A scathing critique of French Health Care System

[barnesfoto]

eek! socialism!

http://www.nytimes.com/2009/08/16/ma...l?ref=magazine

[Lorax]

Exactly my experience, with the exception my caregivers largely spoke English, and there was no charge for three days stay, and I'm not a French citizen either.

I'd be more than willing to deal with surly desk clerks as well, since I already am here in the states with for-profit health care.

[Sstashmoo]

It works in France. And France and the US are equals in regard to their sociological constructs?

What works in France will not work as well here. We need something but before we start calculating our savings, start adding up the numbers. Our huge illegal population for starters. The amount of unemployed etc. France is a totally different ballgame.

How this is going to play out is we're going to wind up with cheaper healthcare, but it's going to come at a cost, better for some, worse for others. It's not going to be free.

[Lorax]

It works in France. And France and the US are equals in regard to their sociological constructs?

What works in France will not work as well here. We need something but before we start calculating our savings, start adding up the numbers. Our huge illegal population for starters. The amount of unemployed etc. France is a totally different ballgame.

How this is going to play out is we're going to wind up with cheaper healthcare, but it's going to come at a cost, better for some, worse for others. It's not going to be free.

Your premise is a misnomer.

France is obligated to care for those who live in former colonies, if they are living in France at the time, as are other EU member nations who at one point in their history had colonies, Belgium, Holland, UK, Spain, etc.

In the case of France, Algerians, Moroccans, West Africans, Viet Namese, Islanders, etc.

The idea of health care is universal. Without our health, we cannot be contributing members of society, and as a society, the US cannot compete with the rest of the industrialized world.

[Sstashmoo]

Weak man weak.

[Lorax]

Weak man weak.

Is that all you've got?

Having a thought and letting it go, I see.

[ghettopalmetto]

What works in France will not work as well here.

And why not?

We need something but before we start calculating our savings, start adding up the numbers. Our huge illegal population for starters.

Illegal immigrants are not part of the discussion in health care reforms. There are exactly ZERO proposals on the table to include illegal immigrants in any sort of universal coverage. You may stash your xenophobia for another battle.

The amount of unemployed etc. France is a totally different ballgame.

It sure is. It's not unusual to have an unemployment rate of 15%-20% in France. Even in this recession, we're not even close.

[MikeM]

How much of a deficit is the French healthcare system running these days?

[ghettopalmetto]

How much of a deficit is the French healthcare system running these days?

According to OECD Health Data, 2002, France's National Health Insurance cost about 9.5% of GDP in 2000. At the same time, the privatizized U.S. health care system cost 13% of GDP, or roughly 50% more than in France on a GDP basis.

http://www.pubmedcentral.nih.gov/art...?artid=1447687

[MikeM]

Aren't they billions [[of Euros) in the red and facing the dilema of either cutting service or increasing taxes even more?

[ghettopalmetto]

Aren't they billions [[of Euros) in the red and facing the dilema of either cutting service or increasing taxes even more?

I can't comment on that, because I don't have enough knowledge of the budget of the French National Health Insurance.

If that is the case, though, how much more sense does it make for us to spend 50% MORE [[as a percentage of GDP) leaving 1/6 of our citizens uninsured, and to funnel $10 million paychecks to insurance company CEOs?

You're implying that if the French system has any problems whatsoever, it must be all bad, and therefore our system is superior. We're still spending a hell of a lot more money than necessary, and for questionable results. If the French system is bad, then our system is at least 1-1/2 times as bad.

[MikeM]

No, I'm implying that the French system is going broke, so it necessarily isn't a good model to copy. Perhaps the aspects of it you admire will be falling by the wayside as the government attempts to rein in its costs?

[ghettopalmetto]

No, I'm implying that the French system is going broke, so it necessarily isn't a good model to copy. Perhaps the aspects of it you admire will be falling by the wayside as the government attempts to rein in its costs?

So that would somehow excuse our system, which covers a lower percentage of people, going broke 50% faster???

[MikeM]

You can't hold up the French system as an ideal until it proves to be sustainable.

[Sstashmoo]

Quote: "You can't hold up the French system as an ideal until it proves to be sustainable."

Exactly.

Re: Illegals, part of this discussion. You can omit them from the discussion if you'd like , but they will be part of the equation, as they are now. Is there something in this bill to deny anyone coverage, based on their nationality? They'll be using our system and we'll be paying for it, just as we are right now.

[ghettopalmetto]

Quote: "You can't hold up the French system as an ideal until it proves to be sustainable."

Exactly.

Re: Illegals, part of this discussion. You can omit them from the discussion if you'd like , but they will be part of the equation, as they are now. Is there something in this bill to deny anyone coverage, based on their nationality? They'll be using our system and we'll be paying for it, just as we are right now.

Well, our system is even less sustainable, chief. Hmmm...premiums doubling every ten years.... Yeah, our system is far superior. Better not fuck with it, so that the health insurance CEOs can keep making $10 million a year at the expense of our health.

Where do you get this idea that illegal immigrants would be covered under some sort of national health insurance? Illegals don't receive benefits under the three existing public insurance programs [[Social Security, Medicare, and Medicaid). Why would they be included in this one? All of the discussions I have heard to date have explicitly said that health insurance would not be provided to illegal aliens.

[Sstashmoo]

Quote: "Yeah, our system is far superior."

I never said that or even alluded to it, our current system is a disaster controlled by free-wheeling market capitalists. They have turned one's health in to a hedge fund. We need something, but to throw France out there and say "see what they got and it works" is just ignorant [[oops) unknowing of the reality France and the US are two totally different societies.

Quote: "Where do you get this idea that illegal immigrants would be covered under some sort of national health insurance?"

They may not be covered, but that doesn't mean they won't be taken care of. I'm just pointing out they are a factual consideration of any discussion we could ever have on healthcare. Are you in favor of turning them away when they need medical assistance? Sounds like it.

So whatever system we adopt or is forced on us, it better have cost provisions for illegals or it will not be sustainable. That's what I'm trying to say.

[rb336]

No, I'm implying that the French system is going broke, so it necessarily isn't a good model to copy. Perhaps the aspects of it you admire will be falling by the wayside as the government attempts to rein in its costs?

do you have any facts to back that up?

You can't hold up the French system as an ideal until it proves to be sustainable

and ours is? frankly, 40 years is pretty good for sustainability. the added benefit is that it is a much leaner system, and when there are problems, they are willing to actually do something to fix them, whereas we bow and scrape to the insurance gods and beg them to please stop raising rates at triple the rate of inflation, all to no avail

[MikeM]

do you have any facts to back that up?

I was the one asking if this was true. Maybe you could Google up some statistics that indicate it isn't running a growing deficit. Or that no cuts in service are planned. Or that more cost aren't going to be passed onto its citizens.

and ours is?

So you agree that we can scratch France off the list of systems we should emulate.

[ghettopalmetto]

I was the one asking if this was true. Maybe you could Google up some statistics that indicate it isn't running a growing deficit. Or that no cuts in service are planned. Or that more cost aren't going to be passed onto its citizens.

So you agree that we can scratch France off the list of systems we should emulate.

I'd think the LAST system we want to emulate, though, is our own. Nowhere else in the world does anyone spend so much money for so little in the way of results. We're the only industrialized western nation that does not have universal coverage. I'd take the French system over ours any day of the week.

[ccbatson]

Here is something few mention, but all must consider...A utopian socialist system could truly exist IF you throw an obscene amount of money at it, and then it will only be temporary.

For this reason alone, pursuing socialized medicine is short sighted and doomed to fail. Notice the European nations restructuring [[dismantling) their socialised systems as we speak because they are breaking the bank and falling apart at the same time.

On top of this, free markets work better than socialised programs, EVEN AT THEIR [[the socialised program's) ZENITH.

[rb336]

I was the one asking if this was true. Maybe you could Google up some statistics that indicate it isn't running a growing deficit. Or that no cuts in service are planned. Or that more cost aren't going to be passed onto its citizens.

So you agree that we can scratch France off the list of systems we should emulate.

i never said that at all. they still have better outcomes, lower costs, longer, healthier lives, lower [[by far) infant mortality, etc.

i'm for looking at systems from a strictly pragmatics angle, see what works, what doesn't, figure a few things out. So far, I like the German/Swiss model best

[ccbatson]

Rb...do you not understand that health and outcomes are not the same thing as access and quality of health care?

A is not B....A is A and B is B.

BTW, do you need proof and physical evidence of this Rb?

[vetalalumni]

Health Care: Choose Your Own Adventure
by Marc Ambinder, The Atlantic, Aug 17 2009

With apologies to Edward Packard and Bantam Books...

The White House is always accusing the media of treating health reform like a game. So..

Step 1. The health care system is broken and needs reform.

If you agree with this statement, please go to Step 50.

If you disagree with this statement, please go to Step 50.

Step 2: If you're afraid that ObamaCare will spell the end of private insurance and be a total disaster, Go to Step 54. If you support -- in general -- the consensus insurance reforms in the House and Senate bill, go to Step 3. If you support a single payer system and are worried that the White House has conceded way too much, go to step 33.

Step 3: If you believe that, even with insurance reforms, health care isn't worth the effort unless it includes a "public option," go to step 5.

If you believe that "consumer protections," combined with some cost-cutting measures, higher taxes on the rich, structural reforms and inducements TBD are good enough, Go to step 4.

Step 4: Congratulations. I've identified you, at heart, as a health care policy wonk with center-left tendencies. Or, you work in the White House. Go to step 6.

Step 5: You're outraged that the White House thinks the public plan is negotiable. Go to step 6.

Step 6: House Democrats say that a conference bill without a public option won't pass their chamber. If you believe their threat, Go to step 8. If you think they're bluffing, go to step 7.

Step 7. All your focus is on getting to 60 votes in the Senate. If you think Sen. Ted Kennedy will be able to return to the Senate and cast the 60th vote, go to Step 8. If you don't think Kennedy will return to cast the deciding vote, go to Step 9.

Step 8: You're focusing on a handful of Democrats and a few Republicans. If you think you should play hardball, go to step 10. If you think you should let the finance committee, messy as it is, reach a consensus, go to step 11.

Step 9: If you think 61 votes is undoable, you decide to take a gamble on the reconcilliation process. Go to step 35. Else, proceed to step 8.

Step 10: The White House fills in the details: reform is a must. It's a clarifying issue. When the American people watch the final, final vote, they're going to view the pro-reform side as being "right," and senators need to get on the right side of history. If you think this is sufficient enough, go to step 14. If you think this is an insufficient threat, go to step 13.

Step 11: Your base approval rating drops another 10 points. If you think this is temporary, go to step 12. If you're worried, to back to step 6.

Step 12: Wait a while. Then go to step 16.

Step 13: You have your chief of staff threaten to cut the balls off of any Democrat who KOs his president's signature item. If you think this will work, go to step 16. If not, go to step 15:

Step 14: You bargain that the polarization of the health care debate will diminish over time, and that appeals to logic and reason are sufficient, and that things will sort themselves out in the end. If you're confident, go step 16. If not, go back to step 8.

Step 15: You resort to bribery and trickery, are arrested, and thrown into jail. Game over.

Step 16: The Senate falls in line, and passes a health care bill that includes a government-funded co-op and no public option. The House passes a bill with a public option. A conference begins.

If you think this is plausible, go to step 17. If you think the Senate won't fall in line and won't pass a bill, go to step 20.

Step 17. Stalemate in conference. If you think the conference bill is reported out WITH a public option, go to step 24. If you think the conference bill is reported out without a public option, go to step 25.

Step 20: Health care is scrapped for the year. If you agree with James Carville that the Democrats should punish the Republicans for killing it, go to step 21. If you think the Democrats should punish the Democrats for killing it, go to step 22. If you think the Democrats ought to remain mute, go to step 22.

Step 21: This works. Go to step 40. This doesn't work. Go to step 23.

Step 22: In January of 2010, The Democrats try again. If it works this time, go to Step 16. If it does not, go to step 23

Step 23: Democrats are wiped out in the election of 2010,. having no accomplishment to show for it. If you think this is a likely scenario, go to Charlie Cook's symposiums. If you don't, turn on MSNBC. Game over. Go to Step 61.

Step 24: The House and Senate pass a bill with a public option. Obama has won. Go to Step 61.

Step 25: If you think House liberals will cave, having been sufficiently, ah, induced, by the White House, go to step 26. If you think they will hold, go to step 27. If you think the Senate Democrats won't support the conference report with a public option, go to step 27.

Step 26. Go to step 24.

Step 27: If you think that a permanent stalemate arises, go to step 20. If you think that a third way compromise can be reached, go to step 28.

Step 28: A third way compromise is reached. If you think that the House and Senate manage to pass a bill and that Obama will get credit by the American people and his base for health care reform, go to step 29. If you think that Obama's "win" will be seen as a loss, go to step 30.

Step 29: Obama, brimming with confidence, ends the year with high approval ratings again. Democrats, sensing the popularity of the president and his bill, have something to run on in 2010. Go to step 40.

Step 30. You convene a conference to figure out what Obama should do in 2010 in order to cast his first year and a half as a success. Public opinion gradually softens over time, and Obama's approval rating creeps up. If you think it will creep up, go to step 40. If not, go to step 32.

Step 32: 2010 opens with Republicans and Democrats on an even footing, but President Obama has lost much of his luster, and struggles to regain the magic. His experiment at political reform -- the Obama project -- has failed. Obama decides to govern as an unreconstructed liberal. If you think this is a plausible scenario, e-mail me. If not, you recruit Joe Lockhart and Joel Johnson to take over the White House. Go to Step 61.

Step 33: If you believe that reform ain't worth the paper it's printed on unless it changes the health care system to single papyer, go to step 34. If you agree that the consumer protections are worth having, even if the rest of the bill totally sucks, go to step 4.

Step 34. The bus to Canada has plenty of open seats. Game over. Go to Step 61.

Step 35. If the Senate parliamentarian is skeptical, go to step 8. If the Senate parliamentarian lets you wind up with a pretty good bill, many provisions sunset within five years, and you're consistently fighting an implementation battle with Republicans. Go to Step 61.

Step 40: Democrats lose, at most, a few seats in the House and one or two in the Senate. It's possible that they pick up seats in both chambers.

Step 50: You have private health insurance. You develop pancreatic cancer. Your health insurer won't pay for experimental treatments. Go to Step 51.

You have Medicare. You develop pancreatic cancer. Treatment is available, but you won't get it for several months. Go to Step 51.

Step 51: You decide that the health care system is broken and needs reform. Go to step 2.

Step 54: You are probably a Republican, or a conservative independent, or a libertarian.

Step 61: Turns out that the White House underestimated costs. Congress approves emergency supplemental of $500-billion and raises Debt Ceiling to $14.5-trillion.

[ccbatson]

If only it were that simple...OVER 1000 PAGES folks....this alone should be grounds to dismiss any bill.