Health Reform and French system

A lot has been said and disputed about Obama’s Heath Reform aiming to give access to Health care system to everybody.

Coming from France, our Heath care system is often viewed as a typical French privilege. I think this perception has to be explained and clarified.

It is true that French and American systems are very different. In France, EVERYBODY, even homeless people, can go to the hospital 24/7 and receive care they need. It is one of the basic foundations of the French ethic where everybody has to be treated as equally as possible.

I remember the first time we have had to find a doctor for a throat infection. My mom called a family doctor to get an appointment. The first questions asked have been: “ Do you have an insurance? How will you pay? Who are you working for? Do you have a financial guarantor?” Because we were a self-cash payer, the lady said she was sorry but we had to go to an emergency care center to see a doctor.

This would not have happen in France. Each town, village has a panel of family doctors and specialists that can be visited upon an appointment or family doctors can be called to visit a patient if needed.

Medical costs are mainly covered by the Heath branch of the Social Security budget coming from the two third of tax-payers. Care reimbursements are governed by rules. That means that the rate of reimbursement will depend upon the type of care concerned. Typically what we call “Comfort care” will be reimbursed at low rate while others will be reimbursed at 100%.

For a better coverage, you need to have a personal insurance often proposed in your employee package.

This is a very good system but too many abuses have lead to a serious debt in the State budget. Abuses and unfairness come essentially from the increasing portion of population, which does not pay income taxes because of their low revenue (unemployed, immigrants…) and who benefit the system without contribution in return. This results in several tensions in the population between those who have a job and those who do not.

So I would not say that French system is ideal. It is different with some advantages and drawbacks. To me the main weakness of the French system is to make people too dependent of the medical care. In other words, people go to the doctor for nothing. In reaction and to reduce the deficit of the budget, more and more medications and cares are less reimbursed by the Social security.

At the opposite, the United States system, based on 100% assurance coverage, is a real penalty for those who cannot afford an insurance and may people take risk with self medications as regularly reported in the news.

I hope that Medicare program will help to find a balance between both and make people responsible of their health.