This is a great overview of the French health care system, from Edward Cody of the newspaper’s Foreign Service.

Some years ago, I learned my best friend, who was on a vacation in France, was not on the beach but in an emergency room.

She was in a tourist area, where one might wonder if there were serious medical care available. That was unsettling to me, here in the States, with almost no way to assess the quality of the facility or the credentials of the doctors. By the time I was through checking, her surgery was over, she was fine and I was sitting stupidly looking at a list of international telephone numbers I had called. No need.

When it is appendicitis, the patient needs action—not her own personal informal quality-control director.

She received excellent care.

She especially loved the fact that the French assume that once the patient is awake after surgery, said patient should have a lovely meal—-not broth and Jello, the American way.

Her company is an international powerhouse.  It is self-insured.  The procedure is for the employee to pay the bill and file for reimbursement back home.

Gulping hard at check-out, she asked the total, thinking she would use up a whole credit line.

Not at all. The cost was modest, very modest when one considers the emergency care, tests, surgery and hospital stay (no extra charge for much, much better food).

Modest enough to be less than her monthly American Express card.

However, as this story points out, the French are facing the same demographic challenges all developed countries are.

In the U.S., which continues to have a growing population, there must be a new plan which can cover more patients (population growth in the U.S.) and more older, patients (aging).

The Washington Post

“France has long been proud of its national health insurance, part of a many-tentacled and costly social protection system designed to embrace almost everyone who is legally in the country. Most French people have grown up with the idea that the government is the ultimate guarantor of health care, even for people who cannot afford to pay. The concept has become so ingrained over the past half-century that it is an untouchable part of the political landscape, making the debate over President Obama’s proposals in Washington and the fading chances for a public option seem, in the words of the newspaper Le Monde, “altogether surreal.”

“But the fast-rising cost of drugs and medical care, particularly for the elderly in their final days, has raised the question of how long France can afford the health care it has come to expect. Seeking to beat back rising deficits, the government has reduced the reimbursement rate for many medicines and routine medical services, opening a growing market for private insurance policies, called mutuals, to cover the steadily increasing co-payments.

“Without abandoning the bedrock of health care for all, therefore, the French system has begun to evolve toward something resembling Medicare, the health insurance for older people in the United States, except that it covers people of all ages. The shift is regarded as inevitable, specialists said, but increasingly it is raising the delicate question of how much the government will be forced to resort to even higher co-payments in the years ahead.”

Source: Washington Post, September 22, 2009