The French way of cancer treatment
blogs.reuters.com
blogs.reuters.com
This is when I understand what people means when they say that France is a socialist country: we have very strong public service. This means that police, fire fighters, healthcare, school and so on are mostly public: we have no militia, prisons have no incentive to get more people jailed by bribing judges, fires are fought without caring if the flat's owner can pay for it, people are being taken care of without delay for checking if there private insurance will accept it, and kids from poor families have a firm chance of getting a good education.
The amusing part is that having this critical services being managed by the state seems so obvious to us that we don't think we are specially socialists (well, the French social party seldom wins the presidential elections). I guess it would seem odd for the government to nationalize a company, but it would be nearly impossible for them to try an privatize a critical public service.
Also, screw Translink. I still can't fathom why a 15% increase in price for a worse service makes sense. Sigh
Australia has not been moving towards that model.
Private health care options have always been a significant part of the Australian healthcare system. In the current Australian settlement: (1) there is a catch-all system that's available to everyone; (2) if citizens want to chose a chosen private option, the government subsidises this.
There's a similar dynamic in school funding.
The result is that people can choose to funnel money towards the education and health system that's in addition to what they pay in their taxes. Their choice also reduces load on the free options. People spend money on health and education that would otherwise be spent on new cars or more ludicrous mortgages, and have done this through an exercise of freedom, rather than having had the government tell them what to do.
Australia is one of only a handful of countries with both solid education and health systems, yet a contained federal government debt situation.
Privatisation of infrastructure (and a general lack of building new national infrastructure) is also a key sign that the system is not very 'socialist'
The US system is a tangle of health systems provided by every level of government and charities. It's different state by state. There's a major veterans scheme. Some states have systems a bit like Medicare. The majority of people get their care through a employment tied insurance. It doesn't serve as an example of freedom, privatisation, variations in levels of care. It's just a big complicated mess.
I think it'd be more straightforward if you just stuck with 'less socialist' rather than trying overloading America as the standard for those qualities.
Not sure that Australia has evolved that way though. There was a recent reform to introduce means-testing to medicare. And the new hospital in Adelaide - 1.7 billion dollars, 120 extra beds.
Something that ribs me about the political culture in Australia: the intelligentsia will never miss an opportunity to claim their identity as being distinct, yet they judge themselves from a very American world-view. In this sense, the Australian identity is like a rebellious teenager - desperate to be making a break from mum and dad, but unaware how its rebellion is defined entirely by mum and dad's world-view.
You are welded to the (American) popular culture myth that American is an antonym for socialism. This is more important to you than the fact that it isn't. Even after we've discussed that there are better ways to express the idea, after you've gone through the pain of admitting you could have done this differently. You've then recanted, pulled back into your shell and defended your original expression. You won't grow if you do this.
It's not just you. But you can fix it. Turn off the television, blank your mind, read, travel, think, build your ideas on this foundation.
A potential downside to the world (maybe good for Americans) would be if changes in American healthcare reduces funding overall for drug research and development. I've always heard we fund most of R&D.
Libertarians are suffering from the same delusion that the communists did: In a world where humans are perfectly ethical towards each other and always put the public good ahead of their own interests, it will work perfectly. In the real world, it won't.
Charities are much more common in the US than in Europe, because they cover services and treatments which are provided by the public sector in European countries. In the US, many of these services are based on voluntary donations and volunteering.
Of course, if the state is as corrupt as it is in the US, I understand the reluctance to pay more taxes. But in effect, charities do the same thing, except veiled by the fact that contributions are voluntary.
The problem is that for the insurance to work optimally everyone have to chip in so that those that are healthy offset the cost of those that aren't.
In the US the young aren't getting insurance which is one of the reasons for the Offordable Healthcare Act. To force everyone to have an insurance so that economics become better.
Of course in reality the best possible system would be a single payer (tax based) healthcare system with some payment for usage but where no one can go bankrupt or be dropped or fall under the deadly pre-existing conditions clause.
Or a mandated private insurance like in Germany & Switzerland. Obamacare is one step of that way but it's so alien to US culture and have been so poorly implemented that on could fear for its future.
There is no mandated /private/ health insurance, there is just mandated health insurance in Germany.
See e.g. http://www.slowtravelberlin.com/guide-health-insurance-germa...
I'd release new products regularly, while increasing the insurance premiums of old products. Healthy people would just switch to the new product to avoid the price increase, but people with pre-existing conditions wouldn't be eligible so I could price-gouge them.
So you could get insurance against expensive medical conditions - but if you had to claim on that insurance, suddenly your premiums would start rising by 30% a year, and you would have no alternative because of your pre-existing condition.
The companies that didn't engage in this would then look expensive to healthy people and attractive to unhealthy people. And if the healthy (profitable) people leave and unhealthy (subsidized) people join, meaning premiums have to go up further, you could get a chain reaction putting them out of business.
To bolster this example, I hear from my parents that this is more or less what's happened to insurance premiums in Switzerland since some idiot in government deregulated the insurance industry.
Get lung cancer? Here take $200k courtesy of your insurance. Only going to cost you $150k? "No problem, glad you found a cheaper place. Buy a nice gift for your wife with the difference"
Not to mention you are by necessity limited by the hospital and doctors on the insurance companies approved docs list. No thanks; they don't have my interests at heart.
Not to mention the very real incentive for such an insurance company to stop paying for "problem" clients with long ongoing illnesses.
It doesn't work because of other reasons. And libertarianism is quite irrelevant. A good economist can point out the flaws in economic markets...using economics. A marxist alternative is clearly from the wrong century and is irrelevant. The important point that govermnet semi-intervention is part of the problem is perfectly plausible. That is a different point than no co-operation is needed for a viable solution. People co-operate all of the time without the need for a "government solution". Try staring at people in the elevator or invading the personal space of someone on the NYC subway if you want to prove this point to yourself.
Only Norway has a substantial amount of natural reserves in the Scandinavian countries, with Denmark a distant second.
Also, the healthcare system you talk about is the Swiss, the Scandinavian and Canadian systems do NOT have anything close to an insurer (except the State itself).
Re healthcare: I was talking about Scandinavian and Canadian systems. Government pays the cost but private companies provide the service. Contrasted to the UK where government provides the service.
I can't speak for Sweden and Denmark but here in Norway whilst private institutions provide services (X-rays, MRI, etc.) under contract to the state, the hospitals are nonetheless public institutions (barring a few, and as far as I can tell not very successful, private hospitals).
What does seem to unite the three Scandinavian countries is a general belief that we really are in it all together. When a rich owner of a chain of supermarkets started making a noise about moving to Switzerland because he was fed up of paying high taxes he was immediately told to " off then" not just by us poor peasants (of course there aren't many genuinely poor here) but also by other seriously rich people. It wasn't long before he was back here.
Percent of GDP from natural resources:
Norway: 13.6
Canada: 5.1
Denmark: 2.4
US: 1.7
United Kingdom: 1.5
Sweden: 1.2
Germany: 0.3
Italy: 0.2
France: 0.1
Japan: 0.0
Switzerland: 0.0
Update: The data for my claim above - http://www.theguardian.com/news/datablog/2012/jun/30/healthc... - the US had the 4th highest per capita government spending on health in 2010 behind only Luxembourg, Monaco and Norway.
Living in another country with socialized helathcare, each time the situation in the USA is described, I'm really glad I don't live there.
You forgot the word "crappy" services. It's widely known that for life threatening conditions in the UK, the NHS has a wait list and you have to wait for your turn no matter what and that be months or sometimes more than a year. Sorry, but I want to have a system that allows me to pay more to get priority (or better treatments).
'Force de Frappe'
(Also ask whether the French would actually have used nuclear weapons to stop a Soviet non-nuclear attack on France. That's relevant because in a conventional war without U.S. forces, the Warsaw Pact forces could have rolled to the Channel in weeks if not days.)
No, it was NATO that served as the real deterrent to the Soviets. NATO was largely (and expensively) underwritten by the U.S. Le Grand Charles [de Gaulle] withdrew France from the NATO military alliance in the early 1960s. That freed up who knows how much in the way of French resources, with France still effectively still living under the protection provided by NATO.
Personal note: When I was a kid, my dad, a U.S. Air Force officer, was stationed in France; we lived "on the economy" in a little farm village, where my sisters and I went to the local schools and as a result were bilingual. We were upset when we thought we were going to have to move back to the U.S., and leave our friends, sooner than scheduled because of de Gaulle's announced intention to kick out U.S. forces. (As it turned out, that didn't happen until after our scheduled move back to the U.S.)
Also ask whether the French would actually have used
nuclear weapons to stop a Soviet non-nuclear attack on
France.
The thinking was, for the same reason France might not use nuclear weapons against a non-nuclear attack, the Soviets might not use large nuclear weapons against a small nuclear weapon attack.
I dunno whether the French would have, but I know the Americans would have. It was US policy through much of the Cold War that conventional forces in Europe were only to be a "tripwire" to trigger a nuclear response, rather than a force strong enough to contain a Soviet attack on their own. This allowed the US and other NATO nations to economize on conventional arms and avoid having to conscript massive numbers of men.
Try this thought experiment:
First, recall the Soviets' ability to absorb fearful military punishment, as well as their willingness to act brutally in eastern- and central Europe during and after WW2; in East Germany in 1953; in Hungary in 1956; and in Czechoslovakia in 1968.
Second, imagine that in the 1950s or 1960s the Soviets had invaded Germany --- but also imagine that there was no effective NATO protection because (hypothetically) the U.S. had gone isolationist.
Third, assume that the Soviets had punched through Germany; reached the Rhine; and pushed through into France.
OK, now let's assume for the sake of argument that in response, the French had nuked the invading Soviet forces, but not the USSR homeland (for fear of provoking massive Soviet retaliation), using only small, tactical nukes.
It's not unreasonable to think that the Soviets would have responded in turn along much the same lines as they did in WWII --- but this time with their own nuclear weapons --- by obliterating the French armed forces, and probably a French city or three to make sure the message got through.
The French would (sensibly) have surrendered, of course. The Soviets then would have done much as they did in eastern Germany after WWII: They'd have carted off everything useful that they could, as war booty (euphemistically described as "reparations"). They probably would have shipped thousands of people off to slave-labor camps in the gulag, most of whom would not be seen nor heard from ever again. They'd have settled in to administer the ruined France as yet another impoverished Soviet vassal state under a Communist puppet government.
So France's nuclear Force de Frappe likely wasn't a real deterrent to the Soviets, but instead was merely anti-American and anti-British posturing by de Gaulle, safe behind what he knew would be the protective shield of NATO military power.
(Do de Gaulle's attitude and actions remind anyone else of what Hamid Karzai has been doing lately?)
When you compare the US and the French system, you don't get to just say "well, they did it why can't we?" as if that question exists in a vacuum. We have a defense program which is a massive government expenditure -- which pre-empts other government expenditures such as single-payer health care -- so a fair comparison would have to look at the fact that the French had a de facto defense subsidy.
If each country in Western Europe had been responsible for building up the kind of deterrent force which we were able to present, the calculus for a single-payer program would change. Certainly Force de Frappe was a strategic asset. Can you concede that without NATO (dominated by the US) the French investment in defense would have needed a drastic increase in order to fill that vacuum? If there were no NATO, at the least I think you can acknowledge that all of Germany would have been a Soviet client, putting France on a front line against the Warsaw Pact countries.
EVERYTHING we do ultimately comes down to trying to spread and preserve
* our genes * our family's genes * our friends' genes
and all the other social groups humans form, in the order of priority being group size smallest to least.
Emotions are the definable channel to that "gene preserving" desire.
Everything we do in life is to achieve a certain emotional state (think about it). We don't want money. We want what it will mean to us (e.g. security, power, fun, freedom, etc.). We don't want a relationship, we want what it will mean to us (love, belonging, etc.).
Nature's calibrated human has his emotions correctly / optimally linked to spreading and preserving his and other humans' genes.
Yes, I do. I believe that I have personal experience of people doing thing detrimental to themselves, that they know are detrimental to themselves, that they do willingly. We are capable of overriding our emotional and physical reactions.
I suspect you have already decided on your conclusion, and will fit all evidence to that conclusion.
For America WW2 meant opening up it's trade with the war. Let's not forget that Europe's welfare states were born in hardship.
The U.S chipped in quite a bit too. $15 billion, or $148 billion in today's dollars, which was almost 6% (!) of the U.S. GDP at the time. This was in addition to a previous $15 billion in aid before the Marshall Plan was enacted.
http://www.trumanlibrary.org/anniversaries/healthprogram.htm
http://pediatrics.aappublications.org/content/127/3/399.full
The whole premise of social security in France after the war is that people with their basic needs unfulfilled voted for the nazis. So they decided that the State should provide some minimum services for everybody.
Not purely --- I would imagine that certainly American leaders had future markets in mind --- but there was definitely a large component of altruism, quite possibly more so than with the French support of the American revolutionaries in the late 1770s and early 1780s.
In the post-WWII era, the U.S. had nukes, as well as two broad oceans as moats. After the Japanese surrender we demobilized as fast as we could, in response to overwhelming domestic political pressure to "bring the boys home."
It might well have been feasible for us to have largely retreated to our own borders and leave the western Europeans to their fates at the hands of the Soviets. Instead, we spent billions, perhaps even trillions, to maintain forces in Europe to deter Soviet aggression and to try to help western Europe recover from the devastation of the war. (We offered Marshall-Plan aid to the Soviets and their vassal states as well, but the Soviets prevented those countries from accepting [1].)
Of course self-interest was part of the U.S. motivation. But there also was altruism, and generosity.
[1] http://en.wikipedia.org/wiki/Marshall_Plan#Rejection_by_the_...
Le baron de Beaumarchais (famous writer and weapon smuggler) that lobbied the french monarchy for helping the US revolution was clearly doing it for the sake of freeing the people from monarchy (he was one of the philosoph supporting the strange idea that merit matters more than birth rights).
You should really read more. Especially 'le mariage de Figaro'
According to a U.S. State Department history [1]: "In 1795, the United States was finally able to settle its debts with the French Government with the help of James Swan, an American banker who privately assumed French debts at a slightly higher interest rate. Swan then resold these debts at a profit on domestic U.S. markets. The United States no longer owed money to foreign governments, although it continued to owe money to private investors both in the United States and in Europe."
Granted, 1795 was a bit too late to help Louis XVI, who had lost his head two years before. Still, it was only 12 years after the peace treaty with Britain -- not too terrible for a brand-new nation, I'd say. And in any case, it'd be unconventional (to say the least) to try to blame the Americans for the French royal government's mismanagement of its financial affairs.
---
> Le baron de Beaumarchais (famous writer and weapon smuggler) that lobbied the french monarchy for helping the US revolution was clearly doing it for the sake of freeing the people from monarchy (he was one of the philosoph supporting the strange idea that merit matters more than birth rights).
Nations aren't monoliths; their governments act in response to pressures from all sorts of different people who have all sorts of different opinions and motives.
(Example: When the U.S. entered WWII, the triggering event was the Japanese invasion of Pearl Harbor. But for months before that, and especially after the Nazi German invasion of the USSR in June 1941, a significant number of Americans had wanted the U.S. to enter the European war --- some to help the British, and some because they were Communists or sympathizers who wanted an immediate second front in Europe to take the pressure off the Soviet Union.)
In the rough French revolution context is basically the same as today: * huge debts contracted by gvt; * unfair repartition of the fiscality (the 1% wealthiest don't pay in proportion to their income); * producers (the 10% wealthiest) are not able to produce anymore because fiscality is to high;
The convocation of "tiers etats" that triggered the revolution was about asking how to make the repartition of fiscality more fair.
the 1% wealthier said we don't care we don't pay and you can't change the system anyway because we make the rules and they "mouhahaha"ed The remaining said, okay, are you losing your head (saracasm and irony)? and they said to the other europeans 1% (germans, brits, dutch, spanish)... Oh btw, we are not a kingdom anymore. As a result, we dont have anymore debts. Go fuck yourselves
The banks were pissed off and they said: WUT! Debts are to be honored, if people begin to think that money don't rule the world the world is doomed.
Thus the coalitions against France, battles (Valmy), Napoleon tricking Italia in Republic and then betraying them so that the bankers got another ennemy ...
And here we are, in the same situation again.
Now, takes Forbes top 500 fortunes of the world and tell me how much people are not xth generation dynasty kids.
I love Bill Gates he has a lot of merit, one of which is being well borned.
We do have a meritocratic system, but this system is biased because he is mainly accessible through birth.
This is the definition of a society based on casts. We are regressing in the name of a so called "liberalism" that looks like the "communism" of Lenin : an implementation that contradict the purpose.
Our political systems are wrong implementations of good ideas. How can we repeatedly fail that much collectively?
As opposed to the professionals, who dribble drive-by snark and Wikipedia links?
You could start your remedial reading with: http://en.m.wikipedia.org/wiki/France_in_the_American_Revolu...
Other than in an abstract sense, what does the American Revolution have to do with the Postwar Reconstruction, some 170 years later? And how does that mute or counter the statement I made?
That's not the way it appeared at the time. Up until the mid-to late 1960s, it was entirely rational for Western leaders to conclude that the USSR wanted eventually to dominate all of Europe and even the Western Hemisphere. [1]
[1] http://en.wikipedia.org/wiki/Cold_War#Beginnings_of_the_Cold...
But how much of that appearance came in form of various gaps that were essentially paranioa turned into a marketing hoax for the weapons industry?
In the US there is no functioning price mechanism. So, it it is quite unlike a trip to the super-marche. Your money disappears down a rabbit hole (insurance) for which there is very little practical choice; and the rest of it is like a giant "dark pattern" puzzle where all kinds games are played to milk out the most money. That is not to say introducing "market pricing" is the correct answer, in a naive sense, this is not correct. Because markets don't function with opportunistic negotions under duress and asymmetric information (ie, typical medical situations). So, the problems with healthcare are precisely this: money changes hands but it is part of a system that is neither here nor there. As such, its just a corrupt opaque and insider-exploited bit of social engineering. Of courese, that likely describes many of the alternatives. (Hence, tough choices and an unwillingness to do anything other than something well thought out and pragmatice.) At least EU countries have evolved a unique ecosystem over time that has developed it own internal logic. The US is a frakenstein system, and the more money we spend trying to "rationalize it" (buzzword of the 1990's?), the worse it gets...MBA type's and the hippocratic oath don't really mix.
Being French living abroad, your comment makes me smile.There's nothing but socialists in France, you just have right wing and left wing socialists but their economic and social policies are all very much converging except for some minor social issues about homosexuals and stuff like that. Liberals or should I rather say Libertarians do not exist at all in France so you have basically a single mindset in power. That's why France is known abroad as "La Petite Russie" (the small Russia).
> be nearly impossible for them to try an privatize a critical public service
and thats exactly why you end with shitty companies like SNCF and the former France Telecom who did not care about their users at all. Having competition does not solve all issues, but God, it can't be worse than State monopoly services.
> and thats exactly why you end with shitty companies like SNCF and the former France Telecom who did not care about their users at all. Having competition does not solve all issues, but God, it can't be worse than State monopoly services.
Some context for non-French: SNCF is the Société Nationale des Chemin de Fer (litteraly national railway company), that now manages most train traffic in France (but not the railways themselves, ironically); France Télécom (sometimes abbreviated FT) is the company which set up the infrastructure for land-line phones and started using it. Both SNCF and FT are public companies.
The statuses of SNCF and FT were logical at the time of their creation as it was an initiative of the state to build the infrastructure so that most people could benefit from it. However, this also meant that the companies had the monopole and, even when it was finally broken (legally speaking), they were considered as the "by-default" company so they still detain most of the market in their respective domains. Because of this, they were never really threatened by competition and evolve very slowly, leading to a degradation of the services they provide. Additionally, it is difficult to privatize those company because of social protests that raise whenever the topic is discussed.
Neither does most Americans with many of their socialized services. Very few people are protesting for disbanding of police fire or public education or highway infrastructure.
Then we get people protesting like this
http://www.pensitoreview.com/2010/04/05/sublime-tea-baggery-...
(Medicare is socialized medicine. It is only available for the elderly and disabled though.)
>In 2000, the World Health Organization ranked the French health system as the best over all in the world. Do you agree?
>I question the W.H.O. methodology, which has serious problems with data reliability and the standards of comparison. A study I would take more seriously is one published last year by Ellen Nolte and Martin McKee in the journal Health Affairs. They examined avoidable mortality — that is, deaths whose risk of occurrence would be far lower if the population had access to appropriate health care interventions. In that study, based on data for the year 2000, France was also ranked No. 1, with the lowest rate of avoidable deaths. The United States was last, in 19th place, with the highest rate of avoidable deaths. That’s a severe indictment of our health care system in my judgment and calls attention, quite justifiably, to the high performance of the French health care system.
http://prescriptions.blogs.nytimes.com/2009/09/11/health-car...
Alas, a negligible price to pay for Freedom™.
Sure, you can coin a definition of "free" that excludes France, but you can do that for any country, including (and perhaps especially) the United States.
(or perhaps you were being sarcastic)
haha. Funny comment. There are probably a thousands ways the US is more Free than France. Let's not start by checking all the administrative barriers to do ANYTHING in France. The US is certainly not an exemplary model for Freedom anymore, but trying to compare France and US in terms of Freedom is a lost battle.
Freedom in USA and France is decreasing because citizens are not involving themselves in the functioning of the Republics we live in.
Quis custodiet ipsos custodes?
This should be quoted on the internet by the way.
EX: On September 11, 2001, the FBI had a list of 16 people deemed "no transport" because they "presented a specific known or suspected threat to aviation."[6]... In April 2007, the United States government "terrorist watch list" administered by the Terrorist Screening Center, which is managed principally by the FBI, contained 700,000 records.[15] A year later, the ACLU estimated the list to have grown to over 1,000,000 names and to be continually expanding. Note: There are no where near 1,000,000 known terrorists this is just name matching including known alias and including anyone close and well into the 90+% false positives.
On the World Bank economic rankings of the easiest place to start a business, which is what Forbes have been using to bash France, France does score rather badly at 41st place, but the US is only at 20th place. Mind you, I am not sure if I should take these figures all that seriously. Rwanda is 9th, apparently, while being 53rd on ease of getting electricity.
What you probably wish to argue is something like: "Those unique 'American freedoms' that ostensibly result in such a crappy health care system --- and the inevitability and necessity of this is highly debatable --- do not contribute nearly as much to actual freedom as you seem to think."
What you are actually arguing is: "There exists no sensible definition of freedom wherein the citizens of the United States are free and the citizens of France are not."
A disagreement which continues from this point will devolve quickly into an argument about when and how ideas are "sensible". This is perhaps a really interesting topic when pursued in its own right, but the assertion has, at that point, effectively derailed future debate about the different freedoms enjoyed by the French and Americans.
And that's just looking at the direct cost to the patient, completely ignoring the costs to society and the economy. Having to treat severely ill patients in late-stage scenarios where the patient is now out of work for months on end.
I still recall one story I heard during the Obamacare debate about a young father who died from a gum infection. His insurance had lapsed (unemployed) and he only had enough cash to pay for either painkillers or antibiotics, not both. He made the wrong choice unfortunately. This scenario does not exist where I'm from. Hell, I'm happy to pay for other people to get this kind of care. It still costs me less than the US system!
NB: Having personally had a serious abcess that needed root canal in the past (was abroad so couldn't get immediate treatment), I can't honestly blame him for taking the painkillers, it is astonishingly painful.
I don't like when people focus 1 specific aspect of a country. I've seen Canada and Scandinavia also mentioned in replies further below. You have to look at the country as a whole.
What people forget to mention is all the other less desirable traits of an economy. For example, I'm from Quebec, Canada and there are plenty of people that question the sustainability of our free health care with the aging population. There are tons of French people coming from France because they can't find a job over there.
Oh, the same questions should be asked in France as well, since the French Government needs to borrow 4 to 5 billions Euros on the market every few weeks to keep functioning. Of course it's not sustainable.
I am living in both Paris and the US. It's not what I have experienced.
In Paris, one of my friend has been hit by a motorcycle. The motorcycle run away. She hits the ground and nobody cares. She was disoriented with weird bubble on the skull. I call the french 911, they send the firehouse department who came for finally asking me to go get my car to get her to the hospital. When she can walk, they don't have to take her. I mean WTF?. I took her to the hospital, lot of homeless people, cold waiting room. We wait for 2 hours for her to be taking care of and after that we wait for another 4 hours. The hospital staff were making fun of her because she can't remember her first name and a lot of stuff because of the disorientation (She is pretty so maybe they wanted to take advantage of the situation or something, wtf). Duh? They finally say the scanner didn't revealed anything and send us home. Actually she had blood in her skull and suffer from permanent brain damage now. I mean WTF? Yeah we've paid something like 7 euros I guess, but what's the point if it's for getting treatments from the middle ages?
In opposite, one of my friend got in a car accident in Austin. They wanted to run away, they were DUI but finally get caught. He get to the hospital by an ambulance. Duh? And I finally join him in the hospital. Wahoo, this is day and night. The hospital have scanners or IRMs in every rooms and he has been take of right away. Someone was checking on him every 15 minutes or so. Plenty of devices with computers (duh!) and electronic devices (duh!). And the hospital food was not that bad (for hospital food I mean)! Everything clean and warm, people professional. He didn't get to pay anything because of good coverage.
I have been in a motorcycle accident, the "fire house departement" ( we call them that but they do 90% medical emergency, they are trained for that ) arrived promptly, i had to wait 1h as i was not in a critical condition but i had all the treatment and analyses you say you had in dallas. And i live in a small country town.
The only other thing who feel real in your account is that the hospital might feel old ( walls, paint, etc. ).
Your friend might not tell you everything or he had a very bad exeptionnal experience who is not representative.
I think US system is superior for tooth care.
I am French and a public hospital actually forgot my father in a room for a week. He needed surgery, not urgently but in the meantime he had to be kept sedated. They kept him on morphine, fed him but he was not tracked as scheduled for surgery by their information system. And of course nurses kept telling us it was normal.
There is also a lot of abuse from this system, especially since the pharmaceutical lobby is quite powerful. They actually cover 30% of the cost of homeopathy! And when there was a H1N1 epidemy a few years back the French government ordered wice as many doses as the population of the country.
Comparing the cost of healthcare does not take other parameters into account. For instance obesity is not as much of an issue in France than it is in the US, and that helps decrease the overall cost of healthcare.
And of course, part of the reason is also that it is easy to keep prices down by having the State decide them instead of a free market. But the result is that some health professions are clearly underpaid. There were huge demonstrations of midwifes recently because of that, for instance.
But all in all I cannot deny that I still prefer our system to what exists in the US. As comments in this thread shows, it is not our system which is perfect, it is yours that looks terrible.
Profit driven economy is important for competition, it applies for many market, like luxury, automobile, housing, furniture, etc, and it's also important when the government need to make expenses: they will buy from the company who offer a good service at a fair price.
That's where capitalism fails. Capitalism doesn't directly make the poor wealthier, but if you make programs that help the poor, it will always have benefits to the rich. That's what I don't understand when the wealthy wants the poor to not be given aid: it might increase the wealthy's relative wealth, but not their absolute wealth.
I think the wealthy don't like socialism not because it doesn't reward their effort or their wealth, but because it gives them less decision power in general. Which is stupid, since wealthy people have a career in business, not in politics. I guess it boils down to an inferiority complex.
Also don't forget france's budget is mostly financed by the valude added tax, which doesn't exist in the US.
IMO France now needs to rebuild its economy so it continues to support this gold standard system. Let's not let it degrade.
Being Irish, I'm used to a public healthcare system that, while slow and filled with red tape, does actually work. Private health insurance is expensive and quickly becoming something that can mean the difference between paying your mortgage or not, but still is seemingly better than whatever is going on across the pond
Definitely worth a read, if only to highlight the stark difference in approaches.
By and large, Italy is not a stellar example of how to run a country, but the health care system is less bureaucratic and easier to deal with than the US, and generally not something you have to worry about much.
That said, it's not perfect, either. When our son was born here, it felt very much like a factory operation with the pregnant woman as an input and a woman+child as the output. I felt they were competent in the event that anything went wrong (in our case, everything was fine), but it was all very impersonal and felt designed to maximize throughput. I was not allowed to be with my wife for most of her labor, for instance.
Best I can figure, country X also has these undesirable attributes A, B, and C. The premise here is that you can pick and choose various best features of wildly divergent societies and then combine them, like eating at a buffet bar.
I do not believe this premise is valid. If you want socialized French-style medicine, then you also get national strikes that shut everything down, Mediterranean time reckoning, really bad enviornments for startups, and so on.
That doesn't make the effort worth abandoning. American healthcare is broken and it has remained broken through major political turmoil designed, presumably, to fix it. Just at some point, you have to decide for yourself whether or not you want to form political opinions based on how emotionally moved you can be from listening to just part of the story, or whether diving deeper is worth it for you. I applaud the French system's strengths and the efforts to improve our own. I'm just not sure how much here is useful. There's much more to this than "But if we could only just expand Medicaid!"
That's ridiculous.
All the European countries have healthcare systems that are far more civilized than ours. Not all of them have those problems.
Also, it's not that Europe is a bad environment for startups. It's that Silicon Valley (for all its defects) is the best environment for startups in the world, and there's a power law distribution. (Whatever #2 is, it's not even close.) The US minus Silicon Valley is no better than Europe in terms of supporting entrepreneurs.
Also my insurance company in France would rather pay for my flight ticket to go back home instead of going to the hospital in the US.
I've been in the US for almost 2 years now and it still puzzle me that I had to pay for STD test(!) and I still don't understand the US healthcare system.
For non-French people: in France it is standard that STD tests can be done anonymously and for free by anyone (you are never asked any identification information, everybody can do it even non-French person).
I know people who are very careful about this because they don't want premiums going up. These things all add friction to the process in a time of high stress. As a user experience, it is of very poor quality.
Which isn't to contradict that French health care is good; just pointing out an area in need of improvement.
http://www.slate.com/articles/life/family/2012/02/postnatal_...
I found that representative of a great healthcare system: they are not just doing the minimum or the obvious or unnecessary 'nannying', but taking a holistic approach to postnatal care.
If I want convenience and pretty flowers for simple procedures I'll go with private, but for anything serious public all the way.
And that fate has pretty much been sealed now for the next few generations, maybe even hundreds of years.
There are now many millions of people in the US that will never have health care under the insurance model because of the medicaid gap caused by the loophole the supreme court made and the states that refused medicaid expansion.
Work hard and pay high taxes all your life. Your country should take care of you when you need it the most.
We all have our national pride and there are real philosophical difference on how to organize societies - and these differences matter. Being smart however includes the ability to sometimes ignore one's ego, compare solutions based on their merit, and learn from each other where possible.
US has better cancer survival rates than France
But I think that chart is ranking cancer deaths per 100,000 people in the general population. Death rate of people who have been diagnosed with cancer would be much more informative.
Countless well prepared doctors from countries like Bulgaria and Romania leave to work and live in France, UK or Germany.
They are happy with the higher standar of life and better income in the west. However their education is subsidized by the East with the losses never recouped.
Without those doctors, the health care in Western Europe would be significantly worse, kind like how Silicon Valley would be without immigrants.
Another problem is that clinicians make mistakes, and those mistakes kill people, and the risks of those mistakes rise with Whatever national language as a second language.
We can't possibly have that here however. "Capitalism" (meaning oligarchy / monopoly based market control to Americans) must be applied dogmatically to everything, regardless of outcome.
It's Poland so neurology ward was overcrowded and begged for renovation and radiotherapy mask was initially too tight, but we don't care, she was given two years and counting of full quality life witout any unnecessary burden on her, us and our families.
As a kid, I always dreamed of living in America - now I wouldn't want to do it even if someone paid me to. Nope.
If the cancer makes it into the bloodstream, and isn't wiped out completely by the chemo (cancer cells have an evolutionary dynamic like antibiotic resistance; this is why chemo drugs can stop working before they kill all the cancer) it's very likely that it's a chronic illness and terminal within 5 years: often much less.
This is one of those claims that has to be attacked. Day after day, I hear people defend our horrible healthcare system by claiming that people on the "global rich list" still come "to the US" for healthcare. That was true in the 1980s. Not now.
No one who knows anything thinks highly of our healthcare system in general. Even if you have insurance, the quality of care is inferior to what many countries have for free.
What is true is that very wealthy people (for whom money is no issue) travel to specific doctors for treatment, especially when getting an experimental procedure. If that doctor's at Sloan Kettering, they go to New York. If she's in Paris, they go to France. If she's at Hopkins, they go to Baltimore. If that doctor's in London under NHS, they go to the UK. No one comes "to the US"; some people come to specific specialists.
Anyway, if you're an average American-- little wealth, no connections, unable to afford treatments insurance won't cover-- you're probably not going to be able to get appointments with those specialists no matter what.
The U.S. insurance-dominated healthcare system is a world-class embarrassment. It's the first sign that we're no longer a first world country.
Comparing radically different countries always yields good results, right? It's important to also note the French are bankrupt and have massive internal problems.
It's great they shifted all of their effort into health care. It will make a nice epitaph.
This very closely matches the population differences between the UK and US (at a population of 63M vs. 317M).
Within Europe, the UK represents 23% of all pharmaceutical R&D funding; France is only slightly lower at 20% of the total.
http://en.wikipedia.org/wiki/Pharmaceutical_industry_in_the_... http://en.wikipedia.org/wiki/Demographics_of_the_United_Stat... http://en.wikipedia.org/wiki/Demographics_of_the_united_king...
He witnessedthe difference in how the interns are paid, how the researcher are paid, how the labs are funded, gow modern the equipments are, and how much money the pharma corp are ready to spend todevelop new drugs. And this is a completely different world.
Now you're perfectely right and the market size is a big factor. I should have compared europe vs the US. The conclusion would have been the same.
And fixed prices is a big reason why our social security has been working in the last decades in France, and why medicaid may not work in the US.
It is an ecosystem, where everyone has to aggree on keeping the prices down.
In many cases it's not really the research that drives the cost, but rather the ability to charge the cost they do because people want to live. I understand that perspective is controversial and some will down-vote me for it. One instance was when my Dad had Metastatic Melanoma and was on DTIC therapy (Dacarbazine). It was nearly $20k per infusion. Are you kidding me, $20K/infusion!? They did 8-10 infusions. Unfathomably expensive. Oh and DTIC is one of the crappy old drugs from the 1970's. Anyone who believes that the cost to produce the drug is anywhere within several orders of a magnitude of what it costs patients is delusional.
TL;DR The FDA and their non-startup friendly political processes are suppressing new players from emerging in the medical field who could create companies with revolutionary treatments. These treatments would bring a natural balance back to medical pricing through free market principles. Instead we're stuck with the current oligopoly where there's no major inventive to create cures which would cost billions in research while simultaneously ending hundreds of billions per year in recurring revenue on current semi-effective treatments.
/rant
Anecdotally, I've been told of pharmaceuticals that only get cleared for future development because the expected U.S. pricing will make them viable.
That doesn't mean those meds are effective or even not actively harmful. People willing to pay tens of thousands of dollars to gamble on getting an extra 4 weeks of shitty quality life doesn't sound like a good way to run medication development.
(This is not a direct response to your post, but I place it here as you put a market argument upfront)
But i just wanted to provide some perspective to that generaly over optimistic OP post. The fact that cancer drugs are created in the US is not a coincidence. It's an ecosystem where there is a lot of money to be made, and as we know it in IT, money drives innovation.
The U.S. by no means has a monopoly on "cancer drugs".
But thanks, i didn't know that. Maybe the british and swiss R&D isn't in such a bad state as France.
If McDonald is too expensive for you, you can switch to Ramen.
If Insulin is too expensive for you, what do you switch to?
If Radiation therapy is too expensive, what 7do you switch to?
If Dialysis is too expensive for you, what do you switch to?
If psychiatric drugs (for bipolar disorder, or schizophrenia) are too expensive for you, you lose the ability to be part of society.
Totally unlike food, despite being non-emergency.
The moment you have patents on drugs (which you do), and a $400M cost-of-bringing-to-market independent of the resarch (which you do), it's not a free market. Totally unlike food.
French NHS works because everybody accepts to lower the rates of everything. We ( the french) live in a pseudo state-regulated health economy. When you're doing this, you're reducing the total amount of money that's flowing into that economy, which logically impacts the financing capabilities for R&D.
Other people have said the same thing : http://www.nber.org/digest/may05/w11114.html
Not to mention that France has some very edgy teams working on cancer treatments, such as for leukemia at Hopital Saint Louis in Paris or for various cancers at Hopital Paul Brousse and Institut Gustave Roussy in Villejuif (for instance they are sort of world leader on chronotherapy of cancers, team of Pr. Francis Levi)