Healthcare In France

A reader writes:

As I understand it, "Sicko" also looks at the French system - which is very different from the NHS and shouldn't be placed under the rubric "socialized medicine."

The French system is a mixed public-private system that covers all residents of France. Social security "charges" paid by employees and employers pay all or part of most health care services. Many people also have a "mutuel," a private insurance company that pays for services beyond what Social Security, aka Secu, pays. (And the unemployed also are covered; if you lose your job you don't lose your health insurance.)

The U.N.'s World Health Organization surveys the health care systems of nations around the world and in its most recent survey named the French system as the best in the world. From my own experience, I concur.

My wife and I have had stays in hospitals, public and private, and have been well satisfied by the quality of care. Hospitals we have stayed in are the equal of the best in the U.S. Fees are far lower than those in the U.S.

Does the French system have problems? Sure. It runs a big deficit each year. And, yes, Social Security charges (which pay health insurance, pension, disability and unemployment insurance) are very high for both employees and employers. Doctors who are under the Secu fee schedule (though they are self-employed) complain the fees are too low. Nurses also complain about low wages. According to the WHO, France spends much less per patient than the U.S. does. If I recall, France's per patient cost is a third less than that of the U.S.