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

(CBS)  "A votre sante" ... "To your health" … say the French as they raise a glass in toast. The French do take health care seriously, and provide it in a system quite different from our own. Our Man in Paris, David Turecamo, offers his take on the French model:

---

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.

So the French go to a drug store to fill a prescription and most people don't pay anything.

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 …

Look, every doctor makes house calls, but this group, SOS Medecins, specializes in making house calls at off-hours and weekends

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.

[jean123123]

I'm french and I can undestand why the US wich still the more powerful country, do not have a similar system. In fact we should ask a question to ourseleves : are people more important or is money more important ? That is the point, it is simple as that. I prefer to pay more taxes but knowing that the baby next door wont't die because her mother as no money, whenever I do not have health trouble myself...I think the main purpose of humanity is to care about other Humans Being, not about money...I hope Obama will success. Good luck.

[bonitalulu]

I understand all those people that are againts abortion! Life is important and they want to protect it. However, many of the same people refuse to give health insurance to the childrens that are born and when they are adults! Senators cry against abortion but in Obama inaguration many did not applaud when the President anounce that
1 million children will have health insurance ! Some people who have health insurance ? say : what is there for me? I always have health insurance and I can not imagine myself without this protection. We think that we are a christian nation, but people forget we need to help those in need.Also, why nobody speak about all the claims against
Blue Cross, Kaiser and others? Then people will know they are not so great as they want us to believe. The speak about Canada: Let me inform you that at Kaiser takes 2 months to get an appointment for a Ginecologist, in Emergency room we waited 45 minutes to get a room and another 30 minutes to se the doctor. This was when my husband had severe chest pain.They left him overnight for observation .Next day he was told he could go home. In the early hours of the next day he die from heart failure! Could they have kept him an extra day in the hospital? May be something could have been done to save his life...
I can't wait for Public Insurance. They need competition from the government ! May be then they will treat us like they care for a Senator!

[rayray92869]

"public healthcare cuts overall costs. less name brand drugs, less overpaid doctors in ferraris, and less waste."

are you kidding me? I am a physician and NO ONE drives a ferrari. Only plastic surgeons can even make enough to afford a ferrari. Doctors are far from overpaid. From the hard work, college, medical school and then residencies and specialization training afterwords, we work very hard to help people but also deserve to be compensated for the work. What is it that you do? I can almost guarantee that you did not work as hard as I did throughout my schooling. My father is a retired physician. His insurance premiums per year were in excess of 50k a year. His income during the Clinton administration decreased by 66%. If you want socialized medicine you will price out intelligent people from being your doctors. In addition the cost of schooling is increasing and most doctors are hugely in debt. Paid 50-100k, most doctors wouldn't be able to pay off their schools debts.
I wish people like you would actually think things over before posting comments like this.

[mscore]

Here in Finland the French model seems very natural. We pay 22? per day in a hospital regardless of the type of treatment. Even if you were picked up by helicopter and given heart surgery the price is the same for every citizen.

And the same goes for education. From daycare to a doctor education is free for everybody. The university fee is 65?/year an includes health- and dental care.

The American model seems very, very discriminating.

[pswanberg]

PS the comments section on this website is a serious failure, l2program.

[dzunakwa]

In the USA most obstetrician/gynecologists who deliver children pay $80,000 to $100,000 for their malpractice insurance. Does anyone believe that true Americans would give up their right to sue so that doctors could be paid less? If you introduced a system like the one in France without a complete overhaul of our courts there wouldn't be any doctors here. However, that would definitely reduce the cost of health care.

[Martin_Turow]

The difference is this simple-- in America, healthcare, including doctor services, IS A BUSINESS, a big one. In France, it is more like the Postal Service is here, a quasi-governmental system that strictly regulates everything. As soon as America decides that they don't like healthcare being a business, the sooner we can get down to true reform. Until then, healthcare will continue to seek the biggest return on investment possible and if that means gouging the crap out of everyone and everything, well, then, that's what's going to happen.

[davefromcamp]

This article is another example how liberals don't understand money. 1 Drs make 50-100k?!?!? Why not go work for pay pal and have a 40 hr week with less stress. Drs here work 60-80 hrs have the looming fear of law suits and possibly dying people in their palms of their hands. Seriously med school debt in the US is 175k PLUS residency, so 8 years after college. Less people would go into medicine OR less qualified people. So when 50 million now have insurance and are seeing Drs when are further into a shortage. 2) 1 sentance about how the program is 12-14 BILLION $$ in debt. Obviously not free care. That logic gets me a free house. YES we have a problem, but fixing it in 2 months is a terrible Idea.

Side note: They also said the ambulance as General Anesthesia drugs. We have that too its called Fentanyl, Versed and Vecuronium. Our EMS are better at trauma than most physicians.

[persocialismo]

**GRAYLION1** First of all I commend CBS on shedding light on what Socialized Healthcare actually is instead simply feeding into bogus media rhetoric trying to perpetuate a spin on politics instead of focusing on the issues at hand.Many Americans are opposed to something that they really don't know about, it's FEAR, a tactic promulgated by wealthy conservatives, and greedy capitalists. Second, Mr.Vogler, if you're going to tackle such a long shot and compare the median U.S. Salary to that of France you need to compare many other aspects, such as quality of LIFE, education (almost free), living expenses which are far LESS, access to efficient public transportation. Even the approah to drug addiction, and family couseling is more comprehensive and offered at virtually no cost. The quality of life in France is much greater than here in the U.S. according to the "Economist" and it doesn't take as much to live, so you need to research a little more before you spew out figures like that! We Americans define ourselves by salary, and profession and this is precisely the problem with such a debate as Healthcare.

--Dionigi (Miami)

[bobgeli]

While the segment on Sunday Morning October 26, 2008 was interesting, I believe you left out three important items. First doctor salaries in relation to other professions like teachers, fire fighters, or garbage collectors. Second is what it costs them for mal-practice insurance vs a US doctor. Third, how much is paid out per capita for medical law suits vs the US as well as the number of lawsuits filed each year. My belief is that US doctors run many unnecessary tests to ensure they get a valid diagnosis to avoid being sued and that medical costs in the US are significantly impacted by the lawsuits.