Lessons from France - 'Vive la difference': the French health care system and US health system reform

Article Abstract:

The French health care system may provide an example for US health care reform. French citizens receive almost universal health care coverage that includes drugs, physical therapy and treatment at spas. The French government spends less on health care than the US, and the French life expectancy is between 73 and 81 years old. Several principals underlie the provision of health care in France. These include the responsibility of the French government and its citizens to provide universal health care coverage. The French system is complex and is part of a larger social protection umbrella. Health care coverage is provided mainly through sickness insurance funds (SIF). The main SIF is supported by the payroll contributions of employers and employees. Different measures have been taken to regulate the cost of health care. The features that may be most beneficial to the US are the uniform benefit program and the unified financing and payment schemes.

France, Medical care

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Memorandum to the president-elect: parameters for health system reform

Article Abstract:

Several areas of consensus exist about the issue of health care reform despite the large number of proposals. The US spends more than any other country on health care and the costs are increasing at a rapid rate. Many US residents have no health care insurance or are underinsured. A plan for health care reform should provide universal health care insurance using employer provided health care insurance as a building block. It should provide employers with a financial incentive for providing health care insurance to their employees. Insurance purchasers should be provided with an economic incentive for cost consciousness, and health insurance for the poor should be subsidized. The cost of health care should be contained, and standards of care should be developed. States should be encouraged to develop their own initiatives for health care reform, and purchasing cooperatives for health care insurance should be established.

Editorial, Medical economics

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Community-oriented primary care: the cornerstone of health care reform

Article Abstract:

The community-oriented primary care (COPC) model of health care presents a practical means of reintroducing elements of cost containment and humanitarianism to medicine. The current health care system is fragmented and depersonalized. It emphasizes biotechnology and acute hospital care over health status and patient outcome. The three main problems facing the health care system are skyrocketing costs, inadequate access to care and inappropriate or ineffective care. Lawmakers are aware of the public's dissatisfaction with the system and are realizing that true reform will come only with comprehensive revisions in the financing, organization and provision of care. The COPC model requires a primary care practice based in the community, an identifiable population that will receive the services and a process for evaluation. COPC is socially responsive and would control costs.

Community health services, Medical policy, Health policy

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