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Is French Health System a Model for U.S.?

Is French Health System a Model for U.S.?

The Dallas Morning News

May 18, 2009

Although U.S.-style managed care has started creeping in, the French insurance system leaves consumers free to choose their doctors and leaves French doctors free to make whatever prescriptions and treatment recommendations they think best.

Everyone who’s lived in France for at least three months is covered by national health insurance.

People with chronic illnesses get continuing medical attention without facing a bill for it. Treatments and survival rates for cancers and other diseases are better in the United States, although French cancer patients routinely get access to experimental drugs.

Far more Americans get heart surgeries to clear clogged arteries, but the French death rate from heart attacks is about one third of the American rate.

The French live longer. They have more hospital beds and more doctors.

Price difference

For health economist Didier Tabuteau, though, there is one overriding difference between the U.S. and French systems.

“The difference is the price, not the number of doctors or the number of hospitals,” he said. “You pay a very high price for drugs and doctors.”

The French government negotiates price ceilings with pharmaceutical companies. French doctors earn about 60 percent of what their American counterparts make, although they get free medical school tuition and don’t face high malpractice insurance premiums.

Like us, however, the French have a looming problem with the cost of medical care. If the American way is generous to doctors and drug makers, the French way is generous to consumers. With no deductibles and with out-of-pocket expenses averaging less than $250 a year, the French visit their doctors about twice as often as Americans. The French lead the world in drug consumption.

Cost-control steps taken over the last 20 years have created a two-tier system where medical care is readily available to the very poor and those who are well off. It’s harder to come by for the lower middle class who can’t get comprehensive, supplemental health insurance through their employers and can’t afford to buy such policies on their own.

Tabuteau says a third of French consumers complain they can’t get the dental care, eyeglasses or other treatments they want because of cost.

Jennifer Hua and her French husband can choose any doctor they want. They’ve had their pediatrician come to the house on a Sunday to care for a sick child.


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