Thanks for the answer. What is stopping the US from adopting the French system? Wouldn't be the easiest to transition to and more widely accepted?
Originally Posted by juanab
Yes, it would be, since all the components are private (insurance, hospitals, doctors and pharmaceutical firms). In fact,the Affordable Care Act ("Obamacare") is largely based on the Massachusetts health care reform, which is itself modeled on the French system
Originally Posted by rbb
interesting about massachusetts -- my son and daughter-in-law, and 2 granddaughters live in massachusetts. they have health insurance through my daughter-in-law's employer, a pharmaceutical company, and pay $8, EIGHT dollars, per month for family coverage. they can see any dr they want. i know both my granddaughters were born in mass gen, a good hospital. i always assumed it was because their insurance was thru a pharmaceutical employer, but now you are saying that massachusetts has health care reform based on the french system. why can't the rest of the country follow suit?
In order to sell policies in MA, health insurance companies must submit plans to the state for approval. As a result, prices and options are much more reasonable than under a typical health care regime. In addition, the state provides assistance for poor individuals and families to buy insurance.

The flip side is that all MA residents must purchase insurance (the "individual mandate") so that insurance companies can spread their risk across a pool of both healthy and sick people. Otherwise, the majority of people buying policies would be those with pre-existing conditions, and the insurance companies would go bankrupt.

Why can't the rest of the country do likewise? Because of Americans' traditional hostility to any government involvement in the economy. It is typically portrayed as an invasion of privacy and an instrument of control. You should hear the arguments that were made against Medicare - you'd have thought the country would become a Stalinist gulag! Right wingers organized a campaign called "Operation Coffee Cup" to whip up opposition to the proposal. Future president Ronald Reagan even cut an album to support the effort (Ronald Reagan speaks out on Socialized Medicine - Audio - YouTube)

And now we couldn't imagine eliminating Medicare. Yet some people don't get that this is national health care for the elderly and disabled - hence the "Keep the government out of my Medicare!" signs at protests against Obamacare. Ignorance kills.

I must also say that President Obama did a p*ss poor job selling the program to the public. The facts speak for themselves: we spend more than any other advanced democracy on health care, yet are much less healthy by any measure. Pay more, get less! But Obama really didn't lay out the case in persuasive way. Did you know that before the ACA was passed, 50,000 Americans died every year because they lacked health insurance? If not, you're not alone.

We also have this irrational hatred towards all things French, especially since they refused to go along with the invasion of Iraq. So there's a reflexive objection to the idea of emulating the French system, even if it would benefit millions of Americans. Freedom fries for all

since this seems too good to be true -- another question -- are the drs earning a living wage? (clearly their own health insurance would then be affordable so that would be one personal cost lowered, LOL!)
Doctors in the US make about twice what French doctors earn, BUT there are a few caveats. Medical schools in France are free, so if you are good enough to get in, you don't have to worry about graduating with $200,000 in debt. Malpractice is also not a major issue in France like it is here, for several reasons. Yes, tort (injury) lawsuits are excessive here, but the larger problem is that incompetent doctors are allowed to continue practicing medicine, even if they have numerous complaints against them. State medical boards are generally made up of doctors, and are reluctant to rule against a colleague. 85% of doctors who have been found guilty of malpractice 4 or more times are not even disciplined. As a result, a few bad apples cost us all a fortune: 5% of doctors account for 53% of malpractice awards. Not only is this expensive, it's also scary as a patient!

i'm not following the other part of your discussion. it seems that the insurance companies just name the reimbursement rate, not individuals nor doctors. there does not seem to be any negotiation with anyone. i know in my profession here in ny at least, united healthcare has gobbled up many insurances, if not the whole package, then at least the mental health part, and so consequently they are naming the reimbursement rates, copays, like a monopoly.
Yes, that's the point - individuals and small businesses face a "take it or leave it" proposition in regard to medical insurance. We simply have no bargaining power. OTOH, those who are able to negotiate as a group (such as unions and larger firms) are able to get much better policies. There is strength in numbers, which the single-payer systems use to great advantage.

ETA: One point I forgot to make earlier - if you need any proof of the extent to which insurance & pharmaceutical companies manipulate the system, note the fact that Medicare Part D (prescription coverage) does not pay for mail-order medication from Canada, even though it would save taxpayers billions.

Last edited by yossarian; 02-26-2013 at 08:31 AM.