Comparing the U.S. and French Health Care Systems
General Description of the French System
The French health care system is a national and near-universal health insurance system that has been characterized as relatively complex by Lenain (2000). Roughly 75 percent of the total health spending in France is publicly funded, 10 percent is paid for by supplementary insurance, primarily through mutual insurers, and the balance is paid directly by patients.
Supplementary insurance has expanded greatly over the past decades to eliminate co-payments and now covers approximately 80 percent of the population. In January 2000, France introduced universal health insurance providing basic coverage to all legal residents regardless of their employment status. Lenain (2000) states that the plan also offers free supplementary coverage to people who earn less than FF3,500 per month per person.
Lawday (1998) points out that the French system is extremely accessible and highly liberal. Fees for physicians are controlled by the government only to the extent that, if general practitioners and specialists abide by an officially approved scale of charges, 70 percent is reimbursed to the patients. In theory, patients pay excess charges, but in reality, these fees are paid through state-guided mutual insurance funds which wage earners are required to sign up for.
According to Kielmas (1999), employers make contributions to both the state-funded system and to private health insurance and France spends nearly twice as much on health care as other developed countries. Rising costs are leading to demands for reform, which has taken shape via the aforementioned supplementary insurance scheme.
Dalen (2000) claims that health care costs in the United States, as of 1998, were $1.2 trillion, 15 percent of Gross National Product (GNP), and the highest in the world. In France, which the World health Organization (WHO) considers to have th...