Yes, The US Could Probably Learn A Lot From The French Health Care System

Bastille day military parade, french flag

Photo: AP Images

In 2000, the World Health organisation took a long hard look at the world’s healthcare systems, and ranked France as the best in the world. The US ranked 37th.Since that point France has repeatedly been called the best system in the world, to the point where doing so became a cliche.

Unfortunately, the world isn’t quite so simple, and critics argue that searching for the “best” healthcare system in the world may be futile — there’s simply too many variables to produce meaningful results. WHO’s report in particular has been criticised for the weight it gave to cost efficiency, healthy living, and life expectancy (the organisation apparently declined to rank countries in the 2010 World Health Report).

Regardless, we think that the French system may have something to teach the US. For one thing, other more recent sources have given some credence to the WHO’s findings. One, published by US journal Health Affairs in 2008, found that between 2002-2003, France had the lowest rate of mortality amenable to health care — that is, the lowest death rate from ailments that could probably have been prevented by proper healthcare — of 19 developed countries. The US, on the other hand, came 19th.

More importantly, however, is the fact that the French system and the US system actually share some key similarities.

It’s tempting for Americans to compare their healthcare systems to that of English-speaking countries like the UK and conclude that things aren’t so bad, or that the systems are so different that change is impossible. The UK in particular has a full-National Health Service that is subject to near constant negative coverage from the UK tabloids and appears to be entering the first stages of privatization — hardly enticing.

France, on the other hand, doesn’t have a “National Health Service” — it has National Health Insurance. Many French people don’t even consider their health system “socialized”, Paul V. Dutton, executive director of the Interdisciplinary Health Policy Institute at Northern Arizona University, writes in Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France.

Like the American system, the French system prides itself on choice. “The vast majority of ambulatory care physicians in France are in private practice and patients enjoy extraordinary freedom of choice among them. Virtually all primary care providers and specialists participate in the nation’s public health insurance system, Sécurité Sociale“, Dutton writes. Notably, France also has the largest private hospital system in Europe.

This system, whether its socialized or not, is (at worst) fairly successful. Last year a Deloitte poll found that 55% of French respondents believed their system was the best in the world. Contrast that with a March 2012 Gallup poll which found that 81% of US respondents had a great deal or a “fair amount of worry about the availability and affordability of healthcare.” That’s probably a pretty unsuccessful health care system, and remember — in 2010 the US spent 17.4% of its GDP on healthcare, while France spent around 11.8%.

Crucially, the French system shows how the American system could grow.The French system of National Health Insurance that evolved slowly to meet needs, Victor G. Rodwin wrote in a 2004 academic article, “The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States”. Rodwin argues that “patchwork accumulation of federal, state, and employer-sponsored plans” could gradually work in the US, as long as the country decides to “recognise the legitimate role of government in overseeing the rules and framework within which these actors operate.”

Whether that actually happens is anyone’s guess.

But it could.

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