With all the talks around about the US healthcare system and how we are much better off in Europe, I wanted to explain how the French healthcare system works and why it is so awesome and so broken at the same time.
The good stuff
In France, healthcare is universal. Everyone has access to social security, whether you have a job, are looking for one, or are homeless. If you have a job, a % of your salary goes to fund the Social Security. If you don’t, a % of your benefits above a certain minimum goes to fund SS as well. If you are homeless or earn under $10K per year, you can apply for universal health insurance, that will cover ALL your medical bills.
When we go for a routine checkup with a GP, prices are fixed, at the moment at 23 euros ($30) a visit. 70% is refunded by Social Security, so you have to pay 6.9 euros ($9) to see a doctor, unless you have health insurance, which would cover that, or you earn under $10K, then you pay nothing. Same for prescription drugs and anything your GP refers you to.
Now you always need to get the GP to determine if you need more tests, scans or to see a specialist. If you go straight to a specialist (except dentist, ob/gyn and ophthalmologist), you will have to pay 100% of the fee.
Alternative therapies are being covered, like acupuncture and homeopathy, you can even get a thermal cure to treat depression, paid by Social Security! Psychotherapist? Covered. Want to stop smoking? Covered. And so on.
Every five years, you are entitled to a full checkup for free, with hearing, eye and teeth exams, scan of your lungs if you smoke, blood test, etc. Whatever they find out during that checkup will be taken care of for free.
If you are pregnant, since there aren’t enough beds in public hospitals, you can choose a fancy private clinic to have your baby, courtesy of Social Security. For other private treatments, you will be covered at 70% of the public rate, and will have to cover the other 30% and private care premium. Say a private GP charges 50 euros, you would have to cover the 27 euros premium for private care, and the usual 30% of 23 euros like any visit.
The bad stuff
The fixed prices of medical acts are set by Social Security and rarely revised. A GP needs to see many many patients to make a decent living on 23 euros a visit and they don’t care for you as well as a 250 euros doctor.
Since they are overwhelmed by patients, for a routine checkup you may have to wait several weeks, and several hours for them to squeeze you in between patients if you show up for an emergency. The same goes for the ER, hospitals are generally under staffed.
Doctors used to make house calls, they rarely do anymore.
Dental acts are priced even lower for basic treatments, a cavity is set at around 25 euros and a root canal around 80 euros. A 25 euros cavity will take longer than a 23 euros GP visit, and the dentist will have invested in more gear, seat, drills, radio equipment, etc. and studied four more years than a GP. Dentists loses money when performing those acts, but they have to in order to keep a clientele. Then they push you to get a crown and overcharge to make up for the rest. A crown, like other acts considered cosmetic, is priced freely, but SS will only refund70% of its set rate, currently 110 euros. This rate hasn’t been revised in years. Generally the dentist charges 900 euros or more. They will try to push it even when not necessary. Or do illegal stuff, like getting the implants and crowns from China and not respond when it breaks.
Dentists will also rarely see you for long periods of time if you need extensive treatment. You will get an hour per week, like everyone. In the meanwhile, the temporary fix will deteriorate, and the cavity worsen. In Guatemala, you can see a dentist highly trained in the US for the whole afternoon, until your whole mouth is fixed. Many rush their work and do not cure you entirely. I had an infection in France after a root canal that left my face so swollen I couldn’t open one eye, and it was a complete oversight from a bad dentist.
The high cost of some acts, and time it takes to get treated, especially for dental, pushes patients to seek treatment abroad (that is partly refunded by SS, at the same rate it would in France, in all EU countries and a few more), and puts even more strain on the doctors who lose their most lucrative procedures to foreign doctors.
It also prevents doctors from pursuing excellence and expensive specializations. Rare are the doctors who train for more, learn new acts over the course of their careers, try new products or buy new equipment. Many practice a medicine from 50 years ago, for lack of means to make it quicker and less invasive for the patient.
You can get a free abortion but have to pay for contraception, so many women go with the free option.
That system had a huge deficit, due to poor administration and abuse from patients who were seeking treatment and pills all the time. If you have private healthcare on top of the 70% SS cover, you can go to the doctor and get pills for free, while going to the pharmacy and getting a box of Ibuprofen will cost you. There were many campaigns asking people to stop being abusive, as well as attempts to cut costs and lower the reimbursements on some acts, but the system is still in bad shape.
In short…
Good or bad, we manage to have one of the highest life expectancy in the world, well over 80 years. But that may be due to wine. If you relocate to France, companies can help you figure out international healthcare.
How do you do healthcare? Would you rather be on the French healthcare system?
This post was featured on PF Digest, Are Ya Gonna Eat That,
The Outlier Model, thank you!
I would add “covers homeopathy” to the bad stuff as yet another example of government waste. Nothing like a health care system that allows tax payer money to be wasted on complete bunk.
I’d rather stay with the US system. The US system is far from perfect, but at least it doesn’t incentive doctors to do less and not give a crap by paying them far less than the costs of doing business.
On the other hand, I could move to France, start a low overhead snake-oil business and have it be completely covered.
lol. weird we don’t cover medical marijuana.
A bit strange, first it says it is affordable for everyone, then it is expensive !!!
Well I don’t know when this was written. I just had a chance to experience this “wonderful” healthcare system. I am an American and I was vacationing in Paris recently. I started experiencing chest pain and was short of breath. The hotel called the fire department and they decided I needed to go to the emergency room. First surprise-they had me walk to the the ambulance. Upon arriving at the emergency room they had me walk in- no wheel chairs anywhere. This seemed odd. I thought perhaps I was being a little picky. I was sent back to be admitted and evaluated. They thought I might have a pulmonary embolism. I had had one many years before and this was concern as well. One word about the emergency room. It was understaffed, well worn and what equipment there was- it wasn’t much- was quite out of date. The nurse who evaluated me was the one who told me I might have a blood clot. Interesting. Usually only the doctor will give this information. They sent me to another room and instructed me to stay on the cot and not get up and walk as it would be dangerous. Again this room was bare bones. Another note, despite the fact that this was an emergency room no one seemed in any hurry. About 20 minutes later I was taken someplace else. Eventually blood was drawn. My oxygen level was on the border of being too low and I was short of breath and light headed. I was told, however, I did not require oxygen. Okay, different standards. My blood pressure was high. They did not seemed concerned about that and I wasn’t asked if this was unusual for me. About an hour later, a doctor came and said they were going to do any X-ray. Even though I had been told not to walk, the doctor had me walk to the X-ray. We did question her about it but she said it was fine. After the X-ray they had me walk to a different part of the hospital to wait for results. Keep in mind a pulmonary embolism is a serious medical condition. In the US I had been whisked through and given multiple tests quickly. I also can’t say enough about the lack of medical equipment and the fact that what little they did have was quite out of date. We never did see a doctor regarding my test results despite waiting 5 hours. I understand waiting a long time in a hospital emergency room. This was different- this was a serious, potentially life threatening medical issue. The whole experience was disturbing. I could cite other examples of poor treatment- I think this is enough. The system in the US needs to change, but it should be done carefully. Cheap is not worth it if you lose quality.
I would. The healthcare system there’s really similar to the one in Canada – universal healthcare! it’s better than what we have here in the U.S – the private sector jacks up health insurance rates all the time, which leaves a quarter of the populace without any insurance.
But apparently you have Medicaid for really poor people, so you can get emergency treatment. An income based contribution may be a solution to avoid waste while staying profitable.
Hmmm I think I’d have to look into it more before I’d say I want to be on the French plan versus the US, especially because we are seeing a massive change in our healthcare system the next couple years. The universal option is great, but having things at fixed price would stifle innovation I’d imagine? I think there’s a reason a lot of innovations and R&D in the medical industry originate in the US.
exactly, you can do research in France but generally you would be in the public sector, hence earning less than private, and have a tight budget to work with. For example it is very unusual to make a donation to your alma mater for a research scholarship, or at all.
There’s a good amount of price-fixing in the US as well between Medicare and Medicaid. I don’t know what the answer to healthcare is, but there are pros and cons to both a free-market system and a government system. We probably need to a better job of figuring out how to mix the two.
I wouldn’t mind a freely priced system but the government would still have to act in the form of a supervising quality agency, or anyone would open a practice and “cure” people, that could be dangerous.
I agree with Matt – a combo deal would work best, probably, as costs here are often overinflated. I’ve heard from friends in the universal healthcare system who love it, and some who hate it due to super long waits to see docs and poor care due to the docs not making enough money. I heard from a nurse friend here the the hospitals near the Canadian/US border are often plush and full of the latest technological advances in medicine due to Canadians hopping over the border and paying cash for more quality care. True or not, I don’t know. As for us, we love the homeopathic/naturopathic stuff and use it lots. When done right and with knowledge, it can save TONS of money on healthcare costs.
I think it is true about the border. A lot of UK citizens go abroad for hip replacements for example, the waiting list is long and it is usually for old people whose life is much harder with a bad hip. They’d rather pay to save time.
I live in Canada, and we sort of have the same system here, universal care for all, all in hospital/clinic care is free and the doctors bill to the governments at a fixed rate. The doctors here definitely make enough here in Canada for it to be worth their while, and there’s lots of innovation going on – but they are very short staffed, with a typical GP covering 1500 patients. The ER waits are also long, can be up to 8 hours for non life threatening/highly painful issues (I waited for 8 hours when I broke my wrist last summer). Prescriptions and extra care (massage therapy, chiro, dentist) are not free and can be covered by purchasing private, out of pocket insurance.
Even with the downfalls, I would rather have our system over the US one. If I was living in the US last summer when I got in my car accident, I don’t know what I would’ve done! Here in Canada, my treatment was totally free, except for out of pocket expenses (didn’t have insurance) for some pain medication.
See my experience with the ER have always been good in Canada. I think they`re great at triageing and the walk-in clinics for non emergencies have made a substantial difference. I seriously can`t say enough good about Canada`s universal system. Unlike the French system we don`t pay for visits w/ a doctor or specialist.
Jordann: vision and dental is covered by the government until the age of 13 in NS.
I didn’t know that vision and dental were covered, that’s awesome! I think it should be covered anyway, I’m not sure why teeth and eye health don’t count under universal health care?
I don’t have an issue with the ER either, even if the waits can be long from non emergencies. I know they do what they can!
dental and vision are very subjective in terms of what is comfort and what is needed. For example in France if you are on the basic healthcare (people earning less than $10K getting all healthcare free) you can get a free crown but if you want a porcelain one it can only be the front 6 teeth, all the other teeth have to be metal. You can’t get the price of a metal crown back and fork out the porcelain difference, you need to pay it in full if you want a white tooth. Same for vision, you can get the $10 frame and have it refunded or pay the $200 frame in full. Many people go private for those acts since a bad smile can affect your career, confidence, personal relationships, etc.
It gives me peace of mind too to know that any big issue would be covered, or very cheap. Having not needed a doctor for years I wouldn’t mind a system that only guarantees bad injuries and routine checkups every year or so, then all the rest to be considered convenience and billed at a higher price, to avoid abuses.
Like Jordann, I’d rather have our Canadian system than the American one, even with a few drawbacks. I think no matter what the system, there will always be drawbacks. THe situation with your tooth sounds horrible!
yes it was pretty bad, I considered putting pics, but some would read this post for breakfast, not what you want to see with your morning coffee!
No system is perfect. Right now I am happy with my healthcare in the US but that is because we have amazing insurance. I would probably feel completely different if I had bad insurance.
Also I have a fear of the dentist and now I know I won’t be visiting a French dentist if I can help it…
yep, take a pain killer, get on the train to Geneva, and get treated in Switzerland!
This is hard to try and come up with what would be a great system. I get good coverage in the US, but things are getting more and more expensive. The US is trying to go universal in a sense, but it is going to be a tough road that will end up costing us more.
It will cost more if you are doubling it up with private insurance, but if you can go universal for most things, you should save money in the end.
France’s system sounds like a bad HMO in the states.
Personally I’d like to see a system that encourages people to take a more active approach to managing their own health.
We do have a few free campaigns for kids to get their teeth and vision checked and a shots calendar, but the decision to stay healthy has to come from within, you can’t tell people to eat this and do that sport. You could however not cover publicly the obesity or smoke/addiction related illnesses. In France the government spends lots of money treating smokers while it would be cheaper to give them free cigarettes and let them be, but that is not how it works.
That rate for the crown isn’t that bad. without insurance, the taste that was recently quoted me for a root canal and crown was $2500.
We have the same issue with prescription pills in the US. I can get Vicodin for the same price as ibuprofen!
No wonder my Guatemalan dentist gets a ton of US patients. For the same price they are treated like VIPs, stay in 4 stars hotels, visit a new country and go back home with a smile makeover.
I will keep that in mind I ever lose dental coverage and find myself in need of major restorative work!
Where to start. I could write a whole post about this, but I think the quality of health care in the US is amazing. The cost is ridiculous. The French system sounds like parts of the US system. Medicare for seniors and Medicaid for low income work exactly like that. They pay a fixed price, generally well below market value, and doctors have to see tons of patients to make a profit. I also see people on Medicaid who go to the doctor for any small reason because there is no charge to them, which is waste. Our area is understaffed as far as GP’s, so it can take several weeks to get an appointment. If you don’t have a GP, good luck to you, as many offices are not taking new patients. Many also are not taking new Medicare or Medicaid patients. Private insurance is actually lots like a universal system in that they limit what price they pay and don’t allow all procedures. It’s the patient’s choice which plan to have or not to have any, but they do set prices and put limits on service. Those who complain about universal service having limited access to care must not have a typical insurance plan because I seem claims for service denied all the time, then the cost falls back on the patient. What is the best system? I don’t know, but my two cents worth would say that we reward people for being healthy, either with lower costs or tax incentives. Reward people who do preventative things like get annual physicals and get regular exercise. We penalize people who choose to be unhealthy (smokers, obese people who don’t exercise, etc. ) with higher prices or taxes. Don’t pay for people who go to the emergency room for an ingrown toenail. Don’t allow kids on Medicaid to lose 5 pairs of glasses and have them replaced free of charge by Medicaid. Let people take some responsibility for their health or pay a price if they don’t. Obviously, you can’t control every disease or accident that happens, but lots of the problems that cost tons of money are due to bad lifestyle choices, and I don’t know that it should be the government’s responsibility to pay for people’s poor choices.
I have a Health Savings Account style insurance. It has a high deductible, but covers a yearly exam, and allows me to put money away tax deferred to use for more costly medical expenses. It allows me to manage my own healthcare for a reasonable price. Rather than going to a emergency room for an issue, I look for a immediate care clinic that is a fraction of the cost. Rather than name brand meds, I always ask for a generic. It makes you think about how you will use your healthcare, rather than just “it’s free, so i might as well take advantage of it.”
It’s funny, because this is originally how health insurance was designed. It was originally put in place to cover high cost events, and prevent financial destruction for health issues. It has morphed into a blob of abuse and fraud, ands skyrocketing costs.
My wife works in the health industry in the U.S., and I can’t tell you the amount of times someone goes to the ER for a common cold, or general illness that they really can’t help you with any way. Many times they will refuse to leave until the doctor prescribes a med, even though it’s something they could get over the counter. They do this because there is no cost to them. Rather than just going to the pharmacy, and getting an over the counter med, they clog the ER with minor issues, so they have no out of pocket costs.
I don’t know what the answer is, but unless they figure out a way to control costs and abuse, the price of healthcare is going to continue to go up.
I like the idea of universal emergency-only healthcare. Those flu abuses have broken the system.
I am french, I live in France I was entitled to a new treatment for fibroma which prevented me a big surgery in the month that followed my taking of rdv in hospital.
At my doctor, I have a rdv in within 48 hours or in the day in case of emergency. The cost is 23 € but much asks 40 € to pay by the mandatory private insurance.
I do not find this negative description in real life, very few people do their dental operation in a foreign country. I do not doubt that the dentists in Guatemala are excellent, but that does not prevent them from having such excellent in France and the standard of living is absolutely not the same. And if the dental care and the glasses are badly managed in France it may be because the National Healthcare does not take care of it.
I was surprised being in the U.S. that it was $1000 – $2000 NET a month for a freelancer like myself to get basic universal healthcare, like what I’d have in Canada.
I came back to Canada to get private insurance in the interim (3 months) before I was under the Ontario plan, and it was only $120 a month. 😐
my credit card gives me 3 months US healthcare up to $2M with a ridiculous deductible, $100 or so, on the condition that I book the flight to the US with it. It would have been cheaper for you to fly back home with that kind of card than get health insurance!
the GP system looks like the UK from what you describe with Medicaid or Medicare. You can either wait weeks for an appointment or pay private rate and be seen quickly. In France you must have a GP and if you don’t, SS will impose one for you, and many GPs charge the 23 euros rate. A few charge over that but are still supposed to attend the equivalent of Medicaid who won’t pay for a consult, and in this case the doctor will receive 23 euros from the state. They are forbidden by law to refuse Medicaid patient but use sneaky ways, like saying they are fully booked for months or seeing you once if they don’t know you are poor and not allowing you to book a follow up.
I agree with trying to prevent conditions, that is why SS has the free 5 year checkup and also free dental for kids, but you can’t track every person to make sure they don’t abuse the system. What I like in France at least is that you know what things will cost you. With the US system you agree to treatment, then get a bill, then know how much your insurance will cover. I would hate not knowing beforehand what I am getting into.
It’s good to know you’ll live long because of wine. If that’s the case I’ll live to be 100. 🙂 I see that health care is just as confusing in France as it is here. It seems no matter what the system isn’t perfect. One one hand 80 Euros for a root canal? Wow…mine was a couple thousand. And it was still torture, but I’m glad I had no ill side effects after it was over! I don’t know what is going to happen hear exactly, but I do know it’s draining my wallet to get treatment on my shoulder. I pay $85 twice per week for my PT sessions. And I still don’t feel a major improvement. I don’t think I can keep up treatments that long.
have a glass of red, you’ll feel better 🙂 The crazy thing in the US is you can pay for an insurance for years then discover they won’t cover what you need covered, claim it was a pre existing condition or it doesn’t fit the requirements. It sounds really confusing.
Thanks for the insight Pauline, it’s interesting to get different perspectives. How would you rate the French system in relation to the British system? My Mom and stepdad were in London several years ago and my stepdad ended up having to spend several days in the hospital while there. They said it was absolutely great when compared to what they see here in the States. That said, we personally have a high deductible plan and choose to live as healthy as possible so as to avoid having to go into the doctor.
As a side note, almost any healthcare system that is universal is better than in the U.S. from my experience there 😐
I have family who lives in Australia with universal healthcare, I myself live in Canada, and I have friends in Europe (all over). I peppered them with questions about what it’s like to be in Europe under their healthcare systems, and comparing it to the U.S. one, I was blown away.
The best thing Americans can do (as in my comment below), is to stop getting so fat as a nation. It’s really becoming a problem in terms of health, and it’s one thing to enjoy eating junk food as a treat once in a while, it’s wholly another to celebrate it as a way of life or affirmation of the good life.
the UK is great for hospital and GPs (and free contraception, although they have one of Europe’s highest rate of teen pregnancies), but absolutely terrible for dental. When in France you pay $25 per cavity, in the UK you pay a flat $25 for all the cavities in your mouth, whether you go for 1 or 12. Same with crowns, the rate is a bit higher but you pay flat for any number. So many dentists will refuse SS patients and every now and then you’ll see an article on BBC like this one about people pulling their own teeth out because they can’t afford to go private.
My health insurance is paid by my company. I am paying small amount every visit to the doctor or hospital. Most of the time, laboratory tests, x-ray and drugs are covered with my health insurance.
that sounds like the best of both worlds, as long as you keep your job. I have heard about employees not able to keep their policy, even if they wanted to pay for it, once they left the company.
Very interesting post, Pauline. I love hearing your perspective on the good and bad. I believe we have some incredibly talented doctors in the States, but the costs are increasing where people don’t go to the doctor or have to weigh how they sick or hurt they are, which is not right. Changes need to be made, but at this point the health system is such a bureaucracy that it won’t be easy.
and then there are the lawsuits! if a doctor has to fear being sued every time he/she practices, the price includes that risk. In France you almost never sue, people understand medicine has obvious risks to it.
Inexpensive healthcare has its drawbacks such as waiting or less care. I prefer the American system, but it certainly costs more.
The US system is great for people who don’t need it much. You don’t pay taxes to maintain a system you don’t need. If you need a regular treatment, universal may be better.
You have a better healthcare system than in Canada, and a far superior one to the U.S. in my opinion. I have never seen so many clauses and tricky things to remember in the American health system before living there.
Americans could also stand to lose a lot of weight (obesity being the #1 killer) and drop the prices of their healthcare. As a nation, like many Western ones, they’re sick and fat, and don’t really care… which impacts their wallet / bottom line indirectly.
French people on the whole, are getting fatter from Western influence, but I can see that there is the idea of eating well, eating good food, and avoiding junk, unlike in North America where it’s celebrated and even coveted after (watch: Diners, Drive-Ins and Dives as an example).
true, we feast around a healthy meal, seat at the table for three hours and don’t do it five times a week. I imagine smoking costs more to the social security in France than obesity.
Pauline points out one of the faults of a universal health care system, there’s little incentive for anyone to enter the field of medicine. Eight years of expensive schools plus a few years as an intern for a measly Salary will probably end up in a shortage of health care professionals in the U.S. I like your summary Pauline, Drink more wine!
cheers!
That’s really interesting, knowing how things are structured there – and how that compares and contrasts to what is here in the U.S.
Have to say, during my one visit to Paris, I didn’t notice too many unhealthy-looking, obese people like we have here in the U.S. That said, I did see more people smoking there.
That’s sort of how I see the comparison between the two systems of health care – some things favor the French system, some favor the U.S.
yes, lots of people smoke, in spite of a pack being over $7, it is a topic social security hasn’t managed to tackle. Every time a law passes to limit where you can smoke it is a big scandal with the smokers.
I’m not sure I like the idea of the dentist pushing procedures on me to help his bottom line. I want to go to a dentist/doctor that is going to do the best thing for me, regardless if it benefits him or not.
that is what medicine should be about, unfortunately I think it is the same everywhere, a doctor can push a specific drug because he gets a % or the sales rep took him golfing last Friday, or refuse to operate because he has a college reunion on that day, etc. There are different shades of bad behaviors but I imagine most doctors have done some of this stuff at one point.
Really? And what if someone said to you, “you must write a blog every hour, and not doing so is a betrayal of your duty.” Oh, and what about the (almost all) financial blogs that push certain credit cards, etc.? Don’t they earn a referral bonus? Doctors have lives too. And to say they are easily swayed by a drug rep is to really insult their intelligence. If you don’t like them, then don’t go to a doctor. Treat your diseases yourself.
I want you to think of all the education your doctor went through. All the work, stress, hardship it took for him to become an expert on your vital systems. Then I want you to think about how much education, stress, and work it took for anyone else to do what they do. Like a blog writer. Do you really think your doctor is the one that needs to be insulted?
I do not mean to insult doctors, just to tell my experience with them. One offered me a free boob job on social security for no particular reason, just “if you feel like it, I can get you that”. Another has maintained my friend off work for months because he does not like his job so the doctor writes a letter saying he is depressed and can’t work. Yes, the doctor knows it is not true. Another is your go to guy if you want any kind of pills. The last one is a friend who is pushing some miracle natural juices and pills because he is at the top of a pyramid selling them and gets a % on every sale and person below him who sells them.
I have also heard the other side of the story via pharmaceutical reps inviting doctors on Caribbean cruises and golfing around the world in exchange for them selling X boxes of pills.
I have a great respect for doctors who practice medicine ethically and have an extensive knowledge of their profession, but unfortunately have seen too many things that should not happen.
Regarding bloggers, anyone with an internet connection can say anything online, whereas a doctor is sworn to have his patient’s best interest at heart all the time. I haven’t pushed any credit card or financial product I don’t use, I talked today about my bank account with no affiliate links because I think it is great to have a 3% savings rate but even if I do talk about credit cards one day, you will see the facts about said card and then have an opportunity to click on it, or not. What comes out of a doctor’s mouth I respect too much to go against what is recommended. Which can be bad if the doctor doesn’t think about me but about his cut on the drug “I should really take”.
Great post, I’m always curious about other countries’ health care systems, positives and negatives. That’s really unfortunate to hear about a free abortion vs. paid contraceptives, though, as well as corrupt practices by dentists, though I suppose it’s to meet their bottom line. Might you be doing a post on Guatemala health care sometime, by chance? 🙂
I could! We are considering donating a parcel of land for the village to build a new health center, there is only one male nurse in the village at the moment, and he gets drunk at night and tells all the details about the women he saw that day… If you can’t afford to go private, that is the kind of treatment you get.
I would definitely opt for the French system, but I would do my research and work to find acceptable practitioners, etc. That bit about birth control is alarming!!!
“You can get a free abortion but have to pay for contraception, so many women go with the free option.”
Ugg, that seems so counterproductive and backwards. Especially for a country that seems (my perception) as so liberal (in a good way) about sexuality.
it is strange, in the UK the pill is free, but they have one of the highest teen pregnancy rates of the EU, I don’t know how the contraceptive campaigns work. France has a few centers where teens can get free pills and condoms but once you are an adult, you are on your own!
This is largely why I’d LOVE to live more permanently in France. That and the childcare, sorry, schooling! It’s not a perfect system, but it’s better than so many other places. And I think it’s great that a homeless or poor person gets the same level of treatment (ie, in some ways, it’s equally bad for all!) Even as a foreign student, I found living in France and my healthcare expenses affordable, and simple!
equally bad for all is not ideal, but yes, everyone deserves an equal access to healthcare. In France the worst access is in rural areas, where my grandparents live it can take up to 30 minutes for a doctor to get to them and they are 85.
I’m a US dentist. The costs of doing something like a crown in the US or France are essentially the same: labor, materials, and fixed overhead. One can’t really change material costs whether you or there or here. I’d be surprised if the costs of the same materials are markedly cheaper in Guatemala–most of this stuff is EU or Japan made and marketed all over the world. A dental chair must be even more expensive to import to Guatemala. Labor costs sure are cheaper in Guatemala. What about the building and fixed overhead costs? Probably cheaper, but generally that averages only about 30% of my costs.
FWIW, I’ve retreated a significant amount of “cheap” dental work done in Mexico.
Your analysis of socialized dentistry, though, is spot on. Dentistry is a surgical endeavor, not a consultative one. As a GP doctor, I can bounce from room to room writing prescriptions and talking. Takes no more than a keen insight and a building with rooms and chairs. While in with one patient, a low-paid assistant can put the next in another room, etc. I can be an efficient process.
A dentist has to physically sit, with expensive chairs and drills, etc. I can only complete a cavity in just so little a time, and I cannot do anything else during the same time period.
My Guatemalan dentist studied in the US (so same expensive training), and imports his implants, composites, chairs, drills, etc. from the US, they are surely more expensive.
Crowns are made locally, so the porcelain may be more expensive, but getting it done locally is cheap. You can get a root canal and a crown for under $500, and the quality of care is similar to the US. Or you can go to a dirt cheap local dentist and get a $30 root canal in a scary dark room, and need the work done again six months after you get back home. Dental tourists are expecting dirt cheap but need to understand that it will not get them the best dentists.
Oh, boy. I would love to read every comment here. As someone who was denied medical coverage here in the US, I am rather peeved about the system as a whole. Now that we’re going to cover pre-existing, one company who has on two occasions denied me is now sending me solicitations. How ironic!
I would rather have a universal system and let people pay for more if they want it. Meanwhile, I have to take it every few months when the one carrier that would take me ups my premiums.
I am totally with everyone who commented about people living a healthier lifestyle. I actually told one poor woman who was lucky enough to get my call that I am sure I am healthier than most people who they allow to have insurance and run to the doctor every time they have gas. The US is really quite a mess. Work hard, eat lots! Woohoo!
Your situation is so frustrating. I wish there were a real physical exam for people like you to prove that you are healthy and eating well because on paper you can’t say whether a person is sedentary or fit. I imagine people from TX often go to Mexico to get drugs and expensive treatments.
I liked your article re French health care and thought you and other commentators might find the following interesting. I am a Brit, who has lived in Germany and now live in France.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/15/why-an-mri-costs-1080-in-america-and-280-in-france/
Hmmm I still prefer my french system, it’s about society over there, and not individualism. In the end, everybody wins, even if the government has to fork out lots of money; at least they don’t spend it on war to capitalize their investment that will never be returned on their population. There are other countries, such as Scandinavian countries where it is even harder for a doctor to make it, because his salary has to be equal to the one of a worker, but it does not allow them to get more GNP per head in the world compared to France or USA.
Also a doctor at the countryside in France makes more money than a doctor that lives in the city, and they do go visit their patient, it’s an unalienable right.
….etc
Hello, I live in France, too, and I have to correct you on something. A psychotherapist is NOT covered by social security, only a psychiatrist. Social security covers 0% of the costs of therapy, but will cover a visit to the medicine doctor. And I’m sorry you’ve had a horrible dental experience here. It’s the first time I’ve ever heard of someone having problems.
And I forgot to add that SOS Medecins makes house visits 24/7 in cities.
Just a small mistake (it would be nice to correct as it is an article of good quality): a dentist doesn’t study 4 more years than a GP. On the contrary, a GP does study 3 more years than a dentist (9 years instead of 6). Thanks!
I’m an American expat who has been living in France for 3 years and have had a great experience with French healthcare overall. It’s so strange that birth control isn’t covered but on the other hand it’s not that expensive. I pay around 28 euros for three months of medicine whereas in the US for the name brand, I would pay almost $50 for just one month. Cheaper than a baby! It’s also strange that only a psychiatrist is covered and not a psychologist.
Because the psychiatrist studied medicine, not the psychoanalyst. Both psychiatrist and psychologist covered unlike psychoanalyst
The advantage of low population is that the country can afford to provide healthcare to all.
I read your article and it is good way that your prices should be low and fixed. The advantage of low population is that the country can afford to provide healthcare to all.
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Does France still have free abortions?
There is also a good amount of pricing in the United States between Medicare and Medicaid. I don’t know what the answer to medical care is, but there are advantages and disadvantages for both a free market system and a government system. We probably need a better job to discover how to mix the two.
excellent explanation.. Thanks to author for publishing such an informative article.
I think this author is working so hard for making good content of article. And this article is the reflection of it.
Yes it is.The french are aware of it i think. Thanks for sharing.
The health care system of french is aswome in one word.Thanks to author for publishing this article.