The French and Swiss Models

Posted by admin in Health Care, Single-Payer Follies on Jun 8th, 2009 | no responses

Although many U.S. reformers praise the health systems of France, Switzerland, and other European nations, these systems are fraught with problems. They are burdened by cost overruns, and yet they still deny patients the latest care and the choices we take for granted.

In France, for example, the government now dictates which doctors and specialists a patient can see. And strict reimbursement schedules can penalize doctors for performing costly procedures, even when those procedures are clinically determined to be best for the patient. Consequently, many doctors are refusing to treat patients with certain illnesses.

Government efforts have done little to control costs. In 1996, the French government established health spending targets. That was the only year it met them. In every year since, the French health system has run a deficit.

Things aren't much better in neighboring Switzerland.

In response to soaring medical costs, Swiss officials started forcing hospitals and specialty units to close. Between 1998 and 2000, the number of hospital beds dropped by six percent nationally. Not surprisingly, patients have experienced diminished access to care and are routinely shuffled from one facility to another.

Alphonse Crespo, a Swiss surgeon and think tank researcher, traces his nation's shift from a focus on choice and quality care to emphasizing cost reduction to 1994, when his country adopted a compulsory insurance system.

The Swiss have since put severe restrictions on private health options. In 2002, the Swiss government placed a limit on private medical offices. Doctors are now prohibited from setting up new practices unless another doctor's office in the area closes. Although unpopular, this rule may be extended through 2011.