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Strange Criticisms of French Health Care

By Matthew Yglesias on July 13, 2009 at 5:28 pm

"Strange Criticisms of French Health Care"

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Eiffel Tower, Paris, France (wikimedia)

Eiffel Tower, Paris, France (wikimedia)

As every good conservative knows, France is bad and universal health care is bad. This the sneering condescension in this Dennis Boyles post at the Corner must secretly make sense:

A couple of things you can learn if you’re in France:

First, the meaning of “universal.” It doesn’t mean what you think if you’re a poor person in France, where “universal” health care is arguably better than elsewhere in the EU. It means about 75 percent. Le Parisien reports this morning that, as in the U.S., the more money you have the better care you get. Shocking. The paper backed up a recent study with a small-scale sting of their own and discovered that if you rely on France’s medical insurance alone, 25 percent of French doctors will refuse to treat you. That’s how you say ObamaCare in French.

For one thing, Obama’s proposed reforms—unfortunately—wouldn’t actually make American health care much like French health care. That said, the moral of the story is that in France no matter how poor you are, or what pre-existing conditions you have, or what happened to your job amidst the latest recession, or whatever else if you get sick 75 percent of doctors will treat you and the government will pick up the tab. In the conservative free market utopia, as I understand it, what would happen to you is that you would just die.*

The reality is that France provides a very high standard of health care to its citizens:

Some researchers, however, said that study [from the WHO, proclaiming French health care the best in the world] was flawed, arguing that there might be things other than a country’s health care system that determined factors like longevity. So this year, two researchers at the London School of Hygiene and Tropical Medicine measured something called the “amenable mortality.” Basically, it’s a measure of deaths that could have been prevented with good health care. The researchers looked at health care in 19 industrialized nations. Again, France came in first. The United States was last. [...]

There are no uninsured in France,” says Victor Rodwin, a professor of health policy at New York University, who is affiliated with the International Longevity Center. “That’s completely unheard of. There is no case of anybody going broke over their health costs. In fact, the system is so designed that for the 3 or 4 or 5 percent of the patients who are the very sickest, those patients are exempt from their co-payments to begin with. There are no deductibles.”

There’s a lot that could be said about the relevance of France’s success in health care policy to the American debate. But to argue that the French system is unsuccessful is totally untenable. And to argue that it’s somehow worse for the poor than America’s “good luck with that!” approach is ridiculous.

* Now in the current American status quo you might be able to sign up for Medicaid (socialism!) or else go to the ER and get some unpaid-for health care once your condition deteriorates enough. But it is worth being clear that the free market solution to someone being poor and sick is for them to die. If you’re too poor for HBO, you go without watching True Blood. If you’re too poor for a MacBook Pro, you make due without one. And if you’re too poor for statins you get a heart attack. And if you’re too poor to get your heart attack treated you die. Whether or not anyone in the United States actually wants to implement such a system isn’t clear to me, but that would be what a free market health care system looked like—like free markets in other things.

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