blog chatter on European health care

[jlittlej]

Last week, Matt Welch, who writes for the libertarian mag Reason and is married to a French girl, went against political ideology and stated that he'd rather be sick in France than the US:
http://mattwelch.com/archives/week_2...03.html#003088

This got picked up by Kevin Drum:
http://www.washingtonmonthly.com/arc..._04/006078.php

Interesting stuff in the comments section on both sites. What often goes unstated, however, is the differences in the costs of medical education for American and European docs.

[Miklos]

A couple quick comments. (IMO, this thread might be better suited for the longue.)

There are a number of key differences between France (and Sweden, the other socialized medicine poster child) and the U.S.;

1) Significantly smaller countries in both land area and population (therefore cheaper delivery systems).
2) Highly homogenous populations (much easier to convince compatriots to shoulder significantly higher tax burdens, greater impact of public health programs).
3) Higher rates of medical malpractice. Don't have the reference at hand, but saw a WHO study that showed the U.S. had the lowest rate of medical malpractice, thanks in part to 'defensive medicine' that drives costs up.
4) Much lower malpractice insurance premiums, capped damages in Europe. (Can sue anyone for anything in the U.S., and many think that there's a free lunch to be had. Not so, everyone pays more.)
5) Yes, medical education is low-cost in much of Europe.
6) European physicians (and health care workers) make a lot less than their U.S. counterparts.
7) No national formulary for the U.S. Pharmaceuticals are sold (mostly) at market rates.

Sure I missed some, but no doubt someone will add them.

[blueeyes]

The French system seems to work a lot better than what we have in Canada. Sure, the French complain about their healthcare system too but when you look closely at what they're complaining about most of it centres around things that aren't even an option in pretty much any other country. They really are spoiled here.

The downside to this is that costs are spiralling and the government has finally started to cut out many "nice" but unessential aspects of French healthcare.

It's true that French doctors earn quite a bit less than in ths US, especially if you're in any sort of surgical specialty. Salaries were just raised this year (finally) but are still less than in the US, Switzerland, the Netherlands or Germany. (Incidentally, I think family doctors in the Netherlands and Switzerland earn more than in the US--they used to in any case.)

And, yes, taxes really are too high here. But I think that's mostly because of a huge web of social programs. France actually spends a low percentage of its GDP on healthcare (something like 9.4 %--lower than Canada and much lower than the US's 15%). Rather than healthcare, I'd much rather see spending cut in a number of social programs which I think a lot of people abuse. Personally, I'd like to see another increase in doctors' compensation and an increase in the number of training spots for certain specialties. But overall, the system here seems to work.

Interestingly, some of the things we pride ourselves on in North America, the French actually criticize in their own system. I posted a message on another thread in which I mentioned Hôpital Européen Georges Pompidou--a big, modern hospital of the sort you'll find in many North American cities. (It's actually much more modern than most NA hospitals but you get the picture.) As a Canadian, I was impressed...but the French, in general, aren't. Apparently, they're convinced that it's more cost effective and provides better service to simply improve preexisting, older, smaller hospitals that are more dispersed. It's a different approach from what we value in both Canada and in the US.