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Assurance maladie à la française

Posté le mardi 25 août 2009 par lagrette

Bons arguments pour des discussions sur les sytèmes de santé des differents pays.

Guy Sorman
Paying for Le Treatment
Nothing is free—certainly not French health care.
24 August 2009

Recently in the New York Times, mystery writer Sara Paretsky published “Le Treatment,” the story of how she took her husband, suffering from chest pains during their vacation in France, to a local hospital, where he was treated without delay. A cardiologist correctly diagnosed the problem, pneumonia, and administered the necessary medication. The hospital charged no money up front, though the doctor apologetically said that he would have to bill the couple, as they were not citizens. Six months later, an invoice arrived for $220. Paretsky expresses one minor reservation about what she sees as a nearly perfect health-care system: the hospital staff’s behavior was more bureaucratic than cheerful. She concludes, however, that this is a small price to pay for excellent health care at an unbeatable price: “I might put up with a lot of ugly bureaucrats for that.”

What she doesn’t realize is that the French, too, would love to have such a system. Paretsky’s adventure is a parable based on a false assumption: that health care can be public, reliable, and free. It may indeed seem free, or close to free, for an American tourist receiving treatment in an emergency; as a French taxpayer, however, I paid a heavy price for Paretsky’s husband’s treatment. And you, my American reader, did too.

How much? France’s costly national health insurance is mostly financed by taxes on labor. A Frenchman making a monthly salary of 3,000 euros will pay approximately 350 of them (deducted by his employer) for health insurance. Then the employer will add approximately 1,200 euros, making the total monthly cost to the employer of this individual’s services not 3,000 euros but 4,200. High labor costs in France affect not only consumer prices but also unemployment rates, since employers are reluctant to pay so much for low-skill workers. Economists agree that unemployment rates and the cost of national health insurance are directly related everywhere, which partly explains why even in periods of economic growth, the average French unemployment rate hovers around 10 percent.

High as they are, taxes on wages are not enough to cover the constant deficits that national health insurance runs. France imposes an additional levy to try to close the insurance deficit—the CSG (contribution sociale généralisée)—which applies to all income, including dividends, and which Parliament increases every year. Altogether, 25 percent of French national income goes toward what’s called Social Security, which includes health care and basic retirement pensions for all.

French national health insurance is also subsidized by American patients. This is because France decides which drugs to use and at what prices; American pharmaceutical companies must either accept the dictated prices or lose an enormous market. The companies therefore sell their medicines at higher prices in the U.S. in order to cover their expenses and turn a profit; the surplus is then sold cheaply to the French, who take the same pills as Americans but at half the price or less.

In the end, who paid for Paretsky’s husband’s nearly free ride in a French hospital? French workers and taxpayers; American patients; and the young, unqualified, and out-of-work French unable to find jobs because of the unemployment that national health insurance engenders. There is no such thing, anywhere, as a perfect health-insurance system. It’s always a trade-off among competing goods, and the choices to be made are ultimately political ones. Americans commenting on health-care reform should try to make the costs and consequences of these choices transparent, rather than resorting to misleading morality plays.

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7 réponses à “Assurance maladie à la française”

  • 7

    comment5, topamax prices, 8-DD,

  • 6

    Voici un speech de Reagan sur l’assurance sante etatiste; en audio (cliquer su Glenn Beck), ainsi qu’ecrit en anglais;

    …One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it… James Madison in 1788, speaking to the Virginia Convention said: “Since the general civilization of mankind, I believe there are more instances of the abridgment of the freedom of the people by gradual and silent encroachment of those in power, than by violent and sudden usurpations.”

    Ah le bel homme ! Bon sang de bonsoir, qu’est-ce que Ronald Reagan nous manque…

  • 5

    Guy Sorman a raison, c’est un fait connu aux U.S.. Les securite sociales des pays europeens (+ le Canada) imposent des limites aux prix des produits pharmaceutiques (price control) – une pratique qui n’existe pas aux U.S. ou les couts de medicaments sont parfois le double… ou dix fois plus qu’en Europe.

    The high price of drugs in America acts as a defacto subsidy of lower prices in other countries. Why should Americans carry such a disproportionate burden? … The US is the only industrialized nation where prices are unaffected by government regulation. Canada sets a ceiling on the price of each drug. These caps are linked to European price controls, most of which are linked to one another. http://www.supplementquality.com/news/skyrocketing_drug_costs.html
    Differents graphs qui demontrent les differences de prix entre l’Europe et l’Amerique http://www.lef.org/magazine/mag2002/oct2002_awsi_01.html

  • 4

    On savait déjà que le guitou était une buse, mais cependant honnête, mais le coup des médicaments payés moins chers en France et subventionnes par les contribuables yankees, fallait oser, vychynsky à la puissance 10, faut avoir des tripes blindées pour dégueuler une telle énormité !

  • 3

    Rumpf: AARP est une organisation de personnes retraites, et les retraites americains sont couverts a partir de 66 ans par l’assurance etatiste Medicare. Est-ce qu’AARP a obtenu ces resultats en questionnant leurs membres ? ce ne serait donc pas etonnant. More info, please.

  • 2

    A new survey commissioned by the AARP asks respondents to what degree they support or oppose « Starting a new federal health insurance plan that individuals could purchase if they can’t afford private plans offered to them » — a public option, in other words. The results are interesting, though not necessarily surprising to those who have been closely following the debate.

    All: 79 percent favor/18 percent oppose
    Democrats: 89 percent favor/8 percent oppose
    Republicans: 61 percent favor/33 percent oppose
    Independents: 80 percent favor/16 percent oppose

    Not only does a public option enjoy strong support (AARP finds 37 percent strongly supporting such a choice), it enjoys broad support — a finding based not only in this new survey but also in SurveyUSA polling released last week. Indeed, a supermajority of even Republicans supports a federal program to provide individuals with a choice for their health insurance coverage, with just a third of the party membership opposing such a plan.

    So why, again, are supporters of a public option finding such difficulty in Congress?

  • 1

    Même viscéralement attaché à notre systeme de santé, je suis obligé de reconnaitre que les arguments de Sorman ont du mordant. De quoi alimenter le débat ce qui n’est jamais mauvais pour la santé intellectuelle. Bien joué, bien joué petit canaillou…

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