There is a great deal of literature regarding the comparison between the health care systems in the United States and France. In an international ranking created by Organization for Economic Co-operation and Development (OECD) in 2011, the US was ranked last in the quality of its health care system as well as third last in a Bloomberg study conducted that same year. At the same time, France was listed in the 19th position out of 48 nations, although in 2000 WHO had described France having one of the best health care systems in the world. Although the health care systems in both nations have significant differences, there are also certain areas where there is overlap. This paper will compare both nations’ provision of health care services.
Health Care Spending Costs
The United States spends approximately twice as much as France on health care; in 2005, spending in the United States came to $6400 per person as compared to France, which spent $3300 per person (OECD 2011). The United States spends 17.1% of its GDP on health care, nearly 50% more than the country that spends the next highest amount, France, with 11.6% of GDP. The reasons for this discrepancy are multiple; the US uses private insurance in its health care system while France has a national health care system that is socialized. In the US, there is more use of medical technology as well as health care prices that are greater than those in other countries. Finally, prescription drugs are the highest cost in the United States with prices twice as much as in the European nations and all of the other countries around the globe.
Volume, Price, Types of Services
Health care spending in the United States is far greater than that of any other country in the world. Analyzing spending is not attributable to higher incomes, and aging in elderly population, or greater supplier utilization of hospitals and doctors (Health 2011) Rather, the higher spending is mostly due to rising prices as well as more accessible and expensive technological advances in the medical field. In addition, the greater obesity rates in the United States results in higher spending as well. Nevertheless, in spite of health care in the US being more expensive than that of any other country, the quality of health care, contrary to popular myth, does not seem to be appreciably better than that in other industrialized nations. In the US, health care has become largely unaffordable for a large segment of the population. In addition, spending for Medicare and Medicaid has increased every year between 1970 and 2009, and is expected to reach 12% by 2050 (Health 2011).
There is a wide range of health care services available in the United States. Much of US health care spending is attributable to outpatient visits to primary care doctors and specialists. There are also outpatient services available in hospitals and clinics. A wide constellation of inpatient facilities make up a good part of healthcare spending as well, such as hospitals, acute and subacute facilities, nursing homes, and homecare also provides a wide array of services to patients.
The French health care system is a combination of universal coverage with a private-public mixture of hospitals and ambulatory care, higher levels of resources and a higher volume of service provision than the United States (OECD 2011). France’s health care system is characterized, as stated, by public hospitals that provide acute institutional care as well as fee-for-service, private practices for ambulatory care. Services are provided in outpatient offices, outpatient clinics and public or private hospitals, and are delivered by physicians who work in both sectors. People are also free to choose supplemental insurance plans over the national insurance benefits, and are able to access prescription drugs that are also covered by the national health insurance programs. Covered services include dental care, emergency care, palliative care, mental health care, complementary and alternative medicine, rehabilitation and long-term care, services for informal caregivers, and health care for specific populations (OECD 2011).
Factors Contributing to Healthcare Utilization
In the United States, there are a wide range of factors contributing to utilization of health care services. Health care spending is certainly inflated by the high rates of obesity in the nation, in addition to the United States having the highest rate of prescription drugs use, office visits, and medical procedures than any other country in the world (Chua 2006) In combination with the ever increasing use of technological advances in medical treatments and equipment, it is not surprising that the United States spends the most money on health care of any other country.
In France, there are a wide range of factors contributing to the utilization of health care services. Heavy use of tobacco and alcohol consume much of the health care spending in the nation. As in the United States, there are also many social and financial inequalities regarding health and access to care that prevents certain segments of the population from accessing necessary treatment and diagnosis. STDs and HIV have also been on the increase in France, so that the utilization of health care services has risen in response to people with these health conditions needing to utilize their health care service.
Mortality and Morbidity Rates
In the United States, the number of deaths in 2010 was 2,596,993, with a death rate of 821.5 deaths per 100,000 population (Health 2011) In addition, life expectancy in the US is 78.8 years, with an infant mortality rate of 5.96 deaths per 1000 live births. In comparison, life expectancy in France is 72 years, infant mortality rate is 2.4 deaths per 1000 live births, and 9.6 deaths per 1000 people in the population (Health 2011) These figures indicate that although life expectancy is not as high in France has in the United States, the infant mortality rate and death rate per 1000 people is substantially lower than in the US.
The United States spends far too much money on health care that is not considered to be as valuable as the care provided in France, according to results compiled by the French National Care System. Because the health care system in the US is largely privatized rather than public, there is a for- profit motive that makes the whole health care field ridiculously expensive. People like to say that the United State has the best health care system in the world, but this claim simply is not borne out by the facts. Americans are reluctant to invest too much money in taxes to pay for a single-payer system, and are strongly against what they regard as a socialist health care system, despite the fact that it is clear that most of the civilized world provides this type of health care service to its citizens with wonderful results. French citizens pay significant taxes for their National Health Service but in return, they receive free health care that appears to be focused on good health as a goal rather than the profit motive.
The role of the French government is to provide healthcare. There is universal coverage that is either provided through employment or by direct benefit to populations such as students and retirees. A wide range of services are covered, including hospital care, outpatient care, dental care, prescription drugs, health-related transportation, and home care. The Ministry of Health oversees the health care system, and utilizes a wide range of agencies to monitor and evaluate the quality of care provided to citizens. In order to reduce disparities in access to health care, the 2014 National Health Strategy and the 2004 Public Health Act established goals in order to minimize disparities in access to care. In France, Electronic Health Records have been implemented across the nation, records which are fully available to patients. Health costs are contained in the country by a wide range of efforts, including negotiating lower costs for drugs, a reduction in duplicate testing, and increasing the use of generic medications. Finally, some of the major renovations introduced into the health care system in France are making direct payments to general practitioners and engaging in a variety of public health efforts to reduce eating disorders, addictions, and obesity.
- Chua, K.-P. (2006). Overview of the U.S. Health Care System.
- OECD. (2011). Health at a Glance: OECD Indicators. OECD Publishing.
- “Why is Health Spending the United States so High?” (2011). OECD Publishing.