Health Care Usa vs. France

There are four basic models: Beveridge, Bismarck, the National health insurance, and the out-of-pocket. The Beveridge model named after the founder of British health care system William Beveridge. According to McCanne (2010), the majority of hospitals and clinics are owned by government. In this model the government is a sole payer, which controls the costs of medical expenses. Therefore, there is the tendency for low cost per capita. The second model of health care named after a founder of European welfare Otto von Bismarck. The major principle of this system based on the insurance plans, which financed jointly by employers and employees.

Moreover, the insurance plans are non-profit and cover everyone. The government tightly regulates and controls the health system, that allows to keep low medical costs. The third model is a the National health insurance model. It uses private sector of health providers, but payments come from a government based insurance, to which every citizen must pay. The National health insurance controls and keeps low prices for medical services, and tend to be cheaper and simpler administratively. The last and most disorganized health system follows the out-of-pocket model.

The major principle of that system based on the money and basically people with money can get the medical assistance, whereas poor get sicker or die. According to the World health report (2000) released by World Health Organization, France is the country that provides the best health care. The same report states, "The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance. " The question is, why equally strong, politically and economically, countries have such significant difference of health care performance?

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Certainly, one of the major dissimilarity of the systems is the difference of health care models. The French health system rigorously follows only one, as most of European countries, the Bismarck's model. At first glance it seems to be very similar to the American; both countries widely use an insurance system, where employers and employee are both responsible for an insurance payment. However, in contrast to USA, the biggest fundamental difference between the two systems is that the Bismarck-type health insurance plans have to cover everybody, and they do not make a profit.

Opposite to France, the United States of America does not follow any of the models of health care. American health care system have elements of all of the models. When it comes to treating veterans, it becomes a government owned and controlled system, as Beveridge model. For Medicare dependant Americans and population over the age of 65, our health care system uses the model of National Health Insurance, otherwise known as universal health system, which tends to be cheaper and simpler. The health care system of a working population, who gets insurance through the employer, is more aligned with the Bismarck model.

Finally, for those fifteen percent of Americans, who do not have any health care insurance the current system becomes an Out-of-Pocket Model, which is primarily used in Third World countries. Most of health care industries in the World, in order to be efficient, try to meet only three of the models, but very important basics: costs, quality and access. All those major elements of a health care system have a complex and often challenging nature; they often interlace with each other, what leads to a conglomerate of hard solvable health care issues.

For example, the quality of care is tightly bounded to the cost of therapeutic and diagnostic procedures. Consequently, the high cost of health care puts access restrictions for certain populations. Therefore, one of the major health industry concerns is access to quality and affordable health care. The French health care system combines universal coverage with a public–private mix of hospital and ambulatory care, higher levels of resources, and a higher volume of service provision than in the United States (Rodwin, 1993) As shown in Table 1, France has a higher physicians' density per population than USA.

However, France has wide access to comprehensive health services for a population that is, on average, older than that of the United States (Rodwin, 1993). France and the United States, relies on both private insurance and government insurance. In both countries, working populations generally receive their insurance through their employer. However, French health care s based on the National Health Insurance and there is no uninsured population. French national insurance covers about 70 percent of the medical bills, the rest of the 30 percents is paid by private insurance companies, which are typically provided and paid by employer. Furthermore, contradictory to the common American opinion, that universal health care system does not allow one to choose doctors, hospitals and clinics, French people are not restricted in their choice of medical professionals and institutions, and they freely navigate themselves from doctor to doctor (Imai, Jacobzone, Lenain, 2000).

In contrast to that, certain American HMOs allow their members to visit doctors strictly in their systems. The other tremendous distinction of the French health care system is that there is no discrimination of people with preexisting conditions. Moreover, individuals with preexisting conditions have a priority and receive more coverage; patients with long-standing diseases, such as mental illness, cancer, diabetes, obtain 100 percent governmental support for all medical expenses, including surgeries, therapy and pharmaceutical agents (Imai et. al. , 2000).

At a final point, most of American's health budget oriented on the end of life diseases, which as a rule, heavily involve costly sophisticated technology and procedures, that enormously brings operating cost up. At the same time USA still neglects major successful health care steps such as disease prevention and public health education. This perhaps explains, in spite of impressive achievements in the biomedical science and technology the US do not have a better health care performance.

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