Reason's editor-in-chief on the superiority of the French health care system. He makes many good points, but I was especially struck by this:
What's more, none of these anecdotes scratches the surface of France's chief advantage, and the main reason socialized medicine remains a perennial temptation in this country: In France, you are covered, period. It doesn't depend on your job, it doesn't depend on a health maintenance organization, and it doesn't depend on whether you filled out the paperwork right.
Assuming the US enacts health care reform, Americans still won't be "covered, period". All this effort and expense, and they still won't have that assurance.
Oddly enough, as I argued in the summer, the French system has many structural features in common with America's: they are not as far apart as you might think. Not that this makes the French model easy for the US to copy.
The success of the French system does not establish the superiority of public insurance. It establishes the superiority of a system that, as much by historical accident as by design, has kept doctors' pay very low. This, in turn, requires a medical-liability regime that minimizes litigation (so much for patients' rights in that sense) and guarantees essentially free training for medical professionals.
The idea that France's system could be grafted onto the American setup is most misleading. To be sure, in organizational terms, it could be. Structurally, the two countries' systems are not that different. The French scheme is like Medicare on a much larger scale -- with all the virtues and drawbacks of that system. But plug American rates of pay into that design and the impressive cost advantage vanishes.