My paper is comparing the healthcare system in France to the healthcare system we have in the United States. We need to look at France’s healthcare and other countries with universal healthcare and ask ourselves “Is it sustainable? ” Is it feasible? ” “Will it provide for those who don’t have insurance and help those that do? ” The results show universal healthcare is usable, but there have to be guidelines, who it covers, what it covers, and what improvements need to be made to make it work. When other countries have been using universal healthcare for 60 + years, it shows there is hope for it in this country too.
Healthcare is a growing problem, but it might become more of one if taxes are raised to cover the cost. France’s NHS system is not costly compared to the United States. The U. S. thinks when universal healthcare goes into effect; we will give up our choice in doctors, hospitals, and care facilities. The French agree with the United States in their distaste for restrictions on patient choice and insist on autonomous private practitioners. In France, there are no waiting lists for elective procedures and no need for pre-authorization. There are no uninsured in France. No one goes broke for health costs.
The system is designed where the 3% to 5% of the sickest are exempt from co-payments and have no deductibles. Out of the people with one of the 30 long term and expensive illnesses (diabetes, mental illness, cancer…), the government covers 100% of health costs including surgeries, therapies, and drugs. They have a very unusual guarantee from the government. All cancer patients are able to get any drug, from experimental and still being tested to the most expensive, for free. The French healthcare service is costly, but is the best in the world and offers the greatest choice in general practitioners and specialists.
In the movie SICKO, Moore describes healthcare in other countries as the way to go. He gives several fine points on the way France’s NHS is utilized. There, everyone is covered. They have a choice in physicians; there are no waiting lists for elective procedures and no need for pre-authorizations. The sicker a person is the better covered they are. In France, a pharmacist has the right to give you medical advice when a person is not seriously ill, and can consult you about the right medications to take.
Just as medical emergency personnel include an MD in the ambulance, that person’s job is to o as much as possible for you before being taken to the hospital, where in the U. S. , it consists of a person driving as fast as they can to take you to the hospital. France has a universal healthcare that is outta this world! The largest study ever done of its kind was by the World Health Organization in 2001, it rated France number one out of 191 countries because of access to universal coverage, responsive healthcare providers, patient and provider freedoms, and health and longevity of its country’s population. The United States was ranked 37th.
Researchers thought the study was flawed so the London School of Hygiene & Tropical Medicine redid the rating based on the measured “amenable mortality” rate. They basically believed the measure of deaths could have been prevented with good health care. They looked at 19 industrialized nations and France still came in first and the United States came in last this time. The United States didn’t rank well because of the high cost of healthcare, health disparities, and problems with those that had no insurance. Right now there are 47 million Americans with no health care coverage and the number keeps going up.
Almost 84% of the working population in the United States needs some type of extra health coverage. The U. S. wants to have mandates on employers to provide health insurance. The link between employment and health security is a disadvantage and far outweighs the advantages right now. Economists estimate there are between 25% and 45% employees in the U. S. that are in a job-lock. (Employees apprehensive to make career changes based on the need to keep their present insurance coverage, or avoid elimination based on a pre-existing condition. ) In the U.
S. and in France, the employers and the employees split the cost of insurance each pay period. In the U. S. , insurance premiums can’t be pre-determined because of the “risk” classification, and that of different group sizes looking for coverage. The average employed person in the United States pays roughly $6,000 a year, in France; the average employed person pays about $3000. Malpractice consists of an out-of-court, no-fault system brought to a regions government appointment review board. It determines if compensation is in order and how much.
The money comes a patient relief fund which is generated from insurance premiums placed on the physicians money, the hospital, or from a general fund from revenues. We need to look at the different groups, such as the elderly, obese, and smokers in the United States. Elderly- 13% of the population is 65 and older. The Baby Boomers are getting close to the retirement age, and families have been cutting down from 3 children per family to just 2. Obese- is becoming an “epidemic! ” We have 44. 3 million people that are either obese or over weight.
In 1986, the numbers were at 1 in 2000, and they became 1 in 400 by the year 2000. Even our high school age students are at an all time high of 16% overweight and 10% obese. As that number keeps increasing, future projections for covering healthcare expenditures must figure in the obese-related costs thru the lifespan of even the very young. Smokers- are at 20. 8% of American adults. In households that are at poverty level or below, they are 2 and half times more likely to smoke. The National Health Service (NHS) in France, was started back in 1946, and became effective on 5 July, 1948.
It has been active for over 60 years now. It is funded by uniform rates, employers, employee contributions, and personal income taxes. Workers pay approximately 23% out of their paychecks each month to cover the price of healthcare, retirement, and unemployment. Employers pick up little more than half that expense. In the U. S. , we pay about 33% in just taxes. We end up paying more for healthcare insurance, higher out-of-pocket expenses for medicines, doctors, and hospitals. NHS in France is based on two historical bargains; the first with their physicians and the second with their insurers.
France let the existing insurance companies become the nation’s healthcare fund administrators. These insurance companies negotiate with medical unions and set physician fees. The government regulates hospital fees and the NHS works to keep costs down. France is trying to change health insurance financing from payroll and wage levies that hamper many employers willingness to hire. They are thinking about trying to broaden taxes on earned and unearned income alike to help pay for healthcare. It is beginning to break down and cause problems, but as time goes by everything needs to be updated and changed a bit.
There are other countries with socialized medicine for us to look at. We need to study what works, what doesn’t work, and where changes need to be made. There are improvements to be made in all areas over time. In France, all physicians participate in the nation’s public health insurance. They have the freedom of diagnosis and therapy and are protected unlike managed care providers in the U. S. American physicians make 2 times the average person does in France, but U. S. physicians earn 5x that amount.
When a person goes to see a doctor, the NHS pays for 70% of the ill, and the other 30% is paid for by a person’s supplemental private insurance (which almost all people have). It is affordable and most of the time is paid for by the patient’s employer. In France, the physician practice liability is diminished by the tort-averse legal system. Their medical schools are competitive to get into and are tuition cost free. Physicians enter their career practice owing little if any debt, and pay a lower malpractice premium. They don’t face personnel payroll expenses like American physicians do either.
The Securite Sociale (Social Security) has created a standardized and speedy system for billing and patient reimbursement using electronic funds. The doctor’s office doesn’t need an army of billing specialists to deal with all the insurance companies and their complicated changing rules of payment. There are two additional funds for the self-employed and the agricultural workers if they need to see a specialist. France’s NHS covers approximately 92% of the population; only about 8% use private health insurance.
The NHS is trying to make it so that some individuals pay for health services. They are talking about implementing incentive programs and personal responsibility programs vs. the government and those taxed to pay for everything. Physicians can choose to work outside the NHS and the growing minority charges what patients are willing to pay out of their own pocket. The United States believes if we take on universal healthcare, we give up our choice in doctors, hospitals, and care facilities. Not true!
France’s system is set up to ensure patients have many choices of doctors, specialists, and ensure the doctors are not inhibited in making medical decisions. France believes good care starts at birth! New mothers get months of paid job leave. They get a child allowance. There are neighborhood health clinics just for new mothers and babies, home visits by nurses, and subsidized day care. The state makes sure the whole population has access to care; dictates the type of care to be reimbursed, to what degree, and what the role is of the different participating entities.
The state protects patients’ rights, develops policies, and enforces them. Health authorities plan the size and number of hospitals. They decide on the amount and allocation of technical equipment (MRI, CT scans…) each gets. They organize the supply of specialized wards and secure the provision of care at all times. Hospitals- there are two kinds, but there is no difference in the quality of care given either place. Public-has 65% of all hospital beds and are responsible for supplying ongoing care, teaching and training. Private-is profit oriented.
Concentrates on surgical procedures and depends on fee-for-service for funding. Health Professionals- professional and physicians work in both public and private hospitals. 36 percent of physicians work in public hospitals. They are public servants, what they are paid is determined by the government. 56 percent work in private practices because of the difficult working conditions in hospitals. In some situations, certain medical practitioners (surgeons with extra qualifications) can charge more than the amount determined by the government. There are 3. 37 physicians per 1000 people.