I don't think a doctor's practice would last long in the state of Florida, if they didn't take Medicare.
Originally Posted by juanab
lol good point!

My FIL is on Medicare, and has not yet been turned away because a doctor refuses to accept it.

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. But there are several constraints that prevented us from going further.

The first is cultural. Contrast the American mantra of "life, liberty and pursuit of happiness" to its French counterpart of "liberte, egalite, fraternite" (liberty, equality, fraternity [as in brotherhood]). Ours places a heavy emphasis on the individual's right to choose his own path, whereas theirs evokes a sense of solidarity with & responsibility to,one's fellow citizens. In real terms, that means the French have a much broader conception of the role of government. To Americans, that smacks of {gasp} socialism. Every attempt to expand social programs has been met with dire warnings of creeping tyranny.

The second is economic. The US medical industry is comprised of a multitude of vested interests, who stand to lose a great deal if they had to deal with people collectively instead of as individuals. Imagine what a great deal you could get if Aetna, United Health, GlaxoSmithKline etc. had to negotiate prices for checkups, exams, prescriptions etc. with all of us as a group - we would have all the leverage. So of course they will fight tooth and nail to preserve the status quo, spending hundreds of millions to influence the political process.

In the UK and in France, universal health care was established in the aftermath of World War II, so they were essentially starting from scratch. There was also no other efficient way to take care of all the wounded and the refugees than with a government-run system. As a result, there was no organized resistance from the private sector. French doctors agreed to participate as long as they were free to practice as they chose & and patients were free to choose their own doctors. The insurance and pharmaceutical companies had no choice but to go along, or they would have been nationalized.

So the US is behind the 8 ball when it comes to a genuine reform of a broken system. I'm ecstatic that we've taken a big step forward with the ACA, but it's too watered down to fully address costs and access. But it's a start!
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Last edited by yossarian; 02-25-2013 at 10:41 PM.