It’s no secret that j’aime la France. It’s in my blood. And you know who else loves the French? The French. Besides their wine, cheese and “c’est la vie” attitude, one of their biggest bragging points is their health care system. In 2000 when the World Health Organization ranked health systems, France came out on top. The curious thing is that if you take a closer look, our red, white and blue cousins have health care very similar to ours yet spend about half of what we do.
So how do they do it? The French have coverage in two ways. The first is through the government’s Sécurité Sociale. Each working person pays an income tax to finance universal coverage. If you’re not working, pas de problème, there are taxes on tobacco, alcohol and pharmaceuticals that also help pay for universal coverage. De plus, co-pays were most recently added to the pot. The Sécurité Sociale pays for 70 percent of fees and the customer pays the remaining 30 percent if you’re referred by or seeing a primary care physician. This may sound high to an American, but fees are set each year by the government and they are also made known to the patient so prices stay low even though doctors are paid by fee-for-service. In every doctor’s office and hospital the cost of every service provided is presented in clear view.
Even though 100 percent of the population is covered through Sécurité Sociale, more than 92 percent of the population also buys supplemental insurance. This can help pay for that extra 30 percent and give you coverage for some bonus services. This insurance can be private, but providers are not allowed to compete by lowering health premiums. Instead they can offer different benefits and ways to cover the 30 percent. Supplemental insurance is also provided by employers with about half of the cost split by an employer and employee.
Like ours, France’s health care system is not simple, but everyone has coverage. Even illegal immigrants — after they’ve been in country for three months — receive health insurance. And people can go to any doctor they please, unlike in the U.S. where you must stay within your insurers network. And coverage is cheap too. People pay small co-pays at doctor’s visits but to make it even fairer people with chronic illnesses, low-income people and pregnant mothers get free services.
The most magnifique component of France’s health care system is the little plastic health insurance card. The “carte vitale” or “life card” contain all the information needed for a doctor to not only adequately asses the patient but asses how the patient will pay. All medical records have been digital since the 1990s and tell the doctor every note, exam and service the patient has had. The processing of services is also done digitally by the “carte vitale.” The doctor inputs the services and this alerts the government and the supplemental insurance of payment which must be given to the doctor within three days. It’s fast and cuts down enormously on medical errors, unknowns and administrative costs.
En bref, when it comes to health care, the French get more bang for their buck. They have more freedom of choice, better quality, lower costs and more efficiency. Many French people still complain about the rising costs and doctors complain about their low salaries (a general practitioner in France will make about a third of what one in the U.S. makes). Both countries rely heavily on employer-based insurance, pay doctors by fee-for-service and both countries demand choice. But WHO ranked France’s system number one for many reasons — low infant mortality rates, higher life expectancies, low medical errors and low deaths in preventable illnesses. The French decided that health care for all is more important than free markets and excessive salaries, and it paid off. I think we can learn a thing or two from that.
