Friday, February 08, 2008
Health care the French way
By Miriam Falco
Managing Editor Medical News
Ever since the 2008 presidential campaign shifted into high gear last year, CNN Medical News has been taking a closer look at some of the problems in our health-care system. In our documentary "Broken Government: Health Care -- Critical Condition," which made its debut last week, Chief Medical Correspondent Dr. Sanjay Gupta investigated problems with America's health care system. The program will be rebroadcast this weekend, Saturday and Sunday at 6 a.m. ET on CNN in the U.S.
The World Health Organization ranks France as having the No. 1 health-care system in the world. So last month I spent a couple of days in Paris, to catch a glimpse of how French health care works. This certainly doesn't make me an expert. But it was a very interesting experience.
Everybody in France has to have health insurance. If you can't afford it, the government helps you pay for it. If you lose your job, you don't lose your health insurance. (watch video)
I focused on the costs of having a baby in France, as an example of how it's covered by health insurance.
Dr. Laurent Mandelbrot heads the obstetrics department at Louis Mourier Hospital in Colombes, a suburb of Paris. He explained to me that in France, all prenatal care from the fifth month of pregnancy until the baby is 1 month old is free. New moms also stay in the hospital for at least four days, long enough to learn how to take care of their baby, get used to breastfeeding, get some rest. Mandelbrot says this allows doctors to detect problems early, when they might be resolved. "If people don't have access to care and it's too late (to catch a problem), that costs a lot more and it's just a terrible cost in terms of sick babies and maternal complications," Mandelbrot said.
I also met a social worker at the same hospital, Elodie Cadier-Dervaux. Her main job is to help expectant moms navigate the system, to ensure that all her medical costs are taken care of. Another part of her job is to make sure the expectant mom is taking care of herself, getting proper nutrition, vitamins etc.
Knowing that families in the U.S. can fall into serious debt if their baby is very ill at birth and their insurance doesn't cover as much as they thought it would, I wanted to get an idea of how much a family in France might pay in a similar situation.
When I met the director of France's national health insurance organization, Frederic Van Roekeghem, I gave him a hypothetical scenario: Baby is born with a serious problem, perhaps a heart defect. Baby needs surgery and has to spend a month in a neonatal intensive care unit, how much would that cost? Van Roekeghem told me the total costs would be about 30,000 to 40,000 Euros - but the parents would only pay 18 Euros. Even without doing the math (18 Euros = approx. $26), I knew that was a very low amount, but I asked him again because I thought I had misheard his answer. I think it amused him, but he repeated - 18 Euros.
It's hard to imagine that France's system could be duplicated in the U.S. - it's costly and people do pay a lot for it - approximately 21 percent of their salary goes to their version of social security, which includes mandatory health insurance, supplemental health insurance and retirement benefits. But judging by the folks I met in France, having access to health care for everyone is something they don't want to do without.
Do you think our health care system needs to be fixed? Do you think everyone in the U.S. should/must have health insurance?
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