Health care is becoming a big issue in the 2020 elections.
The Democrats are pushing for a government funded model,
while President Trump is campaigning on gutting Obamacare.
We repeal the core of the disastrous Obamacare.
The individual mandate is now gone.
Medicare For All has become a mantra among
left of center Democrats in the presidential race.
Health care is a human right not a privilege.
I strongly believe that we need to have Medicare for all.
I am a strong supporter of Medicare for all.
The candidates do have different interpretations of what
Medicare for All actually looks like in America.
Those differences aside, it's essentially a universal single payer system
closely modeled after Canada's health care system.
But there's another national health care system
that gets a lot of attention: France
Back in 2000, the World Health Organization ranked it as
the best national health care system in the world.
A lot has happened since then.
But France's health care system
remains a model for universal coverage.
Here's why.
Despite spending less on coverage, France has comparable
or even better health care outcomes than the United States.
The United States has a higher rate of infant mortality.
In France nearly four children die out of every 1000 live births.
In the U.S. that
number is closer to six.
France also has a higher average life expectancy
than the United States by four years.
And the rate of re-hospitalization in France is 5.3%
lower than that of the United States.
Lower rates of re-hospitalization in France are likely due
to better access to primary care as well
as longer average stays in the hospital.
Since France gives every citizen coverage from birth,
this system allows them to get more
preventative treatments throughout their lifetimes, which
save on costs and improve outcomes
After World War Two French politicians were concerned the country's
private health care system would not be able to handle coverage demands
So the country established a model of national health insurance
Meant to protect the population against increasing health care costs.
The French call their system Social Security but
it is not an example of socialized medicine.
It's not government run, just government financed.
It's very close to being a single payer health care system.
This mandatory coverage doesn't come at the expense
of freedom of choice in medical care.
The system is set up to ensure that
doctors are not restricted when making medical decisions.
The system covers every doctor every lab every hospital every clinic.
They're all covered and they all have to take the patients.
That's T.R.
Reid author of the book "The Healing of America."
He traveled the world exploring different health
care systems and how well they worked.
America is the only place where we have what the insurance companies
call narrow networks where they dictate which doctors you can go to.
No other country does that in every other country.
The patient picks the doctor and the system pays.
That's also true for our Medicare system Medicare covers all doctors.
So here's what happens in the United States.
Let's say somebody, a clerk or such at 7-Eleven or
a hotel maid has no insurance or very little insurance
and she feels a vague pain on the right side of her abdomen.
It would cost your 120 bucks to go to the doctor she's not going to do that.
She's going to work through it. And
three months later she's in the emergency room
with a burst appendix that costs $60,000.
And we'll treat here. We'll
treat her.
But if she could have gone to the doctor when she felt that first pain,
the doctor could have treated the infection.
It would have cost 100 bucks instead of $30,000.
The way we do it by definition makes things much more expensive for the U.S.
Covering everybody so that people get the care they need when
it's still early and cheap is a much smarter and
a much less expensive way to provide health care.
France's social security reimburses around 70 to 80 percent of medical costs
leaving the remaining amount for patients to pay out of pocket.
France also has voluntary supplemental health
insurance provided by private insurance companies.
In France they want you to know that you're getting something of value
from the health care system so they make you pay and then everybody in France
gets about 80 percent of it back from the insurance company.
France's social security also legally requires price transparency.
And because the government funded system covers the entire population,
it has more bargaining power to keep the prices low.
Social Security also has no waiting lists for specialized hospital treatments.
There's also no physician gatekeeping.
French patients do not need their general practitioner to
sign off so they can see a specialist.
So how does France's system stack up against America's?
The French health care system is considered one
of the most expensive in the world
and yet it's still half the cost of America's.
In 2017 U.S.
spending added up to $10,200 per capita.
In France, it was only $4,900.
Administrative costs are also much lower in France than in the United States.
In France, they're limited to 5.5
percent of the bill.
Whatever the bill is the administrative fee can't be more than 5.5
percent.
In America are private insurance companies have administrative
costs of 20 percent on every bill.
And that's so important to our insurance industry that
their lobbyists wrote that into Obamacare, that they're
allowed to add 20 percent administrative costs.
One of the ways the French keep their administrative costs lower
is with the carte vitale, a health
insurance card carried by every French citizen.
When a person visits a doctor in France, they present their carte vitale
so the doctor can look them up in the digital system.
The card gives the doctor all the information they need to charge for the visit.
French citizens can also opt to have all their medical
records stored on a card for doctors to access
and because the system is available all over
the country, it saves time and money.
Another way France manages rising health care costs
is by having the government regulate them.
Unlike the United States where legislatures are deadlocked
on what to do about health care,
the French parliament votes to set new
health care budgets and guidelines every year.
But France's health care system is not perfect.
French citizens pay significantly more income tax than Americans.
In order to cover government funded programs such as Social Security.
Many French employers say high taxes do restrict them from hiring more people.
But the United States lower tax bite is countered by the fact that
Americans end up paying more in premiums and
out-of-pocket expenses each time they require medical care.
Additionally doctors in France make less money than those in the United States.
French general practitioners make on 
average nearly $112,000 a year.
In America a general practitioner can expect to make around $218,000.
This gap in wages however does not factor in the cost of
becoming a doctor in each country.
American doctors must take on the cost of medical school
while French doctors receive that education free.
American doctors also must pay for malpractice insurance
whereas such lawsuits are not a big issue in France.
A common complaint in France is that certain areas
do not have as much access to health care as others.
However, France has more doctors per resident than the United States does.
For every 1000 residents France has 3.4
doctors whereas the United States only has 2.6.
Some French hospitals are also struggling with
the rising costs to care for patients.
So what can the United States learn from the French system?
France's social security proves it's possible to cover every citizen
without a government run system regulating
choice and how doctors practice medicine.
It also shows that universal health care
coverage can co-exist with private insurance.
Basically France has really done it right.
As the World Health Organization said very good health outcomes,
everybody's covered - all their citizens, all their elite workers, tourists.
And half our costs, so I think they're doing a lot of things right.
