Vive la France on Health Care

I received an email this morning from a dear friend in Paris to whom I had written yesterday, congratulating him on the new nuncio being sent to Avenue President Wilson (the French nunciature). Among other things, my correspondent wrote, "For Europeans, the battle Obama is forced to fight on the health bill is hard to understand. Every body knows that the present American health system is both expensive and inefficient. The European coverage of health expenses has been working perfectly well for 60 years, with both socialist and conservative governments. Moreover, it is shocking to see congressmen, who profit from a state system, criticize a reform that will benefit 50 millions people, nearly the population of France. Well, my dear Michael, you know all that."

Then, the front page of the Post had the headline: "For French, U.S. Health Debate Hard To Imagine" which took my email out of the realm of anecdote. Le Monde editorialized that the hostility to a public option in the Obama health care reform effort is "altogether surreal." The French system, which is almost entirely public, covers ninety-nine percent of the population and costs $3,601 per capita compared to $7,290 per capita in the U.S. The system involves co-pays that any American would envy. For example, the current co-pay for a day in a hospital is $22. although that figure might rise to $28. this year because of budget shortfalls. Nor do the French suffer medically for having a more frugal system. French life expectancy is 80.98 years, compared to America’s 78.11 years.

Politically, these facts do not help Obama one iota. Americans have no desire to "be like the French" even if the French do something as basic as health care better and at less cost than we do. Even the suggestion is seen as an affront to American exceptionalism, the idea that America and Americans are not only different but better. So, the rational argument that other countries have better health care delivery systems gets trumped by the emotional argument that America is different, and proudly so.

This time, however, it is important that pride really not goeth before the fall. This time, America’a legislative leaders need to make health care reform happen. The ads run on television against health care reform are designed to stir up the emotions. The group Conservatives for Patients’ Rights has one ad that warns darkly that the Obama plan does not "guarantee" that health care won’t be rationed or that you will be able to keep your doctor or that you won’t wait longer for care, or that you won’t lose your current insurance. It links these possibilities to the "public option." All of which is true - indeed, the Obama plan also does not guarantee you won't get hit by a bus tomorrow. Health care is rationed today, based on your wealth and your job status. And, you might "lose" your current insurance because there is a better option, although the ad conveniently neglects to point out that the choice remains your and your employer’s choice. And, you can certainly keep your doctor under the Obama plan although he or she might retire and, it is true, the Obama plan does not guarantee against such an eventuality. And, of course, none of these frightening scenarios has anything to do with a public option.

The peace of mind that non-Americans enjoy regarding health care is itself undoubtedly healthful. A friend who is a French and Polish citizen had to undergo surgery this month and, unlike an American, she had no anxiety about paying for the operation. The conservatives who are fighting to maintain our current, broken, inhumane system are trying to disturb our peace of mind as we consider the best legislative options. Instead of getting upset, give your congressman a piece of your mind about our desire for peace of mind regarding health care. Vive la France!