France was chosen as the country for the current analysis because its health care system as well as that of the US has many common features and its experience might be useful for coping with the same problems in the United States. Both countries can be definitely called the states with high level of well being. The health care system improves constantly, the people try to lead healthy life, for which they have numerous opportunities. Consequently, both American and French health care systems face similar problems connected with the increasing number of elderly people and constantly growing prices of the health care. The United States face the financial issues with governmental payments for medical insurance, which results in the serious budgetary problems in the certain states. France also experiences problems with governmental financing of the health care, but the state covers the major part of expenses of its citizens, which increases the burden on the country's budget and leads to the conflicts with the European Monetary Union. The French and the American health care systems are based on the same fundamental ideas. Therefore, it is crucial to analyze their strengths and weaknesses in order to decide how to improve the American health care using its European counterpart.
Health Statistics and Costs
According to the statistics, the life expectancy among men in the USA is 76 years, while in France it is 78 years. The life expectancy among women in the United States is 81 year, while in France women live 4 years longer, namely 85 years. Mortality rate in France is 120.99. The death rate in the USA is 141.23, which is 17% more than in France. The mortality rate among children is also high in the United States, which is 6.8. In France it is 3.2, which is two times less than in America.
It is possible to assume that heart diseases, obesity, cancer, and HIV/AIDS are among the most serious illnesses in the analyzed countries. People in the United States suffer from cancer 16 % rarely than in France, which is 133 as compared to 154. The number of deaths from heart diseases is 3 times higher in the USA than in France: 106.5 per 100.000 people as compared to 39.8 per 100.000 people. There are 150.000 HIV/AIDS positive patients in France. In the United States, this number is 8 times higher, namely 1.2 million. The last illness that is necessary to mention is obesity, and the United States is the first country in in the world according to the number of people who suffer from this disease. The obesity rate amounts to 30.6 % as compared to only 9.4 % in France.
The statistical data shows that generally people in France live more and lead better life than in the United States. The death rates both among adults and infants are lower, less people die from heath illnesses, and there are fewer patients who are HIV/AIDS positive. It is possible to assume that the main problem causing both high mortality rates and the serious heart diseases is obesity. The problem is not new in the United States and both the government and the health care try to solve it. However, the results are not very optimistic, and the Americans are still the heaviest nation in the world. It is possible that with the elimination of obesity problem the US health system might become more efficient.
Health Care Financing
French and American health care systems have similar sources of financing. They are both financed by state and citizens, though in France (the universal health care system) the part of the state is bigger than the one in the US (private health care system). The health care in the US and France is divided into privately and publicly financed sectors. People generally rely on their health insurances that they purchase or get as a bonus at work. The taxes the employees pay go to the public budget of the health care and are spent for the primary care needs, extra urgent cases, and social programs. The US government has publicly financed health care insurances such as Medicaid. The states receive money for these programs from the federal budget under the Affordable Care Act.
Publicly financed health care exists also in France and it supposes that the state covers medical expenses of people. It is financed mainly by the payroll taxes paid by the organizations and employers, the taxes on alcohol and tobacco, and the subsidies from state. People also buy health insurances, and it is related to the privately financed sector of the French health care. The basic health insurance is called VHI. People usually buy complementary insurance SHI that provides more dental and eye care.
Health Care Administration
In the United States, the heath care services are regulated mainly by the federal government and the Department of Health and Human Services in particular. It is divided into 5 smaller state organizations. The National Institute of Health is responsible for the general research in the sphere of health care. The Agency for Health Care Research and Quality tries to investigate the ways of improving the safety and quality of the American health care. The Health Resources and Services Administration is responsible for the provision of medical services to the vulnerable part of population, isolated or uninsured people. The last state division is the Food and Drug Administration that controls the quality of vaccines, drugs, and food.
The main government agency that regulates the health care in France is the Ministry of Health. It creates the current policy concerning the health care issues and implements them in practice. The trends in the medical sphere in France are determined by the Public Health Act. The Ministry of Health also controls the expenditures on the public health care, the prices on drugs, and payments to the doctors. Another state agency is the French Health Products Safety Agency that is responsible for all the questions concerning health production, their quality, price, and marketing. Another governmental organization called the National Agency to Support the Performance of Health and Social Care is responsible for advising and helping the hospitals. They provide them with medical equipment, money, reorganization plans in order to avoid injustice in the health care procedures towards the vulnerable French population such as the poor, the elderly, the disabled, or children.
Health Care Personnel and Facilities
According to the statistics, there are 2.3 physicians and 9.81 midwives and nurses in the US per 1,000 people. Moreover, 70 % of hospitals are nonprofit, 15 % are public and 15 % are for-profit. The medical establishments receive payments from different sources. They include bundled payments, per-case payments, per-diem, or per-service payments. Some doctors are employed by the hospitals and, consequently, receive their salary monthly. However, the majority of the physicians are payed for the particular services. Their work is not included in the Medicare insurance and diagnosis-related group of payments. For this reason the position of the hospitalist gains popularity in the US hospitals.
The number of nurses and midwives in France is 6 % lower than that in the United States, which is 9.3 per 1.000 patients. However, the number of physicians is 47 % more, which is 3,37 per 1.000 people. Public hospitals constitute nearly 67 % of the entire capacity of the French medical care. They are responsible for 42 % of all outpatient cases and 65 % of inpatient episodes. Private for-profit hospitals have a narrow specialization, for example coronarography or endoscopy. They account for 50 % of outpatient and 27 % of inpatient cases. The rest of the cases are under the responsibility of the private non-for-profit health care organizations. They also deal with the treatment of cancer.
Access and Inequality Issues
Despite the high level of medical care and the average well being of both American and French citizens, there are still many problems in the social sphere. Many people do not have access to the professional medical help and often face inequality issues. As it was mentioned above, only those who have purchased insurance have access to the medical care. However, in case of France, a person needs to have a complementary insurance if he has problems with eyes or teeth. However, in the United States, the consultations of the physicians are not included into the Medicare insurance. Consequently, those people who do not have enough money to buy complementary insurances in both countries face medicine accessibility problems. However, the percentage of those who cannot afford buying the basic insurance is rather high in both countries. In this case, the uninsured people can count only on urgent medical help that is free for all people or governmentally sponsored insurances such as Medicaid. The attempts to reduce the level of social inequality became the major issue both in the French and the US policy in 2014.
There are many common issues in the health care systems of France and the US. Administration, financing, and social problems are similar. Both countries try to decrease the inequalities in their societies and make their nations healthier. Despite evident similarities, the statistical data concerning health in France is better than the one in the US. Therefore, it is possible to assume that the reason is not the health care system, but the life style of people.