The Real Cost Of Health Care In France
The Real Cost Of Health Care In France
Guy Sorman sets Sara Paretsky straight in a terrific piece on City Journal. Paretsky published "Le Treatment" in The New York Times about taking her husband, who was suffering chest pains, to a French hospital, and getting him diagnosed (correctly, with pneumonia) and treated, and later getting a bill for the services for $220. Cheap, huh?! Just not as cheap as it seems. Sorman writes:
Paretsky's adventure is a parable based on a false assumption: that health care can be public, reliable, and free. It may indeed seem free, or close to free, for an American tourist receiving treatment in an emergency; as a French taxpayer, however, I paid a heavy price for Paretsky's husband's treatment. And you, my American reader, did too.How much? France's costly national health insurance is mostly financed by taxes on labor. A Frenchman making a monthly salary of 3,000 euros will pay approximately 350 of them (deducted by his employer) for health insurance. Then the employer will add approximately 1,200 euros, making the total monthly cost to the employer of this individual's services not 3,000 euros but 4,200. High labor costs in France affect not only consumer prices but also unemployment rates, since employers are reluctant to pay so much for low-skill workers. Economists agree that unemployment rates and the cost of national health insurance are directly related everywhere, which partly explains why even in periods of economic growth, the average French unemployment rate hovers around 10 percent.
High as they are, taxes on wages are not enough to cover the constant deficits that national health insurance runs. France imposes an additional levy to try to close the insurance deficit--the CSG (contribution sociale généralisée)--which applies to all income, including dividends, and which Parliament increases every year. Altogether, 25 percent of French national income goes toward what's called Social Security, which includes health care and basic retirement pensions for all.
French national health insurance is also subsidized by American patients. This is because France decides which drugs to use and at what prices; American pharmaceutical companies must either accept the dictated prices or lose an enormous market. The companies therefore sell their medicines at higher prices in the U.S. in order to cover their expenses and turn a profit; the surplus is then sold cheaply to the French, who take the same pills as Americans but at half the price or less.
In the end, who paid for Paretsky's husband's nearly free ride in a French hospital? French workers and taxpayers; American patients; and the young, unqualified, and out-of-work French unable to find jobs because of the unemployment that national health insurance engenders.
Bienvenue to Obamacare! Leave your wallet and valuables at the door.
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Stumble It!
That was an excellent piece to explain the "hidden costs" of health care. And in the US, it applies to our illegals too.
I am not even going to use the caveat "I am not a racist" – it's simple, I'm not. A dollar is green and can only be spent once. If our hospitals are using the money for an illegal, and not getting reimbursed, they lose money. And what NO ONE is talking about, "for fear of offending" is how many hospitals have closed due to illegals and due to being sued.
Time to add those dimensions to the debate.
Steven
Are you for real? How much did big pharma pay you to right that article?
You don't the fact that millions of americans, go across the border to buy the same medication at cheaper prices, than what it is sold for in the States.
http://www.uow.edu.au/~bmartin/dissent/documents/...
Guest said:
How much did big pharma pay you to right that article?
Public school, eh? "Right that article"? You kos-kiddies really should pick someone other than Forrest Gump when you go trolling.
I stand corrected right!
I did not proof read what I had written, my mistake. There are a few typos that I had made.
How much did big Pharma pay you to write that article?
and
You do not mention the fact the millions of Americans travel across the borders into Mexico and Canada every year to purchase their medications at cheaper prices, than what it is sold for in the States.
It is also estimated that in the States, fraud accounts for around 10 percent of health care expenditure. So medical fraud in the states is at least a $100 billion a year industry.
Squiggy,
Health wars: six myths about the NHS debate.
http://www.spiked-online.com/index.php/site/artic...
Have a look at the two links I have posted. The first one in particular is a huge website.
In another country there was a scandal where radio announcers accept cash for comments, where they changed their position of bagging big business, to making positive comments towards the businesses that they had previously been making negative comments about.
You're just too drunk on the kool-aid, guest. Who subsidizes those "cheap Canadian drugs"? We do. Americans pay double so Canadians can pay half. "Universal health-care" in America will screw Canada (plus, they'll have no where to go to get that MRI, or surgery).
Take off, ya hoser.
Squiggy,
I see that is impossible to have a rational debate with you.
The website I posted has a lot of interesting infomation.
Mr Guest,
1) The 10% that is fraud is in MEDICARE. On average the fraud for private insurance is at .3-.7%. So, for you to say what you said is technically TRUE, but it's not the private sector that is the problem.
If you want to look up those facts, feel free – you can google it.
2) Now, WHY do Americans travel to Mexico and Canada? It was even stated in the article that other countries will not pay full prices. So, what? The Pharma companies ignore that market or they sell low there and high in the U.S. – because ultimately people will pay for the meds in the U.S.
How on Earth did you miss that?
3) "Big Pharma" huh? And what country, pray tell, with only 5% of the Earth's population produces more than 50% of all new drugs? Could it be the U.S.? And why is that? Let me simplify it for you.
(cont below)
I want to invest in a business. I see BigPharm (inc. TM) and see they produce good products, make a profit, reward investors, and have a solid company. I invest, in the hopes my investment grows. It takes that company about 1000 tries to get the right "pill" to work properly. That's a lot of man-hours, ingredients, equipment, electricity, health care etc. It has to get paid for. Then comes the FDA trials. They can cost more than 100 million dollars. And it's far from a shoe-in that the drug passes. Sometimes the company must go back to previous testing and/or start at square one.
This process takes YEARS, and costs a FORTUNE. What? You'd prefer to skip the prelims and just prescribe meds not tested? I didn't think so.
It costs HUNDREDS of MILLIONS. And, at the end they get to produce a product – the medicine. Now, you'd like them to just "cough it up" and be all altruistic. 2 Problems with that my utopian dreamer:
1) No one would invest in that company and it would go out of business
(cont below)
2) Sure, you get THAT medicine, but no R&D for the next much needed medicine is ever done. You get what we have now, maybe what's in the pipeline, and no future medicines.
The result – the US Pharma market dies, and we have to buy them from other countries that don't have a watch-dog FDA, who will gouge the prices, and may withhold those meds in some future trade/political dispute.
Not to mention that since there are fewer companies that means less competition and HIGHER prices.
Now, you were saying how Amy is shliling for big pharma … what again?
I know it's some utopian dream of "universal free" care that makes your eyes all watery, but it's not feasible. We should not punish SUCCESS. We should reward and encourage it.
Does that help?
Steven
Firstly no health care system is perfect.
Secondly there is no such thing as a free health care system.
People who live in countries that have a universal health care system contribute to the cost via taxation, or in some cases complusory insurance.
In a program on "Health care around the world", the major question asked "has health care sent anyone bankrupt in your country?"
Michael Moores "Sicko" makes for interesting viewing. Especially considering even with private health insurance there is no guarantee that you will covered for an illness, and that HMO's regularly refuse to cover an insured persons health care costs.
The plain fact is, someone has their hands in your back pocket, whether it is private insurers or the government.
Guest,
I appreciate your reasoned reply and hope this can open new ideas. My ideas are not set in stone, by any means.
My problem with Washington controlling health care are many fold – and I'll lay them out to you:
1) EVERYTHING in Washington follows politics. Everything. Should abortion be funded (IMO no), should illegals get coverage (again no), should we continue Medicare (as long as it does not leave debt for the next generation).
With the constant "need to legislate" our Congress feels – so that they are seen as "doing something" I don't want them constantly inserting new laws on health care. Look at our tax code – it's insane. It NEVER gets smaller, NO ONE (sorry for all caps – I don't know how to bold – I am not yelling at you
) understands it completely, and it's completely special interest driven.
2) Private insurance companies want to keep it simple. It's a simple economic model – either the buyer can understand it, or they can CHOOSE to vote with their wallet and go elsewhere – not so with gov't health care.
3) No gov't program (major ones) that come to mind have EVER worked within the budget they "promise" – with private companies the bottom line is just that – the bottom line. They cannot literally print new money to cover costs and if they borrow too much their share holders revolt. And please don't say voters can do that – SS, Medicare, etc have been "broken" for 20-35+ years (depending on the program) and have been a political footbal and are never fixed.
Not one to be w/out answers I suggest a couple of reforms. First scrap that monstrosity of a bill. I am quite sincere, and think it would be wildly popular if they held a "bill burning" party bar-b-que style and burned this monstrosity on the steps of Congress.
1) Allow interstate health insurance. Competition would drive costs down. Everyone agrees this would happen – though IMO Liberals don't want a market answer for ideological reasons.
2) Allow the same tax deduction that employers have for health care to be given to tax payers so that the health care is "portable" – and yes, tie that in to unemployment (for a short time – and with no exceptions) – but let the system where it is tied to jobs become the bygone relic it is.
I love the phrase tha competition will drive the costs down. Mainly because I see no evidence in the assumption that competition drives costs down.____I do not know how many private health insurers there are in the States, ___
_"The USA is the home of corporate medicine. They have had 40 years experience. Multiple strategies have repeatedly failed to control the failures and excesses of this most inefficient, expensive, inequitable and corrupt system. The reasons for failure are quite clear – competitive market forces and responsibility to the share market. Advocates claim that their countries are different. ____No one advocating the application of market forces and the introduction of market listed corporations can legitimately do so without clearly showing that their market system does not foster these forces or depend on the support of the share market OR that these forces operate differently in other countries. Commissioner Romanow invited corporate interests to meet this challenge in his recent Canadian Royal Commission into health care, and show an advantage. No one could."______http://www.uow.edu.au/~bmartin/dissent/documents/...
Originally jobs giving health care insurance came from WWII, where with wage freezes employers had to do SOMETHING to keep employees. During the war (as evidenced by "Rosie the Riveteer" there was a shortage of people to fill jobs, and employers had to offer something to get around the wage freeze.
That fact is not taught to a great many Americans and is easily remedied. Make it portable. People now would not have to worry (as much, I grant you) about losing their health care axiomatically when they lose their job.
One often unknown fact is that Brtitain's "universal health care" ALSO came out of the end of WWII. Britain's economy was in a shambles and it was SUPPOSED to be, and promised to be, a stop gap measure. But, as in the U.S., once a gov't agency opens it's doors "it's mission is never done". I mean, what agency is going to say "Ok, we don't have a use – lay us off – let those in our higher reaches who yearn for political power find private employment (hah!), we have accomplished out goal". Often the "big thinkers" (elitists) think they can manage our lives better than we can. Well, we can see how that worked out for them.
I hope I have added to the discussion.
Steven
The frontline program on health care around the world also examined, Japan, Switzerland, Germany, Tiawan.____What you wrote about Britain is correct, and there a some negative aspects to the NHS as well.____Taiwan it would seem to perhaps have the best of both worlds.____How ever it would appear that the problems caused in Britain NHS is bought about by ecomonic rationalists.
Very well said, Steven. You may have changed a few minds with this.
Unfortunately, not "guest"'s mind. He's a liberal troll. You cannot argue with a liberal. They absolutely will not ever listen to what you say. If they appear to be listening, they aren't, they're just waiting for you to shut up so they can tell you the way it really is. The reason they usually sound like children is that they usually are children (or were, really recently). They get a little college and are ready to Fix The World!! Especially when they have "professors" who have been educated into idiocy (which is the majority now).
P.S. Yes, I was showing off with the "word-bolding". Use a <,b,>, in the front, and a <,/,b,>. at the end (removing the commas, of course).
I've been told that I am ugly enough to pass for a troll.
Suidgy just please you I will now post as the troll
Not unless you can clean up your spelling and your grammar. Otherwise I'd prefer you go away.
Guest Said:
"I love the phrase tha competition will drive the costs down. Mainly because I see no evidence in the assumption that competition drives costs down."
You have got to be kidding me. Look, if you're not going to accept that "competition drives down cost" – I'm not going to debate with you. It's like arguing that:
"Water isn't wet, and you can't prove it to me."
It's non-sensical.
As to Taiwan – umm, have you checked the demographics by AGE? We are "top heavy" with seniors, they are not (as much).
But, as I said, I'll not "debate" someone who is going to just toss out Liberal talking points and who, IMO, won't accept basic well established facts, but instead just blindly "believes" what is told to him.
Wow, just freaking wow.
Steven
Squiggy said:
"Unfortunately, not "guest"'s mind. He's a liberal troll. You cannot argue with a liberal."
While that may be true sir, I can refine my argument, give other libertarians/Conservatives ammo to fight with, and practice my researching skills.
I once supported the idea of the private health insurance system, now I do not.
There was a practice and perhaps it still continues to occur, where lets say the average stay for a surgical procedure was 5 days, but if the hospital could discharge you after 3 days, the cost saving made by the hospital discharging you early, was split 50/50 between the hospital and the health insurer.
The health care market in the States is very competative and it has not driven health care costs down to the consumer.
In the shareholder market place reduced costs means greater shareholder dividends, not reduced costs to the consumer.
I just discovered this article and I have not read the book.
http://www.makingakilling.org/
Provides one of the most descriptive records of the horrors of HMO medicine during the 1990s, with numerous stories of individuals who were denied care or had to fight their HMOs for coverage of medical services. Court and Smith make a compelling case for the absurdity of a health-care system based on the concept of minimizing care to increase profits and please shareholders. They reveal how and why most HMOs have broken their early promises to control costs and reduce the number of uninsured Americans."
Curse you LSBeene,
to debate with you, means I have to do much more reading.
" American
insurance companies use multiple resources to protect their actual practices from
public scrutiny: federal protection from legal accountability for most members;
statutory peer review protections, claims of propriety and trade secrets, confidentiality
agreements and sealed court orders, contractual compliance conditions for
physicians, and legal maneuvers to prevent the release of critical documents, to name
just a few. Every claim made by the U.S. health industry as a whole, or any claim
made by a specific health insurance company should be considered carefully—little
can be verified by material open to independent, public analysis and verification."
http://www.healthcoalition.ca/linda.html
Curse you LSBeene,
to debate with you, means I have to do much more reading.
So you're arguing from an emotional point of view? First get to know a subject, then argue. But like all libs, you kneejerk before knowing what you're talking about.
I have studied this subject for more than a decade. I also work with in the health care industry. What are your qualifications Squiggy?
Secondly, the 'curse' is because I have to spend more time than I really want to spend on this subject.
Please notice I do have manners, and I have not called anyone names.
The above article is a beat up and I will demonstrate why.
Firstly, any half decent clinican can diagnose pnuemonia on signs and symptoms and with a stethoscope, without the need for x-rays and pathology.
Secondly if the pnuemonia is viral, antibiotics are useless. If it is bacterial, then a common and cheap antibiotic like Amoxil is effective.
So a break down of costs, would be something like this;
antibiotic maybe $40, generic brands are cheaper still.
CXR maybe $80
that leaves $100 for the consultation.
A very large number of drugs are no longer subject to patents, so any pharmaceutical company can manufacture these drugs.
Drug companies like Bayer, Hoffman-LaRoche and others like them are not american companies and I suspect they also have negotiate drug prices with the french government.
The population of the States is around 302 million, which is around 5 times the population of France at 65 million.
A bit of simple mathematics, is that US Drug companies would sell 5 times the volume of pharmaceuticals in the States when compared to France. Add to that the world wide market, the influence of the French subsidies become minuscule.
Secondly the cost of Pharmaceuticals only make a small proportion of the total costs for medical treatments, excluding transplants and chemotheraphy, in most cases.
Thank LSBeen for giving my neurons a work out.
Most antibiotics are becoming useless, as germs are becoming immune to them. For some things, like TB, there are only one or two effective defenses left. The cost to develop and bring to market new antibiotics is immense. American companies have been the catalysts for 80+% of all new drugs for decades (and even the companies you mention couldn't make a profit without the U.S. market), and you want to destroy their incentive.
Good luck with your generic penicillin, because with Obamacare that's the best you'll get (if you're even that lucky).
Drug company incentive, Mmmh that interesting.
Let me see, as recently as this year, Clexane which was being manufactured in China at discount labour rates, became contaminated with a compound that proved fatal to some people.
Now, notice even with a reduction in the cost of labour, did this result in a reduction in the price of this drug? The price ot the drug did not fall by even one penny.
“2) Sure, you get THAT medicine, but no R&D for the next much needed medicine is ever done. You get what we have now, maybe what's in the pipeline, and no future medicines.
The result – the US Pharma market dies, and we have to buy them from other countries that don't have a watch-dog FDA, who will gouge the prices, and may withhold those meds in some future trade/political dispute.
Not to mention that since there are fewer companies that means less competition and HIGHER prices.”
I would think that if you have higher prices, US Pharma would be making a bigger profit and therefore not die.
Interesting read.
However, I don’t fully agree that we are incurring additional costs to have drug companies make meds for foreign consumption. The companies sell the drugs abroad because they make a profit even if it’s very small. A company would simply not sell the drugs if they were just breaking even, they would be no reason. I assume that once a drug is approved, the cost to make an additional pill is minimal compared to the development costs. So if France fell of the face of the earth and used no more meds, US consumers would not see a decrease in medication costs. If anything it would be a higher cost since the development costs would be amortized over fewer pills consumed.
I guess at the extreme one could argue that the French pay no development costs and that the breakup is like this:
US consumers pay for development costs, plus production costs plus profit. French consumers pay for production costs plus profit. They obvious fix to that problem is to allow US consumers to purchase their meds in France, forcing the manufacturer to shift some of the development costs to the French. Lack of free trade is what actually cost the US consumer. Why do you think its illegal to buy meds in Canada????