American Health Care & French Health Care: Twins?

Sindri

This is an interesting article given all the discussion about Health Care in the U.S. last year.

http://www.theatlantic.com/business/archive/2012/03/france-and-us-health-care-twins-separated-at-birth/254033/

France has been called the best healthcare system in the world by the World Health Organization. And if there's something everyone in the US seems to agree on, it's that US healthcare, well, horribly sucks, although they strongly disagree about why and what to do about it.

And yet, to me, the similarities are glaring:

Here's a link to information on the author.

Read into it whatever you will......

InTheTrees

Very interesting.

The american right wing seems politically determined to retain a system that all services are based on cash. If you cant pay then maybe you're not really worth it anyway.

They are steadfastly opposed to any kind of requirement for individuals to buy insurance, which I think is a cornerstone of the french system.

SO without their cooperation I dont see how any kind of solution is going to be found, unless the continuing deterioration eventually produces an outrage that prompts people to see sense.

matthew8

InTheTrees wrote: »

Very interesting.

The american right wing seems politically determined to retain a system that all services are based on cash. If you cant pay then maybe you're not really worth it anyway.

They are steadfastly opposed to any kind of requirement for individuals to buy insurance, which I think is a cornerstone of the french system.

SO without their cooperation I dont see how any kind of solution is going to be found, unless the continuing deterioration eventually produces an outrage that prompts people to see sense.

Wait a second, surely having to buy insurance is also based on cash?

InTheTrees

matthew8 wrote: »

Wait a second, surely having to buy insurance is also based on cash?

Their objection to a requirement to buy insurance is that the government shouldn't be forcing people to buy anything.

Something like that.

InTheTrees

This is amusing. The (republican) US supreme court is set to hear the republican challenge to Obamas healthcare bill in the next few weeks and it turns out one of the challengers Mary Brown has gone bankrupt (when you declare bankrupcy in the usa your debts are forgiven.):

"As someone who chose not to purchase health insurance —and felt strongly that the federal government had no business telling her that she had to buy it whether she liked it or not—Mary had become an active and outspoken critic of the law. As a result, she was the perfect candidate to be a human face on the challenge to Obamacare."

http://www.forbes.com/sites/rickungar/2012/03/10/plaintiff-in-landmark-anti-obamacare-lawsuit-bankrupted-by-medical-bills-you-and-i-pick-up-her-tab/

matthew8

InTheTrees wrote: »

Their objection to a requirement to buy insurance is that the government shouldn't be forcing people to buy anything.

Something like that.

Why can't you get that having to pay for healthcare is just as bad as being forced to?

InTheTrees

matthew8 wrote: »

Why can't you get that having to pay for healthcare is just as bad as being forced to?

Right. I absolutely dont get the difference between being forced to and having to.

Maybe you could explain the difference?

matthew8

InTheTrees wrote: »

Right. I absolutely dont get the difference between being forced to and having to.

Maybe you could explain the difference?

The difference is that in one case you get locked up because you don't pay for insurance (or a fine) and in the other case you simply don't get healthcare. Now can you tell me why it is so much better that you're forced to buy insurance as opposed to buying health insurance if you want to or instead paying for the operation?

sarumite

InTheTrees wrote: »

Their objection to a requirement to buy insurance is that the government shouldn't be forcing people to buy anything.

Something like that.

Actually their objections are that it is unconstitutional and therefore illegal for the government to force people to buy anything. Currently there has been a mixed response from the judiciary, with some ruling it is unconstitutional and others saying it is permissible under the commerce clause.

InTheTrees

sarumite wrote: »

Actually their objections are that it is unconstitutional and therefore illegal for the government to force people to buy anything. Currently there has been a mixed response from the judiciary, with some ruling it is unconstitutional and others saying it is permissible under the commerce clause.

Which is why the Supremes are going to hear the case in the next few weeks.

It'll be interesting to see how they decide but given that they're weighted to the right, they'll probably go with the republicans.

Although every state I've ever lived in has required me to buy auto insurance so if its not unconstitutional on a state level it'll be interesting to see how it translates to federal law.

InTheTrees

matthew8 wrote: »

Now can you tell me why it is so much better that you're forced to buy insurance as opposed to buying health insurance if you want to or instead paying for the operation?

Check the link I posted in #5

Who pays for the people who "decide" not to buy insurance?

Now why dont you explain the disadvantages of the french system?

Brian?

matthew8 wrote: »

The difference is that in one case you get locked up because you don't pay for insurance (or a fine) and in the other case you simply don't get healthcare. Now can you tell me why it is so much better that you're forced to buy insurance as opposed to buying health insurance if you want to or instead paying for the operation?

Paying for health care is a major cause of bankruptcy in the US. That's a decent reason. Another would be that you will never be refused treatment because you can't pay for it.

Just because people are stupid enough not to pay for health insurance, it doesn't mean they should die or go bankrupt.

sarumite

InTheTrees wrote: »

Although every state I've ever lived in has required me to buy auto insurance so if its not unconstitutional on a state level it'll be interesting to see how it translates to federal law.

Obviously you are only required to buy auto insurance IF you choose to own a car. That argument as such won't be part of the discussion on the individual mandate since the government cannot force you to buy a car and therefore you are agreeing to buy insurance when you purchase the car.

InTheTrees

sarumite wrote: »

since the government cannot force you to buy a car and therefore you are agreeing to buy insurance when you purchase the car.

I dont believe I agreed to buy insurance when I bought a car?

There's legislation that says I have to buy it.

sarumite

InTheTrees wrote: »

I dont believe I agreed to buy insurance when I bought a car?

There's legislation that says I have to buy it.

You agreed to buy a car. When you made that explicit agreement, you gave an implicit agreement to buy auto insurance. If you don't want to buy auto insurance, don't own a car. There is no such alternative with the individual mandate. Therefore auto insurance doesn't provide a precedence that could be used for the individual mandate. The Obama administration won't try and make that case either, preferring to argue that the mandate falls within the the commerce clause.

Brian?

sarumite wrote: »

You agreed to buy a car. When you made that explicit agreement, you gave an implicit agreement to buy auto insurance. If you don't want to buy auto insurance, don't own a car. There is no such alternative with the individual mandate. Therefore auto insurance doesn't provide a precedence that could be used for the individual mandate. The Obama administration won't try and make that case either, preferring to argue that the mandate falls within the the commerce clause.

The majority of people in the USA elected Barack Obama as president, therefore they gave their implicit agreement to any policy he has the power to institute while in government. If you give individuals the mandate to opt out you're basically agreeing that democracy is pointless.

Now, I'll admit that the system of government here has me bamboozled but if it's constitutional for the Obama administration to enact universal healthcare I don't see how you can make a case for opting out.

InTheTrees

sarumite wrote: »

You agreed to buy a car. When you made that explicit agreement, you gave an implicit agreement to buy auto insurance.

You'll have to explain this one to me.

I saw an ad for a car. I handed over a wad of cash and drove it away. It was a simple contract; offer, acceptance and payment.

Where was this "agreement" to buy insurance??

sarumite

InTheTrees wrote: »

You'll have to explain this one to me.

I saw an ad for a car. I handed over a wad of cash and drove it away. It was a simple contract; offer, acceptance and payment.

Where was this "agreement" to buy insurance??

You bought a car. You should have been aware that ownership of that car would necessitate that you buy insurance. You do not have to purchase insurance if you choose not to buy the car.You explicitly chose to buy the car and with it gave implicit consent to abide by any regulations that accompanied the ownership of that car. Included is such regulations such as the stipulation that you won't drive it without a licence or while intoxicated and another being that if you decide to drive it outside of privately held property you would purchase insurance. None of these are being forced upon you prior to your initial consent to purchasing a car.

sarumite

briankeating wrote: »

The majority of people in the USA elected Barack Obama as president, therefore they gave their implicit agreement to any policy he has the power to institute while in government. If you give individuals the mandate to opt out you're basically agreeing that democracy is pointless.

Now, I'll admit that the system of government here has me bamboozled but if it's constitutional for the Obama administration to enact universal healthcare I don't see how you can make a case for opting out.

Obama as president does not have the power to supersede the constitution, as such whatever the majority of Americans think is sadly irrelevant. If the individual mandate falls within the the remit of the commerce clause, then it is constitutional, if not then it is not constitutional. I personally am not making a case for opting out, though I do feel the discussion about auto insurance has no real bearing on the constitutionality of the individual mandate. In the case of the former, an opt out exists and as such its adherence to the US constitution is not an issue. In the case of the latter such an opt out does not exist which is why the question has been raised and why the supreme court will hear it.

Brian?

sarumite wrote: »

Obama as president does not have the power to supersede the constitution, as such whatever the majority of Americans think is sadly irrelevant. If the individual mandate falls within the the remit of the commerce clause, then it is constitutional, if not then it is not constitutional. I personally am not making a case for opting out, though I do feel the discussion about auto insurance has no real bearing on the constitutionality of the individual mandate. In the case of the former, an opt out exists and as such its adherence to the US constitution is not an issue. In the case of the latter such an opt out does not exist which is why the question has been raised and why the supreme court will hear it.

So the lack of the opt out is what might make it unconstitutional?

What is the situation regarding certain states legislating againest Obamacare then? I believe they are invoking the 10th amendment.

RichieC

Do people end up living on the streets in France because of crippling medical bills?

sarumite

briankeating wrote: »

So the lack of the opt out is what might make it unconstitutional?

What is the situation regarding certain states legislating againest Obamacare then? I believe they are invoking the 10th amendment.

My understanding is that the lack of an opt out is the problem. In terms of states legislating against it, that is the usual internal struggle between states rights and the federal governments rights. If the mandate can be considered to be constitutional, then I would imagine the states will be legally obliged to comply.

sarumite

RichieC wrote: »

Do people end up living on the streets in France because of crippling medical bills?

An appropriate question would be do people end up decalring bankruptcy in France because of crippling medical bills. I would imagine the answer to that is no. However when discussing the cost of healthcare, such a question in isolation is of little or no value as there are several complex issues at play and no one question can ecompass all these issues.

Brian?

sarumite wrote: »

An appropriate question would be do people end up decalring bankruptcy in France because of crippling medical bills. I would imagine the answer to that is no. However when discussing the cost of healthcare, such a question in isolation is of little or no value as there are several complex issues at play and no one question can ecompass all these issues.

From what I can see it is not a complex problem. The cost of healthcare pushes people into bankruptcy. Something needs to be done.

http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm

I honestly can't see why anyone would object to Obamacare, but maybe that's because I'm just off the boat and haven't had the years of brainwashing it takes to declare any government program as socialism. Socialism of course being the most dangerous concept to liberty!

sarumite

briankeating wrote: »

From what I can see it is not a complex problem. The cost of healthcare pushes people into bankruptcy. Something needs to be done.

http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm

I honestly can't see why anyone would object to Obamacare, but maybe that's because I'm just off the boat and haven't had the years of brainwashing it takes to declare any government program as socialism. Socialism of course being the most dangerous concept to liberty!

I was talking about healthcare in general, rather than the specifics. . I haven It is easy to compare the French healthcare system to the US, however without making reference to the French tax system and the US tax system, health education and diet, the types of treatment available etc it seems a little redundant in my opinion.

I am not entirely sure why you felt it necessary to include the last part of your post in a reply to what I said. I currently live in Sweden, one of the the most socialist countries in the world . The healthcare here is universal, however it is funded by very (very) high tax rates. As a result I cannot afford private healthcare and I am reliant on the governments healthcare service.

RichieC

sarumite wrote: »

An appropriate question would be do people end up decalring bankruptcy in France because of crippling medical bills. I would imagine the answer to that is no. However when discussing the cost of healthcare, such a question in isolation is of little or no value as there are several complex issues at play and no one question can ecompass all these issues.

That's all I asked. you needlessly tried to complicate the question to hide the answer.

sarumite

RichieC wrote: »

That's all I asked. you needlessly tried to complicate the question to hide the answer.

so when I said, "I would imagine the answer to that is no I was trying to hide that answer? If I was trying to hide that answer I would have done a better job than actually using the words "the answer to that is no"?

The fact is that people becoming homeless because of healthcare costs is a far far lower occurance (and technically would occur as a result of the bankruptcy) than people having to declare bankruptcy because of healthcare costs.

Brian?

sarumite wrote: »

I was talking about healthcare in general, rather than the specifics. . I haven It is easy to compare the French healthcare system to the US, however without making reference to the French tax system and the US tax system, health education and diet, the types of treatment available etc it seems a little redundant in my opinion.

I'm not entirely sure what you are saying there. Would it be that one must take a holistic view of healthcare at a societal level and not just at treatment level?

I am not entirely sure why you felt it necessary to include the last part of your post in a reply to what I said. I currently live in Sweden, one of the the most socialist countries in the world . The healthcare here is universal, however it is funded by very (very) high tax rates. As a result I cannot afford private healthcare and I am reliant on the governments healthcare service.

It wasn't aimed at you at all. It was more of a general comment on some of the objections I see here. Same kind of people who in the 90s made the news for burning an effigy of Hilary Clinton when she was championing universal healthcare.

The Swedish system sounds great to me.

sarumite

briankeating wrote: »

I'm not entirely sure what you are saying there. Would it be that one must take a holistic view of healthcare at a societal level and not just at treatment level?

I mean that there are more factors involved. For example, one of the problems with healthcare in the US is the that doctors have an incentive to make a lot of money, namely that they come out of Med school with a lot of debt. At this point we are now not talking about the direct cost healthcare but about how 3rd level education is funded. Or another example might be the poor nutritional standards of people some people who are not very well educated. This might now be socio-economic issue, however it directly relates to the cost of healthcare. In socialised healthcare the cost of delays are rarely given an economic value. If a person is waiting 6 weeks for a cat scan v's 2 weeks or 2 days, the financial cost of that scan is accounted for as being the same, even though the value to the patient is clearly not. It is also very difficult to account for the actual cost of healthcare on an individual basis since taxes are usually not ringfenced for specific expenditures.

The Swedish system sounds great to me.

It sounds great until you see the amount you pay in taxes. It can be quite demotivating at times. It has its positive sides and I am very grateful to have been given a job here, though it is far from the socialist paradise I hear people on boards talk about.

Mark200

InTheTrees wrote: »

Very interesting.

The american right wing seems politically determined to retain a system that all services are based on cash. If you cant pay then maybe you're not really worth it anyway.

They are steadfastly opposed to any kind of requirement for individuals to buy insurance, which I think is a cornerstone of the french system.

SO without their cooperation I dont see how any kind of solution is going to be found, unless the continuing deterioration eventually produces an outrage that prompts people to see sense.

A solution has already been found. It's called The Affordable Care Act and solves nearly all of the problems with people not being able to receive affordable healthcare. It's still being implemented but as long as the Americans don't elect a Republican President in November and as long as SCOTUS doesn't declare it unconstitutional (I don't think they will) then its there to stay.

sarumite wrote: »

InTheTrees wrote: »

Their objection to a requirement to buy insurance is that the government shouldn't be forcing people to buy anything.

Something like that.

Actually their objections are that it is unconstitutional and therefore illegal for the government to force people to buy anything. Currently there has been a mixed response from the judiciary, with some ruling it is unconstitutional and others saying it is permissible under the commerce clause.

Rubbish, their objections are that they want a political victory over Obama. If its declared constitutional do you think the Republicans will put up their hands and say "oh well I guess we were wrong. We don't want to repeal it now"? They will say the decision is to blame on activist judges. If the individual mandate didn't exist they would find other reasons to oppose it.

sarumite

Mark200 wrote: »

Rubbish, their objections are that they want a political victory over Obama. If its declared constitutional do you think the Republicans will put up their hands and say "oh well I guess we were wrong. We don't want to repeal it now"? They will say the decision is to blame on activist judges. If the individual mandate didn't exist they would find other reasons to oppose it.

That might be their motive, though legally that argument is about as useful as a chocolate teapot. As such, their legal objection that will go to the supreme court is that the government cannot force a citizen to buy a product. If the individual mandate didn't exist, they would find other reasons to complain about it for sure, but it may not be a consitutional matter and therefore the supreme court would not be involved.

InTheTrees

Mark200 wrote: »

A solution has already been found. It's called The Affordable Care Act and solves nearly all of the problems with people not being able to receive affordable healthcare. It's still being implemented but as long as the Americans don't elect a Republican President in November and as long as SCOTUS doesn't declare it unconstitutional (I don't think they will) then its there to stay.

We can hope. A cornerstone of the act is the requirement to buy insurance though.

And the right wing will fight that one tooth and nail.

I agree that 99% of their objections are politically rather than practically motivated.