France can teach the US something about health insurance

The parasitic presence of private insurers in the system is one of the things that drives up overall medical cost in the United States, a cost that is higher than in any other industrialized county, and with poorer results. Despite this fact, President Trump falsely tells the American public that a Medicare for All system would cost more than our present profit-driven system.

I will take France, where I have spent a number of years as, an example. But other Western European countries, like the Netherlands and Germany, are similar. In France, health care is regarded as a right accorded to all citizens and legal residents. Insurance is provided by tax-funded, nonprofit bodies called mutuels. In 2016, the per capita expenditure on healthcare in France was $4,600. In the United States, it was $10,348.

And the French are healthier than Americans on a number of dimensions. For example, in 2014, French infant morality among live births was 3.5 per 1,000. In the U.S it was 5.8. In 2017, the average life expectancy in France was 82.4 years. In the U.S. it was 78.8. In other words, we are paying more and receiving less for it.

In France, reimbursements range from 70% to 100% depending on the service. But the charges are a pittance compared to those in the U.S., and low-income people and those with long-term illnesses pay zero. A few years ago, I fell in Paris and required a couple of X-rays. A friend took me to a private clinic rather than an emergency room. I was there for over a half hour. I was not covered by the French system, but the charge to me for the X-rays and a written report was only the equivalent of $75. In other words, the lower costs in general healthcare also drive down charges by private entities like private labs and clinics, which are an option open to the French.

The most tragic lesson in the deficiency of the American system for me was a close American friend who lived in Paris, first as a student and worker, and then just as an employee. Her stay in France was about ten years, during which she came down with cancer. Just by being a legal resident, her chemo, radiation, hospital stays, drugs, and even her wigs, were completely covered by the healthcare system. After she was denied a renewal of French residency, she came back to the U.S. but could not afford the periodic checkups that she had gotten free of charge France. She died in her forties.

We need a single-payer, universal system. The AFL-CIO, groups of medical professionals, and other civil society groups, such as the Democratic Socialists of America have been advocating for such a system. Senator Bernie Sanders made it a key element in his presidential primary run and continues to advocate for it. Indeed, an August 2018 Reuters poll showed that 84% of Democrats and 52% of Republicans support Medicare for All!

In January 1917, such a system was actually introduced in the House of Representatives (HB 676) by Democratic Representative John Conyers. Yet mainstream Democrats refuse to sign on and restrict themselves to trying to protect what is left of the Affordable Care Act (Obamacare), while Republican politicians try to destroy Obamacare and see a universal single-payer system as an anathema. They remain devoted to the present private insurance based system, largely tied to employers, that increases costs to consumers and employers, and leaves millions of people without any health insurance.

We don't have to be living and dying like this. People in the rest of the industrialized world don't.

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