Thoughts on French health from a British businessman in France
Elliot Bidgood, 20 March 2013
Civitas has published a comment piece on French healthcare written by Ed Hoskins, a British business leader who now lives in France and at one point worked in the UK NHS. It gives an insight into some of the differences between the French system and ours, and in particular how their system marries social solidarity (specific subsidies and reimbursements guarantee healthcare to the disadvantaged) with a mixed provision approach and efficient, high-quality patient-led care. Mutual insurers, operating as payroll tax-funded primary insurers within the state health system, manage the care of their members and contract with hospitals to purchase care on their behalf. 92% of the French population also then carry supplementary insurance to cover the remaining costs the main system doesn’t meet, while the CMU (Couverture Maladie Universelle, universal health care coverage) programme covers these costs for the poorest and most vulnerable.
France was the top-ranked country in the World Health Organisation (WHO) 2000 ranking of national health systems, while the UK was 18th. Granted, that survey was criticised in other aspects (Germany, usually considered another high-quality health nation along the same lines as France, wound up in 25th place, behind Colombia), but more recent data continues to show that French health outcomes are strong. France was best ranked for mortality amenable to healthcare in a Commonwealth Fund study of data from 2006-2007 – Britain placed fifteenth out of sixteen nations, beating only the US. Two other rankings also placed France in first or second for this category. According to OECD figures, France has more doctors per 1,000 and slightly more CT and MRI scanners per million than the UK. Waiting times for elective surgery are shorter, though they are slightly longer for specialists. France also has a strong system of primary and preventative care and its Carte Vitale system of personal electronic health cards is state-of-the-art, enabling payments and keeping detailed health records easily available when they are needed. French health spending is slightly higher, 11.6% of GDP compared to our 9.6%, though spending alone is not always correlated with quality (Canada spends 11.4% of its GDP on health, but doesn’t quite achieve France’s outcomes), and so the systemic differences the business leader observes in his piece remain important. Ed Hoskins’ piece therefore shows that there are those who live on the other side that can attest that the grass may indeed be greener in many respects and that there are fundamental lessons we can learn.
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