I just had to share this….Myriam is a friend that was born and raised in France and has only been in the U.S. for 10 years. She has a Master’s Degree in history from the University of Strasbourg, France. In the debate about health care reform, France is often held up as exemplary. The success of the French system does not establish the superiority of public insurance. It establishes the superiority of a system that, as much by historical accident as by design, has kept doctors pay very low. This, in turn, requires a medical-liability regime that minimizes litigation (so much for patients rights in that sense) and guarantees essentially free training for medical professionals. The idea that Frances system could be grafted onto the American setup is most misleading. To be sure, in organizational terms, it could be. Structurally, the two countries systems are not that different. The French scheme is like Medicare on a much larger scale -- with all the virtues and drawbacks of that system. But plug American rates of pay into that design and the impressive cost advantage vanishes. It is also worth remembering that, despite this secret ingredient of paying its doctors so little by American standards, the French system is in chronic financial difficulty -- as you would expect, in fact, because of fee-for-service and the other dysfunctional aspects that its approach has in common with Americas. The costs are covered through a high payroll tax, which employers and workers share; but all of it, in the final analysis, is drawn from wages. Constant upward pressure on costs translates into constant upward pressure on taxes, which then meets the same political resistance one sees in the United States. Meanwhile, paying for everything through a tax on labor most likely contributes to Frances chronic high unemployment.
Posted on: Thu, 21 Nov 2013 19:51:02 +0000
Trending Topics
Recently Viewed Topics
© 2015