per year for Medicare/Mediacaid and the unbelievable fraud.
We need *more* competition in healthcare to drive costs down, NOT less. This might be achieved by changes in how we pay for services: making hospitals post rates for services, require individuals without insurance OR insurance companies be charged the same rate for identical services, and, instead of simple deductibles, making me pay a certain percent of total cost of a procedure, thereby, encouraging me to choose the lowest cost hospital/supplier.
To those who believe Universal Care is most efficient, why, then, should the government not adopt 5 year plans governing allocation of resources in other industries? Wouldn''t that improve efficiencies? Hasn''t this been tried before?
Even if you do believe in Universal coverage, a more market-driven approach would be to subsidize private insurance, giving each citizen an allowance if they can''t afford it. At least the insurance companies would act to control costs.
Look, this sounds wonderful but the cost will be prohibitive.... Trust me. Problem is, once Universal Health care starts, it can never stop. It will only get more expensive, and the money has to come from somewhere. If any of you buy that "only tax the rich" line, I have some ocean front property here in Tennessee you will be interested in. That''s the oldest "bait and switch" line in politics.
Look, this is probably a moot point, because we likely won''t even have the numbers with which to even filibuster in Washington for at least the next four years, so all these European aspirations that the left has is probably gonna come true.
I wonder what will happen to the 650+ dollars that my employer pays to my health insurance???? Oh yeah! They''ll keep it. Good for them!!
Talk about picking and choosing.
So, for all those who think France is great-SEE YA.
Too many Americans are unwilling to look at another culture, and God forbid if has a different language too - it might as well be on Mars. I''ve been lucky enough to travel in France and Germany (et oui, je parle francais; auch kann ich Deutsch sprechen) and long ago saw just how much we have to learn. By eliminating duplication, covering pre-existing conditions, letting everyone see a doctor BEFORE a condition worsens, their plans cost far less per capita and people are healthier! The Wall Street Journal''s hardly a leftist looney tabloid and even they''ve said we can''t continue to lose 30% of our health-care $$ on administration, vs. 2 to 4% for other systems elsewhere - including Medicare.
Before any extremists drag out the "S" word again, ask if you want a health care system where bureaucrats overrule doctors, decide who gets treated and who doesn''t, and line their own pockets at public expense. It''s called corporate socialized medicine - we already have it and it sure as h$#! doesn''t work.
The right-wing types who still chant "we''re the best" remind me of the NY Yankees in the 1970s. They relied on images of Ruth and DiMaggio long after the team had descended into mediocrity. They remained the best team in baseball only in their own minds, while other clubs ate their lunch and dinner. The Yankees improved only after they accepted how far they''d fallen. Seems to me there''s a parallel here.
queue, but at least no one has to claim bankruptcy to cover medical costs. NO ONE!! NOT ONCE CANADIAN I KNOW HAS EVER HAD TO CLAIM BANKRUPTCY FOR MEDICAL COSTS. Not having universal health care is dragging down your economy, shortening your lives, responsible for companies outsourcing jobs to other countries.
Again, you seem to work so very hard for so very little.
We have argueably some of the best doctors in the world here in the U.S. Yes, they are at the top of their field because they strive for excellence, and service to their fellow man, but if there was not prosperity in the way of big money at the end, I doubt they would care as much. Look at many of the "doctors" of the former Soviet Union. They were paid about the same as a bus driver, and their apathy was legendary.
True dat. And not only do we work hard, but our ''betters'' in our society have for 30 years felt that with a little paddle in the butt, we could work EVEN harder!!! That''s why they''ve gifted us a $10 trillion debt to work off, which will only take the rest of our lives.
Thanks older generation, for the opportunity to work my fingers to the bone!!!
As for our health care getting more expensive...well, since it is a single-payer/single provider system, and has taxpayer oversight, admin costs are constantly being scrutinized so that direct care dollars increase. You just don''t get it, do you!!
Or is it, when faced with the fact, from France, from GB, from Sweden, from Denmark, from Germany, from Switzerland, from any other industrialized country...that socialized medicine not only works, it works well, does not inhibit research, serves the public, and makes you competitive in the global market? Where is the debate? Where are all the neo-cons? Where are all those who would have US citizens die for lack of insurance? Come on...debate the issue!!
Here there is no difference...all ladies have the same life expectancy. Mammogram...free. PAP...free.
Blood work...free. My doctor is not afraid to tell me if I am overweight or if I smoke too much, and it is to his benefit to prescribe and support a diet, and a smoking cessation program. It is to his benefit to keep me healthy and alive and enjoying life. He is not constrained by an insurance company, who tells him what care I need. I trust my doctor, and I trust my government. That is the difference!!
''''Moore''s behavior is malicious and hypocritical,'''' said Leffler, 51.
``For those of us who have followed his footsteps during these years, his falseness about the Cuban health system and the deplorable state of medical services that Cuban nationals receive shouldn''t surprise us.''''
The Cuban footage was shot in November 2007. It includes scenes at Miguel Enriquez Hospital in Havana that show a dilapidated facility and the somber panorama of the reception area.
''''It is very exciting to know that the images filmed by Kevin Leffler will be seen in the U.S., as he had the bravery to come to Cuba to find out the reality of this nation''s healthcare system,'''' said Ferrer, who runs the Juan Bruno Zayas Center for Health and Human Rights in Cuba.
In Shooting Michael Moore, Leffler contrasts the scenes of the American patients being attentively cared for in the Havana clinic with images of Cuban citizens seeking care at the same facility being turned away.
The dialogue between the hospital''s receptionists and dissident physician Darsi Ferrer and his journalist friend Jaime Leygonier, who request appointments for MRIs, was captured with a hidden camera, and shows a reality far removed from the scenes in Sicko.
''''''''Moore''''s behavior is malicious and hypocritical,'''''''' said Leffler, 51.
``For those of us who have followed his footsteps during these years, his falseness about the Cuban health system and the deplorable state of medical services that Cuban nationals receive shouldn''''t surprise us.''''''''
The Cuban footage was shot in November 2007. It includes scenes at Miguel Enriquez Hospital in Havana that show a dilapidated facility and the somber panorama of the reception area.
''''''''It is very exciting to know that the images filmed by Kevin Leffler will be seen in the U.S., as he had the bravery to come to Cuba to find out the reality of this nation''''s healthcare system,'''''''' said Ferrer, who runs the Juan Bruno Zayas Center for Health and Human Rights in Cuba."
Posted by endofempire
I''m sure our longstanding embargo doesn''t impact the country at all, so any shortcomings must be entirely Cuba''s fault.
...I wonder how it is, that Cuba has developed in some cases, superior medicine than in the U.S. ? Such as a vaccine for a strain of hepatitis that the US doesn''t have.. Hmmm....
Nothing more, nothing less....
Posted by kesac4650 at 05:51 AM : Oct 27, 2008
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Sorry sparky, According to a Congressional Budget Study (Republican presiding) medical malpratice law suits only account for .2% of all US medical cost.. Why do you think Bush dropped his "tort reform" like a hot rock? The report also said only a small percentage of malpratice ever resulted in litagation and defensive medicine at most only added another .1%.
Looks like you conservatives will have to think up another excuse to block progress. Why dont you try the equally as stupid "healthcare rationing in Canada" argument?
My company''s health care premium shot up 13% this year. My wife''s company a whopping 25%. This has been going on year after year for decades now, while income stagnates. Defend the current system if you want, but the fact is it simply cannot be sustained. It''s mathematically impossible.
Problem is they have people who vote with molotov coctails instead of ballots (when they don''t get their way).
Socialized medicine models are falling apart in Canada and the UK as well. People that aren''t enslaved to rationed health care--won''t use it. They''ll travel to a Swiss clinic (or similar) and get a higher level of care than what is determined they are ''eligible'' for. Remember, at one point, Ohio had more MRI machines than the nation of France.
There ain''t no such thing as a free lunch and there ain''t no such thing as state of the art free health care. Rationing is a staple of socialized medicine.
You could buy an insurance policy that would cover every procedure you could possible want. Trouble is--we can''t afford it.
Trust me, I am not an elitist. I believe that everyone whould recieve the best health care possible. I don''t like the idea that pharmaceutical companies get fabulously wealthy after hardworking scientists and chemists develop breakthrough medicines that will keep people alive that would otherwise die, as well as make millions of lives better. I do however, feel that doctors should live at least in the upper middle class financial bracket. Its more than just schooling, it is the gruelling internship they must complete as well as other things. I want them to know that being the best they can be is good for their standard of living.
I live in Tennessee.
What about the land area differences?
It''s hard to compare the US to our EU neighbors. There are good and bad points to both systems and comparing them in such broad strokes is unfair to all.
I don''t want to derail this thread, so lets keep off the whole illegal immigrant thing for now.
A couple of years ago, I responded to the local health department. It was for a young man who did not speak any English. He was an illegal migrant worker who was having severe difficulty breathing. He had gotten sick, and due to condtitions these poor guys live in, it had deteriorated to a severe case of pneumonia. I ended up intubating him before I got him to the hospital, and he spended a week or so in ICU, and a total of a couple of weeks in the hospital before he was released.
What about the land area differences?
It''s hard to compare the US to our EU neighbors. There are good and bad points to both systems and comparing them in such broad strokes is unfair to all.
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