Human Exceptionalism

Obamacare: France Facing the Music About Cost of Universal Health Care

The handwriting is on the wall everywhere you look about universal health care: If you provide almost all things medical to all people, you are going to have a fiscal crisis.  That’s just common sense. No matter how eloquently our  president tries to pretend otherwise, no matter his high decibel charisma, no matter his telling his opponents to shut up (touchy, touchy), basic economics will eventually win out.

Just look at France, one of the nations always looked to as having conquered the universal access to health care beast.  It is in a Code Blue: From the story:

When Laure Cuccarolo went into early labor on a recent Sunday night in a village in southern France, her only choice was to ask the local fire brigade to whisk her to a hospital 30 miles away. Ms. Cuccarolo’s little girl was born in a firetruck. A closer one had been shuttered by cost cuts in France’s universal health system.

France claims it long ago achieved much of what today’s U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.

In recent months, France imposed American-style “co-pays” on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. “A hospital doesn’t need to be money-losing to provide good-quality treatment,” President Nicolas Sarkozy thundered in a recent speech to doctors. And service cuts — such as the closure of a maternity ward near Ms. Cuccarolo’s home — are prompting complaints from patients, doctors and nurses that care is being rationed. That concern echos worries among some Americans that the U.S. changes could lead to rationing

The French made health care  very inexpensive–most of it paid for by a huge public insurance plan supported by taxes.  Big mistake. That encourages over utilization and, given the birth dirth over there and the aging society, makes the economics of the thing untenable.  But, once you tell people they are entitled to something, they get very angry if you try to take part of it away.  Having been to France often and seen how quickly the people resort to Le Grève (strike), French leaders are in for a rough ride if they try to save money. As a result, even small changes can cause an uproar:

Yet even the smallest budget moves are proving controversial. Local residents are up in arms over a cost-cutting measure that makes patients pay €1.10 an hour to park at the hospital. “It’s a scandal,” says retired local Communist politician Gérard Eude. “It goes against the very idea of universal health care.”

There is much to admire about the French system. But we can’t get there from here, as the French find out they can’t stay there.  (I encourage all SHSers to read the whole article. Much grist there for the thought mill.)

Time to pull back, Mr. President. We can increase access, but we don’t have to totally remake the system. Vouchers, increased competetion, basic policies to cover the serious stuff, co-pays and deductibles to prevent over-utilization, chains of basic and chronic care clinics in malls, etc: We can materially improve our system for those who are currently not insured without breaking the bank. 

And while we are at it, let’s start triaging government! We are at the last step in the Ponzi scheme before collapse unless we cut government costs in less essential areas.