As the United States strives for a universal health care system, many have looked to the Canadian health care system as a model. Only a few have looked towards France. That is wrong for at least 2 reasons.
First, according to the World Health Organization (WHO), France has the best health system in the world. It has been widely reported that the WHO found the French system to be number 1, while the Canadian system is number 30 and the American system number 37.
It should be noted here that the WHO classifications actually contain multiple classifications and the numbers generally quoted are the measurement-based classification that the WHO calls the OP classification. OP is said to measure “overall performance” adjusted to reflect a country’s performance based on how well it could theoretically have done. When reporting ratings of 1 for France, 30 for Canada, and 37 for the United States, the OP rating is used.
Why did the French system do so well in the WHO classification? The French system excels in 4 areas:
- Provides universal coverage
- It has responsive health care providers.
- Patients have freedom of choice.
- The health and longevity of the population.
Second, we should take a closer look at the French system because it has more similarities to the American system than to the Canadian or British ones. Many Americans assume that the French system is like the British system. Nothing could be further from the truth or more insulting to the French.
Like the United States, the French system relies on both private and government insurance. Also, just like in the United States, people generally get their insurance through their employer. What is different is that everyone in France has health insurance. Every legal resident of France has access to healthcare under the universal coverage law called universal health coverage.
In the French system, health insurance is a branch of Social Security or the Social Security. The system is financed mainly by taxing workers’ wages. An employee in France will pay around 20% of her salary to finance the Social Security. These taxes represent about 60% of the cost of the health insurance plan.
The rest of the funding comes from the self-employed, who pay more than salaried workers, and from excise taxes on alcohol and tobacco. Finally, additional taxes are levied on other income, both direct and indirect.
The French share the same distance regarding restrictions on patient choice as the Americans. The French system relies on autonomous private doctors rather than a British-style national health service. The French are very dismissive of the British system which they call “socialized medicine”. Virtually all doctors in France participate in the nation’s public health insurance, Social Security.
Perhaps it’s time we took a closer look at French ideas on health reform.
