Friday, April 26, 2013

The aspects of French healthcare that could be adopted in the United States/ Les aspects de santé français qui pourraient être adoptées aux États-Unis (paper)


Résumé du papier en français
Quelques soins de santé aux États-Unis et en France sont les mêmes et quelques autres sont différents. Les États-Unis pourraient apprendre du système de santé en France. Aux États-Unis, les soins de santé sont très chers, donc il est préférable que ce système change. En France, la plupart des assurances soins de santé et hôpitaux sont à but non lucratif. Pour cette raison, l’accent est mis sur les soins de santé et pas sur l’argent. Les deux systèmes de soins de santé sont financés par les employeurs privés et le gouvernement. Ceci a bien fonctionné en France, mais à cause du système, certains pensent que ceux qui travaillent méritent beaucoup plus les soins de santé que ceux qui sont au chômage. Les États-Unis font face aux problèmes de paiement pour la formation des médecins. Ces universitaires qui obtiennent leur licence, préfèrent plutôt travailler dans le secteur privé. Les actionnaires font des bénéfices et les contribuables ne sont pas remboursés. Pas toutes les politiques de la France marcheront pour les États-Unis, mais il y en a beaucoup qui pourraient être adoptées.

Paper abstract in English
The healthcare in the U.S. and France is the same and different. The United States could learn from France’s healthcare system. In the U.S. healthcare is very expensive; so, the system needs to change. In France, most healthcare insurance and hospitals are nonprofits. Because of this, the focus is on healthcare and not money. Both healthcare systems are funded by private employers and the government. This has been working well in France, but because of the system some people think people who work deserve healthcare more than those who are unemployed. The U.S. also faces problems with paying for doctors’ training and university research only to find the graduates work in the private-sector. Then stockholders profit and taxpayers don’t get a return on their money. Not all of France’s policies will work for the U.S., but there are many that could be adopted.

Introduction

            There has been a lot of debate over the recent changes to healthcare in the U.S., both laws that have been implemented and those that will start in 2014. In many discussions among legislators, citizens and the media, comparisons to other countries’ healthcare systems color the debate. Many people have compared proposed polices to healthcare in Canada and England; and some have compared America’s system to France. This paper focuses on the similarities and differences between the U.S and French healthcare systems and what the U.S. could learn from France and the policies the U.S. could possibly adopt in the future. What policies that could translate successfully are largely dependent on the shared history of the countries.
Both countries have similarities, the main one being that both have public and private healthcare co-existing and working together. Another parallel is the countries’ system linking healthcare to work, which has created inequalities in both countries. Indeed, aspects of French healthcare that are successful are worth consideration in the U.S.

Healthcare in the United States and France
            In 2000, the World Health Organization ranked 191 countries’ healthcare systems by life expectancy and access to healthcare. France came in first; the United States 37th (WHO, Shapiro). The U.S. ranked below Costa Rica but above Slovenia (Edelberg). Other researchers measured the "amenable mortality," a measure of deaths that could have been prevented in 19 industrialized nations: France came in first; the United States was last (Shapiro).
            In France, life expectancy is 81 years; infant mortality is 4 per 1,000 live births; health spending as a percentage of GDP is 11 percent; percentage of health spending that is private is 20 percent (World Health Organization); and for every doctor there are 430 people (Cline).
            In the U.S., the life expectance at birth was 76 and 81 years for males and females respectively in 2009. The total expenditure on health per capita in 2010 was $8,362, or 17.9 percent of GDP (WHO). In the U.S., there is a doctor for every 1,230 residents (Cline).
            While many lump Europe together as having “socialized medicine,” each European country has a different system. Historian at Northern Arizona University, and author of the book Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France, Paul Dutton asserts, “The French don't consider their system socialized. In fact, they detest socialized medicine” (Shapiro). In fact, Frances’s system shares many similarities to the U.S. system (Dutton). However, there are also a lot of differences. Both counties could stand to learn from each other as they face some of the same challenges, such as an aging population and concern that the systems are fiscally unsustainable.
            To better understand the systems, the debate, and what could work in the future, it is important to look to history to understand how healthcare became what it is today. Dutton says the French and the Americans want choice. He claims these shared values come out of a shared history: "Both countries are products of Enlightenment-era revolutions.” Dutton asserts, "The French hold individual liberty and social equality very dear ... 'liberty, equality, and fraternity. [...] And in this country [the United States], of course, we have similar ideals: individual liberty, social equality — equal chances for everyone." (Shapiro)
            Both France and the United States have systems that are a combination of employer and government-sponsored, public and private. France has been effective setting up a healthcare system where the public and private sector compete to provide the best service. Also in France, the majority of hospitals are nonprofit. Health insurance doesn’t have stockholders looking for increasing dividends. Instead, the goal is health rather than profit. This puts the incentives in the right place to align with the goal of quality healthcare. It is important to set up the system so that incentives are in the right place so that doctors are free to give the best care possible. This is why many doctors supported pay-for-service plans in the past rather than managed care like in Great Britain and HMOs in the U.S. (Dutton)

The two-class system
            Another thing to consider in the healthcare debate is how the system shapes our understanding of modern-day healthcare. In both France and the U.S., by linking healthcare to the employer it creates a dynamic in which the public views patients as “deserving” and “non-deserving” based on their employment status (Dutton 11, 203). Historically, and carried over to today, the system disproportionally leaves women and minorities with fewer options and less quality care as compared to their white male counterparts. Dutton asserts:

Its ugly underside was the belief that many citizens who, through no fault of their own, lacked access to workplace health insurance were "less deserving" of health security […] This development had a particularly negative impact on women and minorities, who were (and are) much more likely to be considered "less deserving.” (Dutton 11)

            Equality is an issue that should be addressed in both the U.S. and France. Both systems should implement policies to reduce having a two-class system.
            As health insurance developed in the U.S., African American and Latino farm workers were not given health insurance through their work (Dutton 139-40). Likewise, women working in garment factories didn’t receive health insurance as there was more supply of labor than demand in clothing industry (Dutton 140). This made women and children vulnerable. “In the event of divorce or insufficient disposable income for supplemental insurance premiums, women and children were usually the first to lose health security” (Dutton 140). “In this way, federal tax policy not only played a major role in the growth of employment-based voluntary health insurance, it also contributed to its class inequalities” (Dutton 140).
            Dutton argues, “France’s comparable historical tradition of workplace health coverage underlies inequities of health care access because of the continued importance of supplemental insurance.” In 1995 in France, 83 percent of its citizens were covered by health insurance; however, only 68 percent of skilled wage earners had supplemental insurance compared to 90 percent of white-collar managers. (Dutton 203)
            In 1990, the life expectancy of white people in the U.S and France was the same (Dutton 190). However, in the U.S. African Americans had a life expectancy that was five years less, and 37 million Americans were uninsured (Dutton 190).
            In 1954 in the U.S., the IRS made group health insurance premiums tax deductible. While this increased employer spending on health insurance, the most expensive and the best coverage went to those with the highest incomes (Dutton 140). This gave the wealthiest workers, who were in a higher tax bracket, a larger tax break than their low-wage counterparts. The same tax inequality is true of Medicare as well; it is paid for through a regressive tax.
            France’s Sécurité Sociale similarly has policies that promote inequality. Dutton asserts: “[T]he continued reliance on payroll levies that took a flat percentage of workers’ wages without regard for their overall income reinforced the inequality of health care financing” (153). Also, 99 percent of French workers have a health insurance tax come out of their wages, but there is no tax on income that comes from rent and investments, but the landlords and investors still enjoy insurance (Dutton 201). This is eerily similar to the U.S. tax code charging 15 percent on income coming from stock investments, when the individuals who earn the most from this would likely be in the 35 percent tax bracket.

Why the cost has gone up
            Advances in medicine made it possible for people to live longer, but it also costs money. Dutton explains:

By 1980, with fifteen thousand operations a year, the near-miraculous procedure of open-heart surgery had become almost mundane in France. For a short time, the public marveled at this stupendous advance in cardiology, but the price of it all escaped them. In 1980, open-heart surgery cost more than seven times the maximum annual Sécurité Sociale contribution, an amazing statistic if one remembers that only sixty years earlier, medical bills were deemed a practically inconsequential burden of illness. (160)

            Post World War II, people also started viewing medicine differently. Instead of going to a doctor when they were sick, people wanted to go to become healthier. Dutton explains, “[H]ealth was no longer simply the absence of illness, but rather, as the World Health Organization first put it in 1946, ‘a state of complete physical, mental and social well-being.’” (119-20)
            Part of this change was also because people had already paid for the health insurance, so there wasn’t a cost incurred to them for visiting the doctor. In France, second and third medical opinions became more common (Dutton 159). In France, the term coined le nomadisme medical, described patients who went to even a fourth specialist for the same condition “all of which were covered by Sécurité Sociale without question” (Dutton 160).
            In the U.S., to help curb the costs of people overusing care, President Reagan wanted patients to pay more for their expenses. However, physicians pointed out that patients were not sufficiently knowledgeable consumers. Patients might think twice about visiting the doctor because they think something isn’t serious when it might be something that could be treated easily if caught right away, but if they waited until it turned worse it could become both serious and costly. While laissez-faire economics can work to improve products and services and bring prices down in other areas, with medicine it’s different because since consumers don’t know when it’s most cost-effective to visit the doctor or which tests are important because they don’t have a medical education—they aren’t doctors (Dutton 173)

Suggestions for U.S. healthcare
            Policies to improve healthcare in the U.S. could include lowering the cost of liability insurance to physicians. When doctors feel compelled to practice “defensive medicine” it raises the cost of healthcare and doesn’t help the patient (Dutton 23).
            Research should be funded by the government instead of privately. The U.S. could also pool its resources with other first-world countries that can afford it. This way, the projects that get funded will be what is best for society rather than what is best for the bottom line. This will prevent U.S. taxpayers from subsidizing university research sold to private companies that charge exorbitant fees to tax-payers when they get sick and large dividends to shareholders (Frangioni 503). Not only is it corporate welfare, but it also prevents innovations that can cure the sick but aren’t a good investment from a business standpoint. With money going towards research that has successfully found cures to diseases, it makes no sense from an ethical standpoint to let people die because of unfavorable markets (Frangioni 504). Frangioni asserts:

Historically, academic medical centers (AMCs) were places where the next generation of physicians was being trained (with the help of US government subsidies; while fundamental research into the prevention, mechanism and treatment of human disease was being conducted (again, with the help of US government subsidies). […] Should all decisions in the pipeline, from discovery to delivery of a new device, diagnostic product or therapy, be based on maximizing profit when, in fact, US taxpayers have directly or indirectly funded nearly every major discovery in medicine over the past 40 years? (Frangioni 504)

            Professors should also be paid more and there should be stricter laws to stop taxpayers from subsidizing industry through university research. According to Frangioni, many physicians are trained by AMCs with U.S. tax-payer money only to work for for-profit companies that didn’t have to invest money in the researchers’ training, but reap the rewards of the medical discoveries. Paying professors more would help retain them at the universities. A similar phenomena happens with the U.S. military and private contractors: The government invests millions of dollars but never see its investment realized as trainees move to the private sector that pays better because it didn’t have to invest in talent (Maddow).
            Everyone should receive healthcare in the country as well as anyone visiting the country who needs healthcare. However, people can pay out-of-pocket or with supplemental insurance for luxuries such as private rooms or brand-name drugs. Incentive to work is important, but morally everyone deserves first-class healthcare.
            There should also be more preventative medicine. This would reduce costs in the long run.
            Costs should be reasonable, but a token co-pay would make people value the service more. There should also be a higher co-pay for emergency rooms so people don’t take advantage of them out of convenience when they could wait until business hours (i.e., a visit for a cold).
            A goal should be set to achieve 90 percent of health insurance to be nonprofit and 90 percent of hospitals to be nonprofit. When the goal of an institution is on care rather than profit, the care changes to best accomplish the goal: making people well. This would avoid unnecessary tests that are highly reimbursed. “[W]ith fewer machines comes less of a financial incentive to keep them running at a profit” (Neel). This change would also drastically reduce the need for doctors to practice defensive medicine (fearing litigation and running unnecessary tests out of fear of being sued). [T]his is not an important issue in France. […] [S]ince 2002 there has been a national no-fault compensation scheme” (Rodwin). The non-profit change of incentives puts physicians in a less precarious place in other ways. Dutton explains:

In the U.S., An HMO-employed primary care physician who exceeds target referral rates to specialists often faces an annual salary deduction that has been agreed on in advance. A PPO network physician who orders costly diagnostic testing that surpasses agreed-on utilization rates faces the possibility that the managed care insurer may not renew her contract. (181)

            The U.S. should adopt France’s card system. Each French citizen has a green carte vitale (literally a "life card" or social security card) (Cline). By having patients’ health history and banking information on a scannable card, nurses don’t have to ask questions and enter in data over and over again, paper is saved, time is saved and the information is more accurate. Unnecessary tests don’t have to be run or shots given. There are less administrative costs associated with billing. And, with an increasingly mobile workforce, paperwork doesn’t need to be photocopied and forwarded. Some people in the U.S. might feel like the government was spying on them, but they can get over it when they see how convenient it is.
            Costs of going to medical school should not go up. Things are being done to address this should continue to do so. While medical school is free in France and most other countries, in the U.S. new M.D.s can be $150K or even $200K in debt. This puts pressure on students to specialize where they can three times as much money in order to pay off their debt, even if they wanted to go into family practice.
            More of an emphasis should be put on public health in order to prevent problems before they happen. This would also save a lot of money in the long run.

Conclusion
            Healthcare, history and people are complex, but the U.S. should look to France to identify policies that are working that could also be translated to the U.S. given the U.S.’s differences from France. Other aspects of healthcare that are working well should be left alone. Different systems work better for different countries, but if there are positive aspects in a system that might work in a system where things aren’t working as well, why not give it a try?


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