French Feel the Cost of Universal Health Coverage

In France, where universal health coverage is the rule, government officials are trying to rein in stampeding health care costs with American-style tactics such as copays and a push to use generics.

The debate over the Obama administration’s health care reform package is getting hot, with angry consumers shouting down lawmakers at town-hall meetings across the country. As tempers rise, policy makers back in Washington are wondering what the anger is about. Is it the astronomical projected costs of reform or the potential “rationing” of health care that has Americans concerned? Those who hold either point of view may get some ammunition from experiences across the Atlantic.

In France, where universal health coverage is the rule, government officials trying to rein in stampeding healthcare costs are using American-style cost-control tactics to do it. Among the tools being brought to bear on the cost problem are co-pays on prescription drugs and a push to encourage patients to use generics instead of brand-name medicines. The government has also introduced cuts in services, including closing of some medical facilities, which has led to charges that the government is rationing health care, echoing the fears here in America over Obama’s reform package.

To some observers on this side of the Atlantic, France’s cost problems are evidence that universal health coverage doesn’t come cheap. About nine out of 10 French citizens are covered by Assurance Maladie, a taxpayer-funded state-run health insurer, which has been awash in red ink for the past 20 years and is expected to chalk up a deficit of $13.5 billion this year. In addition, even minor cost-cutting reforms are hard-won, as few French citizens seem willing to give up what they have.