Went and seen SICKO last night

[BearDown]

I saw a lot of pros and a few cons in this movie.

Moore does support my candidate's health care plan which calls for Universal Health Care for all, and here is the key phrase. Not for-profit!!!

The plan covers all healthcare needs, including dental care, mental health care, vision care, ************ drugs, and long-term care - at NO extra cost! It's a bit long, but I hope you take the time to read it.

Kucinich's plan, HR 676, is supported by 78 Members of Congress , more than 260 Union Locals , and 14,000 physicians and is endorsed by the New Hampshire House of Representatives.

"Health care is an essential safeguard of human life and dignity and there is an obligation for society to ensure that every person be able to realize this right."
Cardinal Joseph Bernardin, Chicago Archdiocese

Our health care system is broken, and H.R. 676, the Conyers-Kucinich bill, is the only comprehensive solution to the problem. It is also the system endorsed by more than 14,000 physicians from Physicians for a National Health Program. Nearly 46 million Americans have no health care and over 40 million more have only minimal coverage. In 2005 some 41% of moderate and middle income Americans went without health care for part of the year. Even more shocking is that 53% of those earning less than $20,000 went without insurance for all of 2005. In fact, the National Academy of Science's Institute of Medicine estimates that 18,000 Americans die each year because they have no health insurance.

The American health system is quite sick. Pulitzer Prize journalists Donald Barlett and James Steele, in their stunning analysis of the health care industry, Critical Condition (2006 Broadway Books), insist that "... U.S. health care is second-rate at the start of the twenty-first century and destined to get a lot worse and much more expensive." Consider the following facts from Tom Daschle's article for the Center for American Progress: "Paying More but Getting Less: Myths and the Global Case for U.S. Health Reform":

Americans are The Healthiest People in the World.
FACT: Citizens of 34 nations live longer than Americans.

The U.S. is the Best Place to Get Sick.
FACT: The World Health Organization ranked the U.S. 37th in the world for health system performance. Countries like Australia and the United Kingdom rank above the U.S. Americans have lower odds of surviving colorectal cancer and childhood leukemia than Canadians who do have national health care. Americans also experience greater problems in coordination of care than the previously mentioned countries and New Zealand.

Covering All Americans Will Lead to Rationing.
FACT: Same-day access to primary-care physicians in the U.S. (33%) is far less available than in the United Kingdom (41%), Australia (54%) and New Zealand (60%). Per capita spending for health care averaged $2,696 in countries without waiting lists and $5,267 in the U.S.

Global Competitiveness is Hampered in Comprehensive System.
FACT: "Health care costs are not just a burden and barrier to care for individuals; they are taking a heavy toll on American businesses." The strain on employers in 2005 was staggering. "The average total premiums for an employer-based family plan was $9,979 in 2005 ..." Most of our competitors in the world markets finance their systems outside corporate taxes and employer mandates. Without Medicare for Everyone, the U.S. will continue to hemorrhage jobs.

We Cannot Afford to Cover All Americans.
FACT: We already spend enough to have universal health care. "The truth is, we cannot afford to not reform the health system." We spend about 50% more than the next most expensive nation and nearly twice per person what the Canadians do. On May 1, 2006 Paul Krugman explained in Death by Insurance how incredibly wasteful the current system is. The doctor he referenced has two full-time staff members for billing, and two secretaries spend half their time collecting insurance information on the 301 different private plans they deal with. This type of waste is easily 20%. Also consider that 98% of Medicare funds are spent on medical care.
IMPORTANT: The hackneyed -- and inaccurate -- mantra of Republicans when universal health care is introduced is to blame trial lawyers and malpractice cases for our lack of national health care. In fact, 0.46% of our total health spending is spent on awards, legal costs, and underwriting costs -- about the same as Canada and the United Kingdom and about the same amount we spend on dog and cat food each year. While "defensive medicine" may drive up the price, it hardly accounts for our stunning health care costs. The belief that citizens should give up their right to fair legal redress for legally proven medical mistakes in exchange for lower health care costs rings as true as the promise that if we must give up our civil rights to be safe from terrorists.

Even those with coverage too often pay exorbitant rates. The current profit-driven system, dominated by private insurance firms and their bureaucracies, has failed.

We must establish streamlined national health insurance, "Enhanced Medicare for Everyone." It would be publicly financed health care, privately delivered, and will put patients and doctors back in control of the system. Coverage will be more complete than private insurance plans; encourage prevention; and include ************ drugs, dental care, mental health care, and alternative and complementary medicine.

Perhaps the clearest and most eloquent explanation of the Conyers-Kucinich National Health Insurance Bill was given on February 4, 2003, in Washington, D.C., by Dr. Marcia Angell in introducing H.R. 676. Backed by over 14,000 doctors, this is the future of American medicine.

"We are here today to introduce a national health insurance program. Such a program is no longer optional; it's necessary.

"Americans have the most expensive health care system in the world. We spend about twice as much per person as other developed nations, and that gap is growing. That's not because we are sicker or more demanding (Canadians, for example, see their doctors more often and spend more time in the hospital). And it's not because we get better results. By the usual measures of health (life expectancy, infant mortality, immunization rates), we do worse than most other developed countries. Furthermore, we are the only developed nation that does not provide comprehensive health care to all its citizens. Some 42 million Americans are uninsured (nearly 46 million today -- updated figure) -- disproportionately the sick, the poor, and minorities -- and most of the rest of us are underinsured. In sum, our health care system is outrageously expensive, yet inadequate. Why? The only plausible explanation is that there's something about our system -- about the way we finance and deliver health care -- that's enormously inefficient. The failures of the system were partly masked during the economic boom of the 1990s, but now they stand starkly exposed. There is no question that with the deepening recession and rising unemployment, in the words of John Breaux, "The system is collapsing around us."

"The underlying problem is that we treat health care like a market commodity instead of a social service. Health care is targeted not to medical need, but to the ability to pay. Markets are good for many things, but they are not a good way to distribute health care. To understand what's happening, let's look at how the health care market works ... "

"Mainstream" writers like Ph. D. economist and columnist for the New York Times Paul Krugman now agree with those doctors and Dennis that "covering everyone under Medicare would actually be significantly cheaper than our current system." They all recognize that we already spend enough to provide national health care to all but lack the political courage to make the tough decision that doctors, nurses, and medical professionals must run our health care system -- not "for-profit" insurance companies, who make money by denying health care.

It is time to recognize that all the civilized countries have a solution that we must adapt to this country. American businesses can no longer be competitive shouldering the entire cost of health care. Health care is a right that all Americans deserve.

To all of you on the right. Other than the thought of your taxes going up. Which Kucinich say's it's not going to cost anymore than it already does now. If this is true, what's wrong with a Universal Health Care "not for profit" system?

[ULikeApples]

I don't mean to be blunt, but if people want to give up an even higher percentage of their salaries and have to deal with the government for health care, go to Canada or the countries in Europe that have that. We definitely don't need that here. I don't think anyone can point to any place in the Constitution that says the government should provide it's citizens with health care. Obviously life has changed and the Constitution has been amended since it was written, but this would be so drastically against what the federal government is there for that it would be socialistic.

[ULikeApples]

To add to my last post: I do support tax breaks deigned to offset the cost of insurance for people that can't get it through their jobs. They already have programs for the "poor."

The government shouldn't jsut hand anything to people, but a tax break for someone to take advantage of, if they show some initiatives themselves, that makes sense to me.

[buddyluv1968]

I agree with you on some things that you wrote about. But the government should take better care of it's citizens. A little boy died a couple of months back due to an infection that spread to his brain that started from a tooth infection. The mother did not have the $50.00 for the dentist. It ended up costing the state $250k once the infection spread. Now I do not know with whom to blame the mother or the system. I love kids but we need to use constraint in having them. If you cannot afford kids dont have them!!!! I am self employed and I pay close to $500/month for my insurance. I have been blessed to have a successful business but if I had employees I could not afford to pay their insursance. That is the little secret the Bush admin does not tell you. When they tout small business. Now I would not mind paying a little more in taxes to help someone out. But the government need to stop wasting money and start being smarter with spending our tax $.. Stop taking bribes I mean lobbyist money and fix our shit like social socurity, our highways, bridges, and health care...

[husker]

the biggest problem with health care is LAWYERS! they drive costs up here more than any where else, and John Edwards is one of the worst!

[jordanrules23]

the biggest problem is that ppl would actually go see a Michael Moore film.....Go see the Simpsons theres more truth in that movie!@!!!!!!

[BearDown]

This is a E-mail I got.

As a reminder, my (then 4 years old) son was diagnosed 2 and a half years ago with a brain tumor. He underwent surgery, then chemotherapy for a year and a half. Early last year, he appeared to have been cured, but the tumor reappeared last autumn, and he underwent radiotherapy this winter. Next week we'll know how that is working.


In the meantime, as a consequence of surgery, he is handicapped and only very partial use of one arm.

He was first diagnosed by our pediatrician, a private sector doctor, who sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know.

He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.

Surgery - an act that the doctor that performed it (one of the world's top specialists in his field) told us he would not have done it five years before - actually took place the next week, because emergency cases came up in the meantime.


After a few days at the hospital, we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.


Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.


Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, phychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.

My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) - and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).


During the chemotherapy, if he had any side effects (his immune system being weakened, any normal children's disease basically required him to be hospitalised to be given full anti-biotic treatment), we'd call up the hospital and just come around. Either of us could spend the night with him as needed.


We never spent a dime.


After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size). Of course, they manufacture braces and other specialised equipment for him and provide it free of charge to us.


Check up exams take place every 3 months, with all the appropriate exams (usually including a MRI), and we've never had to wait for the appointments.


Again, no cost for us, no funds to be fronted.


When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that's where the best hope was, the costs of that would have been covered too by French social security.


Now that our son is in first grade, he has the right to special help for handicapped children at school (a fairly recent law), and he now benefits from part time help - a person who is around about 20 hours per week to help him do his work and catch up when he is absent for his therapy. This is paid by the city of Paris and the ministry of education.


Oh, and as he is officially handicapped, I recently discovered that we actually benefit from an additional tax break (in France, the taxes you pay are roughly divided by the number of people in the family; the handicap counts as an additional person for that purpose).


So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.


An interesting twist to that story is that we do have private healthcare insurance in France. Basic healthcare is covered by social security, but only partly: except for the poor (under a certain income level), there are co-payments for most expenses like medecine and doctor visits, and doctors are also allowed to charge you more than the official tariff (and you have to pay the difference, in addition to the co-payment on the official price). Thus many people buy private (or mutual) insurance to cover that difference partly or fully. Such insurance is often provided by your employer. But whenever you have "major" expenses, you switch to 100% coverage of expenses by the public system - except that, if you had a private insurer, it has to pay to the public entity a portion of the costs. In my case, as I had a good insurance via my bank, this is what's happening, and thus the private sector bears a portion of "catastrophic risk." (And they have no say in what care is provided. They just pay an agreed fraction of it.)


Thus there is solidarity across the system.


This is not to say that all is well in French healthcare. As in other countries, costs are barely under control, spending increases every year, and there are many ways the system could be improved for doctors, nurses and patients. But the fact remains that if you are badly ill, you will be taken care of; you will not need to give up your job (or if you do, you're helped); you will not need to sell your house; and you will not be denied healthcare (see my second comment below).


It's been tough enough to deal with a sick child; I simply do not want to imagine what it would have been like if I had to beg for care or to scurry around for money in addition.


It's just inconceivable. And thus, I was happy to pay taxes before, and I'm really, really happy to pay taxes now to provide that level of care for those who really need it.

[BearDown]

I don't think anyone can point to any place in the Constitution that says the government should provide it's citizens with health care.

I don't think it say's anything about Schools, Fire, and police departments either, but we have them. And what my candidate is saying that's it's going to cost about what you are paying now.

[BackDoorCvr]

This is a E-mail I got.

As a reminder, my (then 4 years old) son was diagnosed 2 and a half years ago with a brain tumor. He underwent surgery, then chemotherapy for a year and a half. Early last year, he appeared to have been cured, but the tumor reappeared last autumn, and he underwent radiotherapy this winter. Next week we'll know how that is working.


In the meantime, as a consequence of surgery, he is handicapped and only very partial use of one arm.

He was first diagnosed by our pediatrician, a private sector doctor, who sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know.

He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.

Surgery - an act that the doctor that performed it (one of the world's top specialists in his field) told us he would not have done it five years before - actually took place the next week, because emergency cases came up in the meantime.


After a few days at the hospital, we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.


Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.


Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, phychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.

My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) - and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).


During the chemotherapy, if he had any side effects (his immune system being weakened, any normal children's disease basically required him to be hospitalised to be given full anti-biotic treatment), we'd call up the hospital and just come around. Either of us could spend the night with him as needed.


We never spent a dime.


After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size). Of course, they manufacture braces and other specialised equipment for him and provide it free of charge to us.


Check up exams take place every 3 months, with all the appropriate exams (usually including a MRI), and we've never had to wait for the appointments.


Again, no cost for us, no funds to be fronted.


When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that's where the best hope was, the costs of that would have been covered too by French social security.


Now that our son is in first grade, he has the right to special help for handicapped children at school (a fairly recent law), and he now benefits from part time help - a person who is around about 20 hours per week to help him do his work and catch up when he is absent for his therapy. This is paid by the city of Paris and the ministry of education.


Oh, and as he is officially handicapped, I recently discovered that we actually benefit from an additional tax break (in France, the taxes you pay are roughly divided by the number of people in the family; the handicap counts as an additional person for that purpose).


So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.


An interesting twist to that story is that we do have private healthcare insurance in France. Basic healthcare is covered by social security, but only partly: except for the poor (under a certain income level), there are co-payments for most expenses like medecine and doctor visits, and doctors are also allowed to charge you more than the official tariff (and you have to pay the difference, in addition to the co-payment on the official price). Thus many people buy private (or mutual) insurance to cover that difference partly or fully. Such insurance is often provided by your employer. But whenever you have "major" expenses, you switch to 100% coverage of expenses by the public system - except that, if you had a private insurer, it has to pay to the public entity a portion of the costs. In my case, as I had a good insurance via my bank, this is what's happening, and thus the private sector bears a portion of "catastrophic risk." (And they have no say in what care is provided. They just pay an agreed fraction of it.)


Thus there is solidarity across the system.


This is not to say that all is well in French healthcare. As in other countries, costs are barely under control, spending increases every year, and there are many ways the system could be improved for doctors, nurses and patients. But the fact remains that if you are badly ill, you will be taken care of; you will not need to give up your job (or if you do, you're helped); you will not need to sell your house; and you will not be denied healthcare (see my second comment below).


It's been tough enough to deal with a sick child; I simply do not want to imagine what it would have been like if I had to beg for care or to scurry around for money in addition.


It's just inconceivable. And thus, I was happy to pay taxes before, and I'm really, really happy to pay taxes now to provide that level of care for those who really need it.

The French have to present a green carte d'assurance maladie (health insurance card) to show that they are covered. Whoever penned that highly dubious e-mail above kept referencing "social security number". Anyone who had really dealt with French socialized health care system wouldn't make that mistake.

[husker]

The French have to present a green carte d'assurance maladie (health insurance card) to show that they are covered. Whoever penned that highly dubious e-mail above kept referencing "social security number". Anyone who had really dealt with French socialized health care system wouldn't make that mistake.

just more proof of the BS that the left wing radicals are pushing. they all just eat it up. I'm glad I'm not on those email lists.

[BearDown]

The French have to present a green carte d'assurance maladie (health insurance card) to show that they are covered. Whoever penned that highly dubious e-mail above kept referencing "social security number". Anyone who had really dealt with French socialized health care system wouldn't make that mistake.

Well, maybe social security number also means carte d'assurance maladie? I see social security mentioned a few times here in this article. Nothing about carte d'assurance maladie. And this will be America's version of health care and it will be better. Like it or not it's coming.

To best understand how the French health care system works, I think it is best to begin with a look at the French health insurance system.

First of all, all legal residents of France are covered by public health insurance, which is one of the social security system's entitlement programs. The public health insurance program was set up in 1945 and coverage was gradually expanded over the years to all legal residents: indeed, until January 2000, a small part of the population was still denied access to the public health insurance.

The funding and benefits of the French public health insurance system (PHIS), much like Germany's, were originally based on professional activity. The main fund covers 80% of the population. Two other funds cover the self-employed and agricultural workers.

Once varying depending on the fund, disparate reimbursement rates were replaced by uniform rates. The funds are financed by employer and employee contributions, as well as personal income taxes. The latter's share of the financing has been ever-increasing in order to:

? compensate for the relative decrease of wage income,

? limit price distortions on the labor market,

? and more fairly distribute the system's financing among citizens.

Most health insurance funds are private entities which are jointly managed by employers' federations and union federations, under the State's supervision. The joint labor/management handling has always sown discord within the funds' boards, as well as between the boards and the State.

As a consequence, the responsibilities of the various actors in the system are not always shared in the most coherent manner.

For example, the parliament's budget provisions determine how much public money will go to health expenditure, the cabinet decides reimbursement rates and sets the amount of contributions earmarked for the funds, while the funds themselves negotiate with health care professions to set tariffs designed to ensure the system operates at the breakeven point. Responsibilities are frequently redefined, but never to satisfaction of all involved.

1 Permanent Working Group of European Junior Doctors, October 2001.

2 1 rue Paul C麡nne 75008 Paris France. [email protected], www..fr, Tel: 33(0)153934318.

The views expressed here are those of the author, and they do not necessarily reflect the views of the IRDES.

Agn賠Couffinhal - IRDES October 2001 2

The public health insurance system covers about 75% of total health expenditures. Half of the outstanding amount is covered by patients' out-of-pocket payments and the other half is paid by private health insurance companies. These supplementary health insurance policies can be taken out by individuals or groups.

About 85% of the population own such policies.

An important peculiarity of the French PHIS is that the funds cover a very wide range of goods and services, including for example, stays in thermal spas.

In the hope of curbing consumption and expenditures, copayments were implemented and have increased over time. These copayments are relatively high for many out-patient services.

For example, patients must pay 30% of Social security's tariff for a physician's visit, moreover, roughly 40% of specialists and 15% of GPs are allowed to charge more than the tariff. Copayments are also high for dental prostheses and eye-ware. This tended to deter the poorest citizens (few of whom had supplementary insurance) from seeking care. Concerns grew over the system's inequity.

In January 2000, a means-tested, public supplementary insurance program called CMU (Couverture maladie universelle) was implemented to ensure the poor access to health care.

For those whose income is below a certain threshold (about 10% of the population is eligible), this insurance covers all public copayments and offers lumps-sum reimbursements for glasses and dental prostheses. Health professionals are not allowed to charge more than the public tariff or the lump-sum for CMU beneficiaries, which means that in theory, access to care is free of charge.

In passing, I'd like to mention that many experts advocate a change in the way health insurance covers care. They think it would be more efficient and equitable to clearly define a set of indispensable goods and services which should be available to everyone and which should be 100% publicly financed. The remaining goods and services would be available to those who desire and can afford them, with or without relying on private insurance.

To close this aside on access to care, I'd like to add that, as far as I know, France is the only country in which access to care is unlimited: patients can see as many physicians as often as they like. Patients do not need referrals to see specialists, and in general, there is no gatekeeping system of any kind. This may partially account for the World Health Organization's high ranking of France's health care system last year: the rating system emphasized the system's responsiveness (a measure of patients' freedom and flexibility), a quality the French system provides, undeniably at the expense of overall efficiency.

Agn賠Couffinhal - IRDES October 2001 3

-- THE STATE'S ROLE --

1. The State decides on what care is to be reimbursed and to what extent, defines the responsibilities of the various actors, and ensures that the entire population has access to care.

2. The State defends patients' rights, drafting and enforcing relevant policy. The State is thus responsible for safety within the health system. The disaster and subsequent cover-up of the contamination of the nation's hemoglobin supply with HIV-tainted blood resulted in the revamping of public health policy. New agencies were created to oversee safety measures concerning the nation's blood supply, organ donor programs, food, and medical goods and services. The recent handling of the mad cow crisis indicates that these changes have improved public safety.

3. The State is also in charge of planning. Health authorities decide on the size and number of hospitals, as well as the amount and allocation of highly technical equipment (MRI, CTscans...). It organizes the supply of specialized wards (transplants, neurosurgery...) and ensures the provision of care at all times, like emergency rooms.

Since 1991, some of the planning has taken place at the regional level. Indeed, more and more policy-making and negotiation are undertaken at the regional level, and this tendency is likely to continue in the coming years.

-- THE CARE SUPPLY HOSPITALS --

In France, hospitals have always been the core of the health care system. This probably accounts for the extremely specialized, technical, curative nature of our care, arguably to the detriment of prevention and community services.

The number of hospital beds has decreased over time: it currently stands at 8.4 per 1,000 inhabitants, which is close to the European average. Hospitals can be roughly divided into two categories: public, and private for-profit.

? The public sector represents about 65% of the beds. Public hospitals have specific obligations such as ensuring the continuity of care, teaching, and training. They receive a budget which is largely based on a historical basis.

? Private for-profit hospitals concentrate on surgical procedures and rely mostly on fee-forservice remuneration for their funding.

A uniform hospital information system has been implemented to monitor the various establishments activity. Gradually, all public and private establishments are to switch to DRG payment systems.

Agn賠Couffinhal - IRDES October 2001 4

-- HEALTH PROFESSIONALS --

Of the many types of health professionals, I would like to focus on physicians, as they play a key political role in the system. There are currently about 200,800 physicians licensed to practice in France. In the last thirty years the number of physicians has tripled, but the rate of increase is now very slight. Indeed, since 1971, the Ministry of Health has limited the number of medical students, a measure which, along with the retirement of currently active doctors, will result in a decrease in the number of physicians in the near future.

Half of the physicians are specialists.

In France, physicians (and other professionals) generally work in two kinds of environments: public hospitals and private practices. 25% of physicians work in public hospitals (another 11% work in other types of public establishments). They are in essence public servants and paid an amount that is fixed by the government. Today, many physicians feel that the prestige of working in a hospital does not compensate for the trying working conditions. 56% of physicians work in private practices3, and are paid on a fee-for-service basis.

The relative weight of the procedures is set by experts and the prices are negotiated by physicians' unions and public health insurance funds4.

Since the creation of Social Security, the relationship between private practice physicians and the State and public insurance funds has always been strained. A contract (convention) which sets the general regulatory framework and the remuneration of the profession is supposed to be signed every 5 years by physicians unions. The first one was signed in 1971, 26 years after public health insurance was created. Subsequent conventions allowed some physicians to charge more than social security tariffs (1980), limited this right (1990) and implemented official medical practice guidelines (RMO, R馩rences m餩cales opposables) in 1993.

The current situation is particularly strained: negotiations between doctors' unions and the funds have stalled, leaving the specialists without a convention and isolating the GP union which signed a convention in 1998. The root of the problem is that private practice physicians are strongly opposed to the setting caps on outpatient expenditures. They have always had a great deal of freedom over where they set up shop, how they practice, and what they prescribe (compared to their counterparts in other countries). Yet the bulk of their income is paid by public funds. This contradiction has become more glaring as the concerns about soaring health expenditures grew.

[BearDown]

the biggest problem with health care is LAWYERS!

Talk about eating it up (George Bush's "it's the lawyers"). It's not just the Lawyers. You don't want to add the insurance companies in there as well? If you ask me they are the biggest problem with the health care system.

[ULikeApples]

Regardless of how great the health care is in France, 100% government provided health care for all citizens is SOCIALISM, period. If people want everything to be provided to them, go to one of the dozens of communistic countries around the world. Oh wait, there's only a handful left....b/c it doesn't work.

My wife just had knee surgery. My health insurance, paid for by myself and my work, covered alot of it. I don't mind paying an extra $1500 ish when I use it. What I do mind is paying more taxes into a system to pay for everyone else's healthcare. It's already bad enough to have Medicare and Medicaid, but extrapolating that out to 300 Million + Americans would be awful. Everything throwing their money into one big pot for the government to control and then doling it out as needed, regardless of the amount you put in, is anti-American and NOT good for the country.

[husker]

Talk about eating it up (George Bush's "it's the lawyers"). It's not just the Lawyers. You don't want to add the insurance companies in there as well? If you ask me they are the biggest problem with the health care system.

drug Co's are screwing the American people also. drugs shouldn't be cheaper in other countries than here. control lawyers and drug Co's, and you will get health care costs WAY down.

[BackDoorCvr]

Regardless of how great the health care is in France, 100% government provided health care for all citizens is SOCIALISM, period. If people want everything to be provided to them, go to one of the dozens of communistic countries around the world. Oh wait, there's only a handful left....b/c it doesn't work.

My wife just had knee surgery. My health insurance, paid for by myself and my work, covered alot of it. I don't mind paying an extra $1500 ish when I use it. What I do mind is paying more taxes into a system to pay for everyone else's healthcare. It's already bad enough to have Medicare and Medicaid, but extrapolating that out to 300 Million + Americans would be awful. Everything throwing their money into one big pot for the government to control and then doling it out as needed, regardless of the amount you put in, is anti-American and NOT good for the country.

Right. France has endured years of high unemployment, high inflation and zero economic growth. Their 35 hour workweeks and social welfare programs everyone has grown so used to has killed their economy. But hey, they may have no job but at least they could get their gall baldder taken out for free. Businesses and individuals alike are taxed to their gills and Bear, if you actually believe a majority in the house, 60 senators and a President will agree on the details of a government takeover of our healthcare system (and all the taxes/and or spending cuts to go along with it) I have some oceanfront property in AZ to sell you.