Should We Emulate the French Health Care System?

The Bernie bros will not tell you, but universal health care, or Medicare for All has not exactly lived up to expectations… in France, of all places. Naturally, the bros want us to model our country on France or on Sweden or some such, but they do not tell us about health care in those countries.

The French, bless their Gallic souls, are not at all happy with their failing national health care system. One must note, in this Wall Street Journal editorial, that citizens of the French Republic have the right to supplement their national health care with private insurance. This means, to put a finer point on it, that there are two health care systems, one for the rich and one for the rest.

As it happened, once upon a time, the French system worked well:

In France, every citizen is enrolled in a national health insurance program and can supplement coverage with private insurance. Government funds more than 75% of health expenditures. For a while it worked: In 2000 the World Health Organization declared the French system provided the “best overall health care” in the world.

But, it was too good to last. Demand outstripped supply and that system started failing:

But nearly “free” health care creates unlimited demand, and the problem has become acute in recent years. French emergency services treated 21 million people in 2016, up from 10 million 20 years earlier. Meantime, public institutions, which make up about two-thirds of hospital capacity in France, cut some €9 billion in spending over the past 15 years.

The Bernie bros will tell you that we need but increase taxes on the rich and the rest. They imagine that increasing taxes will have no direct influence on wealth production. But, history tells us that taxes kill the goose that is laying the golden eggs. And once you do that, there is simply no money to fund the public’s voracious appetite for free health care.

As the Journal notes, France is not undertaxed. It is overtaxed:

France can’t tax its way out of the problem. Tax revenue was 46% of gross domestic product in 2018, the highest among Organization for Economic Co-operation and Development countries. The strain will get worse. Chronic diseases are becoming more prevalent as the population ages, and the country’s high tax burden has restrained the economic growth needed to fund health spending.

Public health officials have been sounding the tocsin of alarm:

“This system is collapsing and we are no longer able to carry out our jobs in good conditions and to provide quality and safe care,” 70 French public health leaders wrote in a November statement. “Access to diagnostic, medical and surgical care at public hospitals is now extremely difficult, and those in charge of treatment and care are demotivated.” French President Emmanuel Macron’s government has promised more funding, but in January some 1,200 medical professionals threatened to resign from their administrative duties over declining conditions.

So, health care is free in France, but there is less and less of it available for the overtaxed French. More and more people know it:

The French in any profession are quick to protest—see the lengthy transportation strike earlier this year—but the public shares the medical community’s concerns. One survey showed that nearly 90% of the French supported striking medical workers last year, and some 73% were pessimistic about the future of health care in their country.

And now for the statistics:

The number of full-time hospital beds in the country shrank to 410,921 in 2014 from 468,418 in 2003. The number then fell below 400,000 for the first time. This can partly be attributed to advancements in health care, which make long-term hospitalization less common. But in 2018 about 180,000 urgent-care patients spent a night on a gurney in a hallway, according to the French Urgent Medical Aid Service. At one point last year nearly 5% of Parisian hospital beds were out of use for lack of staff.

This ought not to be our role model.