U.S. health care reform: The view from France

DO you think that the welfare class will ride a bus or drive out to a location where they can go to a private doctor?

Not a chance in hell. The reason why emergency rooms are clogged is becuase most hospitals are centered in urban enviroments. Take the Cleveland Clinic for example. Within a ten mile radius of the Cleveland Clinic you have one of the highest concentrations of welfare in the nation. It would be suicidal to open a private practice anywhere around there. Not only would you have to compete with the clinic you would have to employ armed guards around the clock. On the first night your office would be broken into and raised for the supplies and drugs.

The hospitals also would never want to get rid of the easy money medicaid provides to them. Imagine being able to bill medicaid $7000 for a sore throat. $15,000 for a bad case of gas. Urban ERs are a cash cow the American medical system will fight tooth and nail to keep.

The current reforms will just shift the burden of payment from the state to the federal government. Emergency rooms will see an increase in patients because of them.

Hospital billing is rife with fraud. A recent study found that 80% of hospital bills contain fraudulent charges. Mostly extra billing for equipment that was already included with other charges. Many of the errors add up to a couple hundred dollars within bills that are a few thousand. Hospitals know that 9 out of 10 people will not dispute a bill or even know how so they all practice fraud on a large scale. It is a way to game the system.

If you want to fix health care in America:

1) Eliminate all federal subsidy programs
2) Audit every single hospital
3) Pass a truth in billing law and paperwork reduction law
4) simplify billing codes
5) Eliminate outside billing of doctors who do not work at the hospital. If a doctor wants to be paid he should be paid by the hospital out of the bill paid by the patient. Today you can be charged $10,000 for your procedure by the hospital and $10,000 by the doctor who works outside the hospital. The doctor performed the procedure, what exactly did the hospital provide?
6) Force insurance corporations to insure the individual, not a statistic. A person that is never sick should not have to pay the same premium as a person who goes to the ER three times a year.

Having spent the last 9 months living in France and requiring the use of their public health care system I can say from personal experience that they are not a country worth modeling. Despite being extremely ill (I couldn't even sit up without vomiting) I was told it was not serious enough for the hospital and told to see a local generalist which then took forever to arrange an appointment with. The difficulties in getting the appropriate treatment in a timely manner were troubling.

Additionally, while and more importantly, while our costs may be higher than other industrialized nations we are also a global leader in medical advancements and cutting edge treatments. New technologies and methods to fight disease will of course lead to higher costs, but I feel that the trade off for new and better ways to fight diseases are well worth it. Rather than a public option reform is needed. Limit malpractice, increase competition by opening states to more private insurers (in my home state my family's small business has only 2 options despite other non-present providers existing in neighboring states). The free market is capable of letting us reduce health costs, its government restrictions and interference that has largely contributed to the problems we face today so why risk bringing them in and destroying market forces. They have no incentive to be efficient once established and existing programs are clear failures. Why not try simpler, safer, and better reforms, if they fail maybe then consider a public option for once it is created it cannot be undone.

GOVERNMENT IS THE PROBLEM. THERE WILL NEVER BE ANY INDIVIDUAL RESPONSIBILITY AS LONG AS "THE GOVERNMENT" IS PAYING THE BILL.ALONG WITH "GOVERNMENT" COMES FRAUD AND CORRUPTION THIS TRIANGLE WILL NEVER CHANGE AND WILL EVENTUALLY DESTROY THE TOTAL ECONOMY OF THIS GREAT COUNTRY.IS THERE A SOLUTION? NO.ONLY A MASSIVE COLLAPSE OF THE DOLLAR WITH HYPERINFLATION DESTROYING EVERYTHING IN IT'S PATH MAY FORCE THE CITIZENS TO TAKE BACK THEIR COUNTRY FROM THE POLITICAL CLASS WHICH IS DESTROYING IT.

I cannot believe any American would even care what the French think. Maybe we should configure our military after their's.

I agree with Al. Who the hell cares what the french have to say about america, or anything for that matter. Aren't these the same people who bent over for the nazi's and let them walk right into and all over Paris, and continue there anti-semitism to this day.
Everyone hates the french.

The only noteworthy thing France has done in the last 50 years has been the building of enough nuclear power plants to provide 80% of their electricity. Oh yes, and they did give us Bridget Bardow.

If you enjoy a visit to the unemployment office, the IRS, the highway department, or dealing with cable company customer service you'll love government health care.

American government's health care system is bad and irrational. They provides deficit health care services. I think they shold improve their health care system.

I don't exactly know where Jsquared went, but there are TONS of no appointment GPs everywhere, and no, you don't have to wait 2 days on a chair to get treated. There's also an emergency GP service, which will send a GP straight to your location.

There are PLENTY of options, some cheaper, some more expensive, to get treated in France. Going to the ER/Clinic everytime you hurt your toe is not the solution.

A GP's cost is 21€. A emergency medic, depending on the time of the day and if it's during the week-end or not, can go up to 75€ for the visit. Everything is of course covered 100% by either Social Security, or your own private insurance.

And sometimes you don't even have to co-pay anything, since the whole process has been made digital, with a social security smartcard containing your details.

There is however two-tiered system in place, with private clinics with unregulated charges, and plain ole' public hospitals. I had surgery in a private clinic, a pretty invasive intervention... The end cost for me was 2000€. For a 5 days stay.

I spent 6 months in the US too. It costed me $200+ to treat a simple ear infection, and I went to Duane Reade Walk-in Clinic to get it treated, because I didn't know any better. This wasn't reimbursed by my US insurance since I didn't notify them before, and because it was out of their network. $200 is the price of my insurance for a year here, with almost full coverage.

I also know someone who attempted suicide, and spent 3 days in a room for observations. $38000. I still wonder how can someone ask for $38000 for clearing a stomach out and barely watch them.

It is a little bit sickening to see that healthcare in the United States became what it is now, a bunch of people who charge whatever they please, as long as the insurance companies pay up.

And I don't exactly see how our military has anything to do with this topic. Our military past might not be glorious, but it has strictly nothing to do with the subject at hand.

Did your cousin in France mention that the public French healthcare system:

1. Has been running a deficit for 10 years that is growing every year?
2. Only covers 65-75% of the cost of service and 90% of the French also carry private insurance?

Did she also mention that the primary reason healthcare costs are less in France than the US is health status, not our healthcare financing and delivery system?

Take for example obesity: The obesity rate in the US is 30% in France it is 9%. And this has nothing to do with our system versus theirs. (Autoworkers and government employees have some of the best healthcare coverage and some of the highest obesity rates.) It has to do with diet, exercise, and heredity.

I continue to be amazed at how uninformed people keep providing slanted opinions on topics they dont fully understand.

i would like people who leave the united sates, and go to other countries for their health care, to tell all of us, how great that health care is. i dont care how much the united states spends on health care, because the quality is so good. i wish the united states would cut way back on foreign aid to other countries, and stop running up the deficit with stimulis programs. congress spends too much money on pork, and they always give themselves a raise.

Why is this plan not good enough for Congress? If it is sooooo great for us, then why do they get to keep theirs?

Wow, did the Daily Kos buy out this site or something?

Massachusetts tried universal health insurance, most middle income peoples that could use it just couldn't afford it. At this point the costs of health care in this country have gotten plain ridicules, it cost $15,000 to have a baby in a hospital with a normal delivery and a two day stay. What a joke. The main reason for this situation is laws passed by your governments both State and Federal that infuse large amounts of money into the system and give near monopoly status to hospitals and drug companies. Ever wonder why there are lots of abortion clinics and no birthing clinics? Anyway I see the system crashing under its own weight in the next ten years. Only hope is to start a parallel system run by the government much like education. Private care and public care. The public system would compete with the private system and help bring down the costs of the private system. The thinking behind everyone paying for public schools even if you are wealthy and send your kids to a private school is that everyone benefits from a well educated population. The same goes for health care, we all benefit from a healthy work force. The current VA hospital system could be a nucleus for the start of the public system.

To ART: The infant mortality rate, kids under one year old, in the US is about twice what it is in France. WHO 2005 figures. Are these babies obese or could it just maybe be that they and their mothers could not get decent or any medical services? How many abortions do you think were performed because $15,000 to have a baby at a hospital was out of the question but a $450 abortion was affordable?

1. It is not about who likes or dislikes the French. Based on my visits there I wasn’t crazy about their treatment of foreigners but that’s a different story. Nonetheless, I would take their health care system along with their supplementary private insurance any day. Right now I pay around $7,000 premium per annum + deducible+ co-payments + a lot for medications and receive lousy care here in the US.

2. I was in hospital only for 24 hours for observation. (In my humble opinion, the hospital was not needed, a 24 hours EKG would have done the job nicely, if my internist had a better judgment). I was parked in a very cold ER corner from 2.30 PM till 8.30 PM where I witnessed returning "patients" and I was freezing. My husband asked for a blanket - the hospital charged $200 for that. I got no food or water and I finally announced that if I am not transferred to the hospital 'chest center' till 9 PM the latest, I would go home. The nurses repeatedly said that they were changing the linen. Right before 9 PM I was transferred to the hospital's Chest pain center that was totally empty. My blood pressure wasn't high, quite the contrary; run so low, that the equipment started to scream. What the nurse did? They unplugged the machine so I would not disturb them any more. I do not want to go into further details about this miserable 24 hours experience. The fact is , that the hospital tried to charge us over $16,000 for this adventure. Our insurance cut this bill into half - we still had to pay over $2,000 for this “quality” care in a US hospital in a town with over 200 thousand habitants.

3. Waiting list. I needed a spinal procedure and I was referred to one of the top-notch research university hospitals in this country. I had to wait 7 months to see the surgeon. (Yes, here in the US, not in Canada or in the UK.) 3 days before the appointment I got an email that I wasn't going to see the surgeon only his nurse practitioner. We phoned in and we managed to see the surgeon for a few minutes. The surgery was scheduled and then postponed 4 times. It would have been postponed again but I said no, enough is enough.

Do you want to hear more horror stories about the outstanding US health care? I am happy to oblige...

Still, I do not want the Canadian or British System established here ever. But I would be happy to see the French or the Swiss one after paying for the substandard care I keep receiving here in the US because insurance is expensive, deceptive and the doctors are either not reimbursed well enough or do not care any more - due respect to the few exceptions.

We do need tort reform, yes, and we do need to regulate the insurance carriers, too. They sell either very expensive premiums or useless health coverage. I was in a doctor’s office last week where a very sick patient showed up and was sent away by the very nice office manger who explained to her that her insurance is not accepted because the reimbursement offered by her insurance is so low that it is not acceptable. Most doctors in this town do not accept the same insurance. It is criminal to offer insurance policies like this in my opinion.

No healthcare service is perfect
I'm used to the NHS, sure theres criticism, but it never discriminates based on colour, wealth, gender or even if you live in the country.
It's a brilliant model and costs half of America's (per person), it just needs to be able to discriminate against people who have never worked or weren't born in the country.

At the end of the day everyone thinks they can do better, (just like politics) they just never do