What is the argument against this in the US healthcare debate? Are any of the three above points wrong? Or is the French government inherently more competent than the us counterpart (I don’t see a lot of US politicians making this argument)?
France has the same problem every country has: soaring costs of health care outpaces the productivity of its citizens to pay for it.
France’s universal health care is already broken. The primary insurer there has been in the red since 1989. As each year passes, the government implements “cost cutting” measures such as increased co-pays. This starts to resemble the USA model.
The USA model isn’t great but implementing France’s approach simply inherits their broken financial system.
France has to drastically cut back their healthcare provisions or find a way for their citizens to exponentially be more productive (providing more goods & services on the world market) to pay for their health care. For example, if their all their exports of red wine and champagne could start fetching $1,000,000 per bottle, that might fund their healthcare without a deficit.
Healthcare in every developed country is in almost identical positions, but somehow universal healthcare survives and electorates around the world never, ever consider changing.
It’s French.
Do you really need more of an argument?
You do?
Okay, it’s socialism, AND it’s French.
That’s a bit misleading. Yes, the “Sécu” has a big gaping hole in its funding that never seems to fill up (though it did for a very short time, in 99-00) - but our Social Security encompasses much more than simply healthcare.
All due respect, but… emphatic no. There’s no fucking around with “pre existing conditions”, no one gets denied treatment or coverage over petty bullshit (one issue is in fact the opposite : insurance fraud), no de facto triage is done based on who’s got private insurance and who doesn’t, hospital coverage and staffing is excellent which means little waiting…
Yes, peripheral and “elective” medicine (like dental or eye doctoring) is getting more expensive over time, but we’re nowhere near the US model. Breaking your leg around here just doesn’t cost you your life savings.
Of course, all this comes with a price : France is close to the top of the list when it comes to taxation. ANSTAAFL.
Again, the organism that supervises healthcare is in the red every year, that much is true, but they also handles a bunch of stuff besides healthcare, lots of “free money” that you guys don’t seem to dole out as readily or easily - general welfare, unemployment benefits, housing grants, family benefits, student benefits, and of course the big one that’s dragging everything into the ground : retirement pensions. Our population is ageing, lifetimes are getting longer every year, and the old codgers nickel and dime us all the way to the Père Lachaise.
Someone oughta organize a cull, is all I’m sayin’ :).
But be that as it may, the yearly deficit of the institution is not *that *bad, averaging 5-10 billions euros a year, or 2% of the national budget and 10-15% of the national debt. Our general national debt level is 42% of the GNP, still below the European average… and the US’s (43.4%, cite, French pdf).
So, considering we get more while losing less, it’s not that completely broken a system, I don’t think.
Of course, again, we pay tons of taxes. And while we spend positively retarded amounts of money on our dick-waving focused military, we don’t declare wars all over the place with it either (we’d much rather sell stuff that goes boom to questionable people and tinpot dictators instead, thankyouverymuch). So there’s that ;).
Not because of health-care though. The US spends 8.5% GDP on its public financed healthcare, which covers 30% of the population, France spends 8.9% of its GDP on publically financed health care to provide universal healthcare (granted people still have to pay out of pocket for some expenses).
In short, we pay a pretty comparable chunk of GDP in taxes on healthcare. We just do it much less efficiently.
What’s your evidence for this proposition?
Yes and no. Yes the Frnech, like every health care system in the world, is facing a brutal projected cost curve (similar to the one America is facing) as health care costs are expected to outpace economic growth almost everywhere. And no because the French STILL get a lot more health care for a lot fewer dollars per capita than the USA.
France spends half what we do per capita on health care. They spend about $3400 per person vs. our $7000+ per person per year.
So these arguments that ‘frances system is bankrupt’ ring hollow and are more red herring type arguments. At the end of the day France has a superior health system that costs half what ours does. So why shouldn’t we implement it?
The reason is ideological. A good number of people are opposed to government intervention and social programs, even if those programs are good ideas. Add in the fact that we are a nation with very strong racial biases (like it or not, many white people don’t want to pay for health care benefits for black and brown people) and as a result we don’t have UHC.
In fact according to Krugman we were going to have UHC in the 40s, but once southern politicians realized it would lead to integrated hospitals, they shut it down.
So race, Ayn Rand ideology and plutocracy are why we don’t have Frances UHC system.
How about the fact that part of France’s health care system is basically “subsidized” by the U.S.'s spending in medical research. Although this article is a couple years old, I doubt the general theme has changed.
In fact, one the big arguments against universal health care in the US is that it will cut innovation & research. Hmmm… wonder where they got that idea?
Europe lags in general in R&D, not sure why. It isn’t just medical R&D.
In the US we spend about $90-100 billion a year in medical R&D. Of that, about 40% is funded by the public sector. Reading your article, it says the same thing.
If our system were as efficient as France’s, we would save about $900 billion a year. So there would be more than enough money to invest heavily in R&D.
In fact if we had France’s system we could have a great universal health care system, triple our medical research spending to $300 billion and pay for social security (about $600 billion/yr) all for the same cost of our current, flawed health care system, and still have $100 billion left over a year.
So again, why don’t we have France’s system? A great universal health care system, triple the medical R&D and free social security checks for the same price as our current health care system.
Basically, claiming we should spend an extra trillion on wasteful, inefficient health care for an extra $20-40 billion in medical R&D isn’t persuasive.
Decades of successful lobbying of politicians by profiteering vested interests - i.e. buying politicians - combined with a hugely successful propaganda strategy that ties an issue that has no ideological dimension anywhere else in the developed world into national identity, and by so doing creating an emotional response.
It’s Malboro Man meets McCarthyism - it’s by far the most successful long con on a democratic population in the capitalist era.
One of my clients was a Swiss Pharma company. While I was there, they were launching a new product, in only two countries: India and the US. The product required a lifetime yearly course; what it did was turn a specific type of cancer into a chronical illness. Indian patients who got a certificate from their doctor saying that they could not pay for the medication got them free; the company pointed to this and said “look how saintly we are!” The cost was $30,000.
That’s $30,000 per year (with periodic increases). Over your whole life.
One of the patient cases in the “we’re so saintly” website was a member of the national sailing team who, upon being told he had cancer, had flown to Philadelphia to get a second opinion. I’m reasonably sure that he did not have 30K disposable per annum; I’m also reasonably sure that any Indian would have considered him rich, and that any Indian patients who really were poor would not have access to the technologies required for a diagnosis.
A French-style system in the USA would have meant that this company would not have been able to market this product only there and for 30K/year. Perhaps that would have led to them not developing the drug in the first place, or perhaps, to going for higher-volume sales at a lower price, by selling it in more markets. The American system may be subsidizing European research, but in this case at least, it was doing so in a way that’s just royally fucked up - how many Americans do have 30K disposible income per year? Even if someone got that brand of cancer, got the treatment, and was covered for it, losing the insurance would pretty much mean death.
Now and to stay with the OP, how much of the income from that drug made its way to appropriate pockets?
It may well be the case that countries with a healthcare monopsony or near-monopsony get a free ride from the US health system, which bears a disproportionate share of drug company overheads and profit margins.
Surely, though, that simply strengthens the argument for the US to abandon its present system, and adopt a monopsonistic one similar to that already in place in most other counties, so that it doesn’t continue to play the patsy for the rest of the world?
What UHC systems mostly do is to co-ordinate drug-buying (and indeed the purchase of other healthcare services, like medical practice) and so drive down prices. They are purchasers’ co-operatives, in effect. Naturaly, the unco-operating purchasers end up paying more. Ultimately it is rational for drug companies to sell into UHC countries at the marginal cost of production, and to recoup all their profits in the US. UHC systems know this, and take advantage of it.
Yes, but if Stephen Hawking was French would he have surrendered his hold on life by now?
Only to the Germans.
Does anyone know how much French doctors get paid?
What does that matter? Health systems are not there to make doctors rich. But as GP’s are paid in excess of £100k p.a in the UK and the EU is an open jobs market my guess would be
‘Shit loads’.
I don’t know about France’s health system, but in a recent thread we calculated that if America were to implement the U.K.'s NHS it would save over a trillion dollars.
I figured this was a fairly well known fact, but what sort of evidence would you accept?
So far in this thread it seems to be divided not as much into who’s for it and who’s against it, but who actually knows about it and who doesn’t. This would indicate that the US policy is based on perpetuated ignorance. So the argument against French healthcare is that it wouldn’t allow insurance companies to make trillion dollar profits. And in order to protect these profits, hiding information or lying is OK, even though it means Americans get poor healthcare. Basically, it’s OK to let Americans get sick and/or die, because we make money off them. My guess is that people would be unhappy about this if they knew enough to understand it.