France is selected for comparison with the United States for several reasons. First, it is a European country; thus, it is possible to compare the current trends in Europe and North America. Second, the role of government in France is very important, and it is necessary to assess the efficiency of government operations in both countries.
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Health Statistics and Costs: Comparison between US and France
It is reasonable to compare the life expectancies in the US and France during the recent years. The comparison is presented in Table 1 (World Bank, 2015).
Table 1. Life Expectancies in the US and France
|
Country |
2005 |
2010 |
2015 |
|
France |
82 |
82 |
82 |
|
United States |
79 |
79 |
79 |
Thus, the life expectancy is higher in France in comparison with the United States. The current mortality rate in France is equal to 9 individuals per 1000, while that rate in the United States equals to 8 (World Bank, 2015). Hereby, the United States has stronger positions in this regard as its mortality rates are lower. One of the major illnesses in France during the last several years is human influenza A/H3N2. One of the major illnesses in the United States is Lassa fever (WHO, 2015). Thus, the distribution of illnesses in both countries is different. France spends more than 11% of its GDP on health care purposes, while the US spending exceeds 17% of its GDP. With regard to per capita expenditures, they are also different, namely they are equal to around $4,000 in France and more than $8,500 in the United States (World Bank, 2015). It is evident that the US spending considerably exceeds that of France, although life expectancies and mortality rates in both countries are similar.
Health Care Financing: Comparison between US and France
The health care system in France is based on the large-scale government involvement. In particular, the government controls the financing and coverage of the national health insurance. The government also covers the largest part of the total health care expenditures. At the same time, general physicians represent the private sector. The distribution of public insurance funds is also controlled by the government (Gille & Houy, 2013). Furthermore, government agencies impact on the pricing policy with regard to health care services. In general, France effectively combines the potential of free market and government operations.
The health care system in the United States experiences substantial reforms nowadays. In particular, the degree of government involvement in this sphere tends to increase. In fact, such programs as Medicaid and Medicare constitute the dominant fraction of the overall health care expenses (Holtz, 2008). Moreover, numerous additional health care regulations are introduced after the adoption of the Patient Protection and Affordable Care Act. Consequently, it increases the general insurance coverage of the population as well as promotes the quality of services (Pittenger & LimBybliw, 2013). However, the tax burden on the private sector increases; thus, the overall assessment of these reforms is controversial.
In general, France has established the consistent and sustainable model of health care financing. The government plays a crucial role in this process as it controls the concentration and distribution of insurance premiums. At the same time, the potential of the private sector is widely used. Moreover, the French government tries to adjust the flexibility of private companies to the performance of major government agencies. Talking about the situation in the US, it seems to be less balanced. The reason is that the government expands its role in the health care sphere, but the overall efficiency tends to decline. Thus, the effective private sector solutions are substituted by inflexible government solutions. The major observed effect is the rapidly growing health care expenses in the United States.
Health Care Administration: Comparison between US and France
The major administrative functions in France are performed by the Ministry of Health and Solidarity. It is responsible for controlling and overseeing the insurance process in the country. The specific departments of this Ministry are not fixed and may be adjusted according to the existing health care challenges. Moreover, there is the government agency ANAES that is responsible for developing practice guidelines regarding the quality of health care services (Gille & Houy, 2013). In general, the impact of government agencies is considerable, but the overall administrative mechanism is highly flexible.
Talking about the United States, there is a different system of health care administration. The US Department of Health and Human Services is the major federal agency responsible for regulations in the sphere of health care. It is worth stating that some complementary functions are performed by the Food and Drug Administration that controls the safety and quality of food. The National Institute of Health concentrates on the strategic issues and research that serve as a basis for future policy development and reforms (Holtz, 2008). All these agencies have to adjust their functions according to the Affordable Care Act adopted in 2010 (Pittenger & LimBybliw, 2013).
It is evident that administrative functions are performed differently in France and the United States. France tries to maintain the flexible government system that adjusts its operations to any changes in the external social and economic environment. On the contrary, the United States is aimed at expanding the insurance coverage to the maximum possible degree. However, quantitative aspects often prevail over qualitative ones. As a result, the allocation of scarce economic resources is not optimal in the country.
Health Care Personnel and Facilities: Comparison between US and France
The number of nurses per 1,000 people in France is equal to 9.3 (World Bank, 2015). With regard to the US, the total number of nurses is 3.97 million (Kaiser Family Foundation, 2015). As the current US population equals to 325 million people, this ratio for the US is 12 nurses per 1,000 people. Thus, the US directs more resources toward this sphere in terms of health care professionals in comparison with France. However, the situation is slightly different in relation to physicians. In fact, there are 3.2 physicians per 1,000 people in France and only 2.5 physicians per 1,000 people in the United States (World Bank, 2015). Furthermore, there are around 5,000 hospitals in France and around 7,000 ones in the United States (World Bank, 2015).
In general, the US has higher coverage of its population by the corresponding health care professionals and facilities. However, the ultimate qualitative impacts and effects should not be confused with these quantitative indicators. As life expectancy in France is higher and the amount of per capita expenditures is lower, it means that the general efficiency of health care is higher in France than in the US. Therefore, a higher availability of hospitals and nurses does not necessarily mean that it will lead to the proportional qualitative effect.
Access and Inequality Issues: Comparison between US and France
The inequality issues in France are addressed with the help of government involvement. Hereby, the government controls the insurance process, thereby trying to make it accessible for all people, regardless of their income. At the same time, the system is developed in a way to create financial stimulus for the most effective health care providers. The amount of insured people in France exceeds 80%; however, around 20% of people are uninsured (Gille & Houy, 2013). Thus, the government tries to provide some services for these categories of people. However, some people experience health disparities and are underinsured. People with low income face major problems, although the government tries to support them.
The inequality in the United States is a larger problem. The number of insured people is similar to that in France (Pittenger & LimBybliw, 2013). However, the number of underinsured and people with health disparities is higher. The problem is that the government is not highly effective in addressing their needs. Moreover, the growing government’s involvement in this process leads to higher costs and prices for health care services (Holtz, 2008). Thus, even more people need some form of support or financial assistance than before.
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In general, both the access and inequality issues demonstrate that the United States has much more problems in comparison with France. Although the US government tries to increase the accessibility of health care to people with low income, its strategy is not integrated with those of private and non-government organizations. As a result, the growing insurance coverage leads to the concentration of risks and higher costs. The number of people that are dependent on the government assistance tends to increase more rapidly than government’s financial resources. The situation in France is balanced better as the government’s structure is flexible and is oriented to the needs of consumers. Private companies and NGOs also receive fair remuneration according to their contribution to the ultimate result.
Conclusion
It may be concluded that the health care systems of France and the US have both significant similarities and differences. On the one hand, both of them are characterized by the growing government’s involvement in the health care sector. The major attention in both countries is paid to the increase in the insurance coverage of the population. On the other hand, the overall efficiency of health care in France is much higher than that in the US. The life expectancy in France is higher, and per capita expenditures are much lower than in the US. Moreover, the overall government’s structure in France is highly flexible and oriented to the needs of clients. The US health care system is less flexible, and the current health care reform is controversial. The interests of American private companies and those of the government are not balanced. In general, the US may use the French experience for initiating the needed reforms.
