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Sunday, July 16, 2006

Two Lessons from France

Bill Busby, friend of 50 years plus, was good enough to send me a clipping from the July 5, 2006 issue of the Albuquerque Journal – a column entitled Europe Makes Health Care Work by Steven Hill of the New America Foundation.

The article pointed out that several European countries have health care systems that seem to work well and cost a lot less than ours. It made specific reference to France, which has been rated by the World Health Organization as having the best system in the world.

The French system is financed partly by employers, partly by employees, and partly by the government, each of which contributes to a Sickness Insurance Fund (SIF). Most doctors are employed by private medical groups. Fees and cost control measures are negotiated annually between the SIFs and representatives of the doctors.

There are many similarities with the program recently adopted by the Commonwealth of Massachusetts, with one important exception – the Massachusetts program has no provisions for cost controls.

At its close, the column cited two important lessons to be learned from European plans. One is that universal coverage does not necessarily mean single payer. The other is that cost doesn’t control itself – somebody has to do it.

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