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Socialized Medicine in Old Europe


By tovarichpeter   Follow   Mon, 26 Mar 2012, 9:42am PDT   967 views   2 comments
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http://www.newyorker.com/reporting/2012/04/02/120402fa_fact_sedaris

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Expat5   Tue, 27 Mar 2012, 1:47am PDT   Share   Quote   Permalink   Like   Dislike     Comment 1

The article is informative but the title is misleading. France does *not* have a socialized healthcare system. Unlike France's educational system, which is planned from the center, France's healthcare system was and remains highly decentralized. Since World War II, France's healthcare system has been reformed and expanded in a gradual manner over many decades and near-universal coverage was not achieved until the late 1990s. The focus in French healthcare has always been to protect the autonomy and independence of individual physicians, what French doctors refer to as "la medicine liberale" (literally, "liberal medicine", in the classical liberal sense). There exists lively competition in France between private and public hospitals, individual physician practices and more collective health organizations. Frenchmen have standard insurance through Assurance Maladie and many Frenchmen receive supplementary insurance through so-called mutuelles, per their professional group affiliation. France does *not* have a single-payer system where the state plans healthcare supply from the center. It's very important to understand this. Unlike France, the UK *does* have a single-payer system, which can definitely be called "socialist" where supply is strictly planned and there are no meaningful markets or market pricing mechanisms. In the UK, the results for quality have been disastrous, as they were for the Dutch before 2006 (in that year, the Dutch ditched their centrally-planned Soviet style healthcare system for a market-based one). The achilles' heel of the French healthcare system was and remains cost control, not quality problems. Assurance Maladie, France's main national insurer, has been in the red since the 1980s and has needed large inflows of general public funding to stay afloat. Unlike the UK, France has been mostly able to avoid standard rationing of healthcare, but enormous cost pressures may make this difficult to sustain. See: http://online.wsj.com/article/SB124958049241511735.html

oliverks1   Tue, 27 Mar 2012, 2:38pm PDT   Share   Quote   Permalink   Like   Dislike     Comment 2

Expat5 says

In the UK, the results for quality have been disastrous

I am not sure what you are basing this on. Disastrous would not be the word I would chose. Less than ideal, room for improvement, not the best are probably all reasonable descriptions.

Disastrous would be the US system. Even for people with insurance, your health, as measured by a number of respected surveys, is below the health of Britons. Once you throw in the uninsured, the US system is horrendous.

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