Word: systemic
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Aware that the idea of "rationing" health care would prove controversial in the U.S., advocates of reform - from the American College of Physicians to the advocacy group Center for Medicine in the Public Interest - have suggested a system of review that doesn't take into account the cost of new treatments. This would help doctors decide a course of treatment, as currently they have no way of comparing the efficacy of different drugs for the same condition. But it could also raise prices. "In a free-market economy the manufacturers may use the effectiveness review to charge higher prices...
France: The benchmark system is neither truly socialized nor fully equal...
...World Health Organization (WHO) used statistical measures, such as life expectancy and infant mortality, to rank the world's health-care systems. France topped the rankings. In 2008, researchers at the London School of Hygiene and Tropical Medicine followed up the WHO study by showing that France is not only a good place to stay healthy, but also a good place to be sick: of 19 industrialized nations, France has the lowest number of "amenable deaths" - fatalities that could have been prevented by good health care. (The U.S. had the highest.) But France is not immune to the challenges...
...result: a two-tiered system that runs counter to the utopian ideals of most health-care reformers. That's inevitable, says Dr. Roger Rua, secretary general of Syndicat des Médecins Libéraux, a union representing private practitioners. "Anywhere you've got a degree of socialization in a nation's health-care system, you'll eventually find people who feel they aren't finding what they want within it and decide to opt out," he says. "This is particularly true when systems begin having trouble financing themselves, and start cutting back on services...
...others say that what's exemplary about France's system is that it has managed to foster patient choice while continuing to provide a generally high level of care for even the most vulnerable. All French citizens have affordable access to a doctor, thanks in part to one of the highest rates of doctors per capita in the world (3.4 per 1,000, compared to 2.4 in the U.S. and 2.5 in Britain). A sick French citizen who stays inside the public funding system might not get to choose from a list of specialists, but he or she will...