I'm tired of responding to this topic, and it has taken up way more time than it should. So, you all go ahead and talk among yourselves. I do not plan to respond anymore within this particular thread unless I see that someone has come up with a grand plan to solve all of the US healthcare problems.

That works out to be less than 0.3% of the population yearly. So no - it is not that impressive.

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Next races on the schedule: none at the moment

I live in France and while some French people are complaining, I believe we have a good amd affordable health care.
I spend 20 years in USA//China/Poland and India and wouldn’t trade our system for any other.
I am 61 years old, my wife is 58, we have 200usd per month for health insurance and most of the care is free.
For exemple, I tore a meniscus back in September, I had MRI within a week with out of pocket around 60 USD, I decided to have arthroscopic meniscus surgery in December, total out of pocket was 500 Euros including private room for the day and 10 PT sessions.
I bet many people in the US would love to pay this type of monthly health insurance and this type of out of pocket for surgery!
My wife is doind an effort test next week (hrm on treadmill) for no out of pocket!
Docteor visit and drugs are most of the time covered 100%
So I guess universal care can work!

Why would you wish to remain ignorant about what your health care really costs you and your fellow Frenchmen? Are there other products and services that your prefer to deal with as fantasies?

Sorry I do not understand your question?
I am just saying that univeral healthcare is possible without paying outstanding fee and should be available to all!
Same for education, for exemple we do not have kids but I am glad that part of my taxes is paying for eduction.
I am not saying that France is perfect but saying that I am very grateful to know that anybody can get and afford treatment!
I understand bonus malus of insurance for good and bad drivers but I don’t agree that your health premium should be based on your condition!
Except for smoking for exemple most cancer are not linked to lifestyle choices, same for most genetic disease!

I live in france

The entire system is completely dysfunctional. Though weirdly that's why people like it.

If you compare how Général Practioners work in France; they work as private individuals, have no clerical support, have no integrated care Pathways, no on site diagnostics

I think the biggest primary care practice in the UK is 500 physicians, it has long term care beds, integrated diagnostics, purchases blocks of care for a population of half a million

The biggest issue in France is a total lack of transparency about costs and that fact that everyone thinks someone else will pay for it

The problem with this is that eventually you run out of other people's money

Andrew, I agree that most general practitioner do the clerical work but how does it affect you!
As soon as you go to a specialist this is a different story.
I went to sport clinic for my knee (they do about 50 surgery per day so not huge but not smalleither) and have state of the art equipment.
I had colonoscopy at 55 and 60 at zero out of the pocket cost.
My wife is doing a exercise stress test also at not out of pocket cost (covered by our insurance)
Can you tell us why you seem to hate the systemYou prefer a system where people do not know real cost but get treatment or where people know the cost but cannot afford it?
I agree that we should know real cost of procedure to understand where our taxes goes
(I was told that my atheoscopic surgery total cost was south of 3000 euros and my cost was 500 euros, i am wondering how much would that be in the US and why)
.

The system is set up such that no one has any real insight in to the cost of anything.

It is simply not sustainable or possible to continue to provide unlimited care with minimum out of pocket costs because someone has to pay for it

For the same reason, having doctors perform menial clerical tasks makes the whole system more effective

The current system is unsustainable

I don't hate it, I just think the expectations are absurd and rhe politicians who are not honest about it are mendacious

The cost of a knee replacement is 9-12k sterling

The cost of clinical time in the UK is approximately 180 sterling an hour in a clinic setting, more for diagnostics and procedures

what is Ironic is that if you look at the data the system is France is close to equilibirum the first time since 15 years!
The deficit has been divided by a factor of 5 or 6 in 15 years so I guess not that bad!
Plus I would prefer to pay more that to balance deficit if needed that seeing people dying because they couldnt afford medical care.
I assume you just have financial worries about France but no real health system quality complaints?

OK. I agree that I need to be more clear.

Let me go over why your post troubles me...

1.) It is clear that you have no idea what any of your French medical services really costs.
2.) You are presenting this data above like it's the actual cost when it's obviously not.
3.) You've decided you're getting good value even though you don't know the cost.

Those three items above are a recipe for eventual disaster. I certainly don't want that approach from my fellow Americans as we continue to tackle our health care delivery issues.

I think the system has to be reformed to provide value for money. There is zero value for money when a clinician is seeing less than 3 patients per hour, there is no value when you have to go from doctors office, to imaging centre to labs to secondary care clinics

The finances in France are bad, and now macron has caved inn, he will be no better than hollande

The outcomes in France, or at least the perceived happiness with the system is high, but there is so much money being wasted

They need to reconfigure all of primary care, they need to centralise hubs for diagnostics, they need to reduce length of stay; for a straightforward pregnancy being in hospital for nearly a week is clinical practice from the 1970's

They system is broken

Clinical practice is good in some areas but in others it's from the early 80's; specifically length of stay

The organisation of physicians is 20 years behind in order to optimise outcomes and value for money

Classic examples, if a physician is an individual Practioner serving perhaps 2-5k on their register, they simply don't see enough patients to maintain competencies in treating diabetics or others. Where physicians have formed groups in the UK and are serving 100k, they employ specialists to look after specific patient cohorts and they see as a group sufficient volumes to share and maintain competencies

No one in France has any idea how much care costs, they think its free, that there should be more of it and that someone else will pay for it

It's not, they won't and eventually the party will end and people will need to decide which "free" things they want to continue

This will be my last post since you obvioulsy understand better than me and you are capable to guess what I know and believe :)


1.) It is clear that you have no idea what any of your French medical services really costs.
I know the cost of most service I received but as I said in previous post the cost is not mentioned to you unless you ask.
I asked the cost of my surgery and it was around 3000 euros which is probably1/5 of what I would pay in USA

2.) You are presenting this data above like it's the actual cost when it's obviously not.
See my answer above
3.) You've decided you're getting good value even though you don't know the cost.
First 500 out of pocket for a 3000 procedure which allow me to run again is a good investment
I know also that this cost is much less than US where I lived for 11 years!
And good value is a perception that varies from oerson to person.
Some people are upset to pay a 5 euros copay on a drug, some are very ok with this.
By the way I got last year a 1500 euros colonoscopy at no cost for me, should I say it was infinite value then?


Try to relax and be less agressive and don’t judge people when they just oresent their facts!
End of post for me

I'm sorry if my post made you feel bad. I just wanted to point out the shortcomings of that type of analysis in case others found it persuasive.

To be fair, a lot of your points apply equally to US consumers of health care, and probably other countries as well.

We rarely know the full costs (especially ahead of time). So many of us make health care decisions based on out-of-pocket costs and convenience.

I fully agree with you that it's a recipe for disaster if we continue in that direction.

Except there is an outstanding fee, its just not paid at the time of treatment. It is subsidized through taxes, and not itemized. Taxes that you and others most certainly pay. Your cost at time of treatment is essentially additional fees.

You are right that there are no guarantees for lifestyle and disease, however, you can absolutely increase your risk of those medical issues with lifestyle choices.

For instance, if you want life insurance or even major medical coverage for disability, an agent WILL evaluate your lifestyle choices and your premium will go up if you make choices that increase your likelihood of needed their coverage. Extreme sports increase the risk of bodily harm. Smoking is definitely on their questionnaires. They also look back and see every time you've needed prescription medications, imaging, procedures, non-routine blood work etc. Then if your crappy eating habits or exercise habits also put you at increased risk, then your premiums may be at risk also.

So I agree that while smoking and cancers can be completely unrelated, your lifestyle choices can still greatly affect your need for healthcare. I work in healthcare, knee pain and back pain are still some of the most common musculoskeletal issues seen in active and detrained individuals. And guess what, 90% of the time we can fix it with proper strength training. And this isn't some amazing discovery, this is basic 101 stuff. Most people don't take care of themselves, plain and simple.

I don't particularly care how much my doc makes. I can usually get an appointment with here within few days. I needed an MRI done and the waiting was 3 weeks as I wasn't an emergency case. Could have had it within 3 days had I been willing to go in at 2am as it is a 24/7 service. Her income is her business.

You are absolutely correct. Ironically, in the USA we've handled health insurance in such a jacked way that most people don't even understand the true concept of insurance anymore.

To be fair, health insurance in America is quite unlike anything else we call insurance. It’s more managed care plans with a cost spread across plan participants than it is insurance, as it’s simply not used rarely like true insurance.