Spending on health care is concentrated among select members of the population. The elderly and chronically ill represent a large portion of health care spending, as you can see the top 1% of the U.S. population is responsible for using health services (22% of all costs in 2002), while the bottom 50% of the population resulted in only 3% of all health care spending. In California, the top 20% of the Medicaid population (aged, disabled, and chronically ill) represent almost 80% of the health spending in Medicaid. Many U.S. residents do not use health care at all, which is also not appropriate.
French or not, working or not, unemployed, child or retired, legal or illegal immigrant. There are a few exceptions but 0.1% are not covered. The French system is also not inexpensive. At $3,500 per capita, it is one of the most costly in Europe, yet it is still far less than the $6,100 per person in the U.S.
French Medicine is based on a widely held value that the healthy should pay for care of the sick. Everyone has access to the same basic coverage through national insurance funds, to which every employer and employee contributes. The government picks up the tab for the unemployed who can not gain coverage through a family member. In France, when a family is expecting a child, it gets approx. 2,000 Euro in 3 installments and receives a monthly allowance until the child is 20. Retirement: in the range of 750 Euros/month.
All companies, whatever their size, must provide their staff with an annual visit to a doctor. The system was created over 40 years ago by Dr. Marcel Lascar. In France, the ambulances are more heavily equipped.
Medical Bill: Being worried about the health bill does not exist in France. The social consensus is “it is sad enough to be sick and must not have an additional money problem about it.”
The U.S. has a higher cancer incidence rate, and higher obesity and HIV rates than any other OECD country. However, we have lower smoking rates than other OECD countries. We also have the highest homicide rate behind Mexico.
Comparison & Contrast
Comparison & Contrast
Cost & Delivery
*$2.7 trillion spent on
health care annually
*Represents 16.6% of
*Population: 313 million
*$8047 cost per person
*$204 billion spent on
*Represents 11% of
*Population: 62.8 million
*$3300 cost per person
Half of the Population in the U.S. Uses Very Little
97% of all health spending is concentrated in half of the population!
Percentage of Expenditures
Percentage of Population Ranked by Spending
Source: Yu & Ezzati-Rice, Medical Expenditure Panel Survey Statistical Brief #81, AHRQ, May 2005.
*2.4 physicians per
*3.37 physicians per
Universal Coverage in
Everyone working in France must contribute to the French Social
Security System and everyone is entitled to benefit from it.
Threefold system: Health, Family and Retirement. Each is
financially independent from one another.
The Health System is based on the concept of providing a large
amount of help for any medical need and total help when it is
You pay according to your means and you receive (healthcare)
according to you needs.
Universal Coverage (Continued)
To grasp how the French System works, think about Medicare for the
elderly in the U.S., then expand that to encompass the entire
The Family System is financial help to all families plus various
services such as day-care or vacations centers.
The Retirement system provides minimal pension to any person who
has worked 40 years.
Responsive Health Care Providers
• Big emphasis on preventative care.
• Paid incentives based on patient outcomes.
• Little to no waiting time at doctor’s office.
• In France, one can have a doctor come their house
*SAMU: Service d’Aide Medicale Urgente
Patient and Provider Freedoms
• One can go to any doctor or hospital he or
• One can not be denied due to pre-existing
conditions or poor health.
• There is no such thing as a “medical bill” in
• Doctors have no educational loans to re-pay
for medical school.
U.S. Life Expectancy Lower than
Countries that spend far less
Life Expectancy in Years
Organisation for Economic Cooperation and Development Health Data (OECD), 2006
Hunnicutt, Susan (2010). Universal Healthcare Opposing Viewpoints.
Farmington Hills, MI: Greenhaven Press.
Moore, Michael (2007). Sicko. Dog Eat Dog Films Inc., The
Steffen, Monika (June 2010). The French Health Care System: Liberal
Universalism. Journal of Health Politics, Policy and Law, Vol. 35, No. 3.
Dutton, Paul V. (2007) French Lesson: A Model Health care System.
The International Herald Tribune. August 14, 2007.
Rochefort, Philippe (2011). Being Sick in France. Retrieved October
23, 2011, from http://www.understandfrance.org/Paris/Sick.html.
The World Health Organization Assesses the World’s Health
Systems (2000). Retrieved November 16, 2011, from