State regulation of medicine in France

Much more important, however, is different: the recent state began limiting access to doctors. In a study conducted in 2004 by the Supreme Council for the development of health insurance, the question of "legitimacy of absolute freedom enjoyed by the medical profession in terms of the base's own practice." Then, in 2005, the Government introduced a system of "coordinated routes to health services." As part of this system - its mechanism resembles our "regulated medical care" - the patient is recommended to choose "PCP", which will develop for a "route" for further medical care. The goal here is to "fix" the consumer to the physician of his choice and to make the latter the "gatekeeper," which will limit patient access to specialists, various surveys and some particularly complex and "advanced" medical procedures.

While the new system is more "gently pushing" people in a certain direction, but is not mandatory. If you do not want to use the "route", your share will increase slightly, and the insurance compensation fell slightly - about the same as it does with the Americans that "out of the system." But if health care costs will continue to increase, the new system can be expanded and tightened.

More pressing is another problem: the general budget and limit tariffs for medical services, within which the hospital, lead to chronic underfunding of fixed assets, whose result is a shortage of advanced medical technology and unavailability most "advanced" services. Thus, the apparatus for magnetic resonance imaging in terms of a million people in the United States, there are eight times higher than in France, and apparatus for computed tomography - four times more. Partly to show a greater emphasis on technology, characteristic of American medicine, but as a result of some French patients have to wait for the opportunity when they can get the help they need. In addition, the country is experiencing a strong disparity in the geographical distribution of health care resources: in some regions of the health services available than in others.

Thus, although in general the French system avoids the "waiting list" for medical services typical of other countries with public health, for some specialized treatments and access to certain technologies turn, albeit to a limited extent, still exist. In some cases, the hospital, fearing overspend their allocated budget, in order to save refer patients to other medical facilities.

Finally, the state is trying to limit holiday medicines on prescription. French traditionally take an extraordinary amount of drugs. In this country, the average physician writes prescriptions for the year amounting to 260,000 euros]. However, the National Board of Health launched the "cleansing" of the form of drugs, for which compensation is paid insurance. Many French-patients are switched in response to the reception of similar effects of drugs remain in the list, but some may eventually be left without the drugs they desired. For example, in one study found that nearly 90% of asthmatics in France do not receive drugs to improve their condition

There is also a view that government regulation and bureaucracy deprives French system flexibility, do not allow it to respond quickly to changing circumstances. Thus, the incompetence and inability of managers to cope with emergencies, as some believe, have contributed to the deaths of 15,000 elderly people in the summer of 2003, when Europe established an abnormally high temperature, and the shortage of beds in the flu and bronchitis in 2004 .

Recent innovations, of course, did not amount to the introduction of rationing medical services, but 62% of French citizens have argued that "felt the" consequences of these restrictions. In addition, more than half of French people believe the waiting period between diagnosis and initiation of treatment is unacceptable long.

Valentin Petkanchin, Researcher Economic Institute. Molinari (Institut Economique Molinari), warns that France could "be among those countries - they include, in particular, the UK and Canada, where the rationing of medical services and the queues for health care raises serious questions about the availability of treatment for those who are in the need it. " Some medical professionals in France also noted that the waiting period before treatment is gradually increasing.

The impact of all these measures, cost containment is partly mitigated by the fact that in France, the patient can secure medical care in private, out of the system. Say, if he needed medication removed from the list, he can buy it, if it is willing to spend on their own money. The same goes for access to medical technologies. Finally, the patient is free to ignore "a coordinated route" and immediately he needed to get help, even for a higher price.

In addition, the diffusion of new medical technologies and services contribute additional funds derived from payments by private insurers. Increasing the total amount of capital that can be used for such investments, the payments can overcome within the limits set by the state system, and to ensure an increase in the number of beds, as well as the technical equipment in the system. Financial investment through private insurance may also increase the number of doctors and the quality of their training.

In fact to avoid extensive use of normalization French health can because, in contrast to the "pure" single-payer systems, it uses market mechanisms. Even the OECD notes that "the proportion of the population to purchase health insurance from private companies 'and consumers' level of equity in the costs of medical services are the main factors affecting the duration of the wait in line," Queues for elective surgery usually exist in countries where public health insurance (at zero or low equity participation of patients), combined with restrictions "supply" of surgical services. National health insurance removes the financial barriers for patients, which in theory should provide a high potential demand for such services. However, the limitations ... do not allow the proposal to come into compliance with this demand. Under such conditions, non-price rationing in the form of a "waiting list" replaces price rationing as a factor that ensures the balance of supply and demand. "

Ezra Klein, while appreciating the French health care system, says: "[France's ability to restrain the growth of medical costs] is partly due to the fact that the French health care system has found an innovative way to address one of the most complex problems haunting the experts involved in policy-making in this sphere, these are symptoms of the economic order, called "moral hazard." Moral hazard is called propensity to over-consume goods and services that make them a higher profit without a corresponding increase in costs. Translated into normal English, this means people eat more for the "buffet" because there are free to put yourself additive, and often seek medical care, you pay them in advance in the form of insurance premiums, and not after the fact. The obvious solution is to carry a larger share of the cost of contributions to equity and insurance deductions, thereby increasing awareness of consumers of the real cost of each "unit" medical care that they get. "

At the same time, it should be noted that the possibility of a private insurance are not at all. Most often, thus "avoid" wealthy citizens of the state system, which actually leads to the formation of two levels of care. The result is a disparity in the results of therapeutic measures related to income patients. While this situation, of course, is also observed in the U.S. and other countries, and there is no harm in that the rich can afford to pay more for higher-quality care, no, it shows that the stated goal - to ensure that all citizens are absolutely equal access to health services - in mostly remains elusive even in the state-run health care system.

The results of a survey conducted in 2004, show that the French more than citizens of other European countries, are satisfied with their health care system. This is partly due to the fact that the hybrid nature of the system allows to avoid some of the most serious problems encountered by other models of public health. In part, however, the reason lies in the peculiarities of the French national character. For example, two-thirds of those polled said that the quality of the medical care is not as important as the universal and equal access to this assistance. This means that the French experience is likely to be difficult to implement in the United States - it is typical for the Americans is far less egalitarian ethic.

However, although the French and satisfied with the current state of his health and future of concern to them. In particular, they recognize the need for greater control over costs in this area. As a result, the usual controversy associated with the services provided by the state: most people do not want to pay more for them (either by raising taxes or directly out of your pocket), and at the same time citizens are concerned that measures to contain costs in the future may result in to poor quality of service. Regarding the nature of the French health care reform in the society, are divided. However, 65% of adult citizens are convinced that the reform "urgently needed", while 20% consider it "desirable."

Moreover, there is growing dissatisfaction with the French "social state" - an important element of which is the health care system - and the level of taxation required to finance it. Recent election of French President Nicolas Sarkozy is widely seen as one of the manifestations of this attitude. Indeed, the new government as one of its priorities considers reducing healthcare costs.

So, to sum up: certainly, the French health care model works better than most of the other public systems in the field. While there are some problems in the whole of France avoided rationing medical services, typical of other such systems. However, a serious threat to the growth of this program is cost, in the future, it could force the government to introduce rationing in healthcare.

The effectiveness of the French system is partly linked to those of its features, to which Michael Moore and other supporters of the state of medicine are the most negative in relation to the American health care. In France, large enough share patient cost of care, avoiding excessive use of health services, a significant role in the country is largely unregulated market for private health insurance, filling the gaps in the proposal. In addition, consumers are allowed to pay more out of pocket for better or additional services, resulting in a two-level system becomes character.

Obviously, this picture does not match the most common ideas about what should be the public health sector.
medicine should help anyone for free