Health Care Doesn’t have to be this way

There’s been a lot of conversation recently, in the wake of the murder of the United Healthcare CEO, of the failures of the American healthcare system, and particularly the inadequacies of American health insurance.

      For some, the alleged murderer became a kind of folk hero, a Robin Hood pushed to the limit, an avenging angel fighting health insurance’s myriad injustices. For many, it simply uncorked a deep well of pent-up consumer frustration. For me, it provided an occasion not only to think about how much better health care in America could be and should be, but how different it was when we lived in France.

      Because I worked at the time for a French company in Paris, I was part of the French system, covered by the French social safety net. In France, healthcare coverage is universal and compulsory for all those who are in the system, which is essentially single-payer. It is provided to all by France's non-competitive, statutory, government health insurance

      My son was born in Paris, at the Centre de Santé des Metallurgistes—the metallurgy worker’s clinic. After his birth, my wife spent eight days in the clinic—not because she or our son had any post-natal problems, but because that was the humane thing to do for a new mother and infant.

      The total cost, to us, for the eight days, including the birth itself, the nursing care, the room, the midwives, any medications, the food and all the rest…was the cost of two phone calls I had made from the clinic to the U.S.

      In the months that preceded the birth, every time my wife had showed up at for a pre-natal appointment, to monitor how the pregnancy was going, we received a payment—a payment designed to encourage pregnant women to see doctors. In the months that followed the birth, every time my wife and son showed up for a post-natal appointment, to see how mother and child were doing, we received another bonus payment.

The author and his son in France.

      Unlike the carefully designed, legally constituted and patient-centered French system of health insurance, the U.S. system was essentially the result of an historical fluke.

      During World War II, our government instituted price controls on a wide range of products and services. But the War Labor Board ruled that health insurance was exempt from the wage and price controls. In a very tight labor market, with so many potential workers off at war, employers began offering health insurance as a way to attract and retain workers.

      We got stuck with that employer-based system.

      So, which system works better?

      You probably know the answer. But in case you don’t:

      The infant mortality rate in the U.S. is 5.6 deaths for every 1,000 live births. In France, the rate is 3.3. Americans’ life expectancy is 77.43 years. The French average is 82.23 years.