Healthcare systems

I spent quite a bit of time this past week looking at different healthcare systems. For one of my classes I had to try to understand the Affordable Care Act (not an easy task). I also wrote a paper comparing the French healthcare system with the American one. I came to the conclusion that every system has negatives and positives.

The French system provides health coverage for every person living in the country at half the cost per capita of the American system. The negative is that 81% of the funds come from payroll taxes (called "dues" or "contributions"). About 15% of a person's gross income goes to "social security" which includes healthcare, retirement, disability, workman's compensation and family benefits. Most of the burden falls on businesses who pay an additional 30% of each employee's gross income to the government to cover the rest of the costs. As one might expect, this leads to higher unemployment.

The French are able to keep the costs down by controlling what healthcare providers can charge. It only costs 23 euros to go the doctor (about $30). From my experience in France, medical personnel have little risk of being sued, pharmaceutical companies aren't spending millions on ads in the general media, and aesthetics at the doctor's office, clinic or hospital are not a priority. These are small things that help keep overall healthcare costs down and also stand in sharp contrast to the American system.

One of the affects of universal coverage is that people run to the doctor far more often. I discovered that the French go to the doctor almost twice as often as Americans each year. On the other hand, Americans have about twice as many tests such as an MRI or CAT scan as the French. Maybe the French are able to keep their overall costs down because they are at the doctor more often so serious conditions are caught when they are easier to treat. And our extra tests costs more without really contributing to better health. 

Whatever your view on the Affordable Care Act, the American healthcare system needs a dramatic overhaul. However, no matter what the system, resources are limited and decisions have to be made as to how to allocate those resources. Even more importantly, the health of the nation is far more closely linked to the lifestyle of the people than the healthcare system in place.