Public vs. Private

If you read this post, you'd probably think there are only two ways of doing health care in the world: public and private.  So when George Reisman goes on a little fear-mongering like this:

And there you have it. Socialized medicine destroys the quality of medical care and dare not allow the competition of private medical care. To prevent that competition, it must prohibit private medical care and establish a legal monopoly on medical care.

I'd ask him to take a look at France.

There's many ways of organizing health care delivery, and I agree with Reisman that flat-out prohibiting private care is a bad thing.  That's why the French system is the model (not Canada) I'd use for the U.S.

Because France is a public-private hybrid, it combines the best of both worlds.  The public component establishes a baseline of quality and care, along with the efficiency of single payer.  The chief problem with U.S. care is access, and that needs to be addressed first.  Then the private component allows patients more access elective and experimental treatments and shorter waiting times. 

Sounds great in theory right?  How about in practice:

The health care system is mainly under state control. The state plans out hospitals, the allocation of specialized equipment, etc. Some of this is done at the regional level, a trend which seems to be increasing. The hospitals offer about 8.4 beds per 1,000 people (America, btw, offers 3.6. Ouch.) The public sector provides 65% of the beds, private hospitals -- which operate on a fee-for-service basis -- make up the rest, and primarily concentrate on surgeries. French citizens choose which one to go to and get the same reimbursement at either. How's that for choice? Not good enough? The French also get to choose their physicians, their physicians get to choose where they practice, and there's patient-client confidentiality.

That's hardly the doomsday scenario Reisman would have us believing.  Sounds heavenly to me.

The key thing to understand here is that it's not an either/or situation.  For Americans, who tend to be distrustful of government, a hybrid system is much more palatable.  It's funny that de Tocqueville's people beat us to it. 

Comments

[Marc]

Well how better to make your point about how bad universal health care is, than by picking the worst example.

But France isn't the only system that seems to be working better than the US system. Germany, Switzerland, Japan, even the Netherlands have better systems.

The major differences between all those systems and the US, is they all have universal enrollment policies.

Simply implementing a policy of universal enrollment in the US, would go a long way in solving many of the problems the US system is facing.

[Kate]

Marc I agree. Mandating insurance is a key thing that needs to happen soon here. I used France because it's a public/private hybrid, and that kind of model could work very well for the U.S.