us vs france health care systems

Comparison of U.S. and French Health Care : 

Comparison of U.S. and French Health Care Creighton University NUR 692 Presented by Loretta Belknap, Meg Kinney, Sara Loman, Amanda Smith and Sarah Stobbe

Evaluating health care quality : 

Evaluating health care quality Population

Slide 3: 

Geography and Climate

Slide 4: 

Economy

Slide 5: 

Historical and Current Issues

Slide 6: 

Government

Slide 7: 

Quality of Healthcare

Slide 8: 

Healthcare Economics

Healthcare Organization : 

Healthcare Organization Universal public health insurance system Voluntary complementary private insurance Provides reimbursement for co-pays and medical goods and services poorly covered by the public system

Systems : 

Systems Couverture Maladie Universelle (CMU) CMU Protection Complementaire (CMU-C) L’Aide Medicale d’Etat (AME)

Systems : 

Systems Statutory health insurance (SHI) scheme Occupation based Coverage varies Cost sharing Three main schemes General Agricultural Self-employed

Providers : 

Providers Training 3 phases Registration and licensing Type of providers Mixture of GP’s and outpatient specialists Number of physicians, per 1,000 people France: 3.37 (Brunner, 2009) US: 2.4 (Squires, 2011)

Oranges to oranges : 

Oranges to oranges

Delivery of Care : 

Delivery of Care Preferred doctor scheme Most French have preferred doctor (80% in May of 2006) (Chevruel et al., 2010) Individuals register with a physician who is his/her first point of contact within the health care system Financial incentives Exceptions

Care : 

Care Most providers of outpatient care are private Hospital beds are predominately public, or private not for profit Private for profit hospitals specialize in things such as invasive diagnostic procedures, short stay surgery, and obstetrics.

Government Role & Authority : 

Government Role & Authority Sees the entire population has access to care Dictates the type of care that is reimbursed, and to what degree Plans the size and number of hospitals Amount and allocation of technical equipment Organizes supply of specialized wards

Government Role & Authority : 

Government Role & Authority Divides the budget among the different sectors Decides on the number of medical students to be admitted each year Approves the agreements signed between the SHI and the health care professionals Sets prices of medical procedures, and drugs Establishes safety standards; and defines priority areas for national programs.

Vital Statistics : 

Vital Statistics Most Common Causes of Death France Cancer Injuries United States Heart disease Cancer Stroke

Utilization : 

Utilization

Utilization : 

Utilization

Slide 21: 

10% of vaccines are financed by the French government 98% of the population receive the first shot in DPT series 90% receive a measles containing vaccine Patient satisfaction level of 47% in both France and the United States 21% of French patients and 12% of United States patients expressed frustration with wait lists Outcomes

Economic Considerations : 

>96% of the population has access to either free or 100% reimbursed health care with the luxury of freedom of choice of provider and/or hospitals and clinics. Health insurance is a branch of the Social Security System. The poorest citizens have free universal health care Those with chronic illnesses are 100% reimbursed Asthma, cancer, heart disease or any other illness that costs > $100 per month in payments > 80% of the French have supplemental insurance to cover any type of co-pay or deductible (co-pays are almost nonexistent). Economic Considerations

Who pays the bill? : 

Funding is provided by: Worker’s salaries (60%) 13.55% from payroll tax Employers pay 12.8% and individuals pay 0.75% 5.25% general social contribution tax Indirect taxes on alcohol and tobacco Direct contribution paid by all revenue proportional to income Who pays the bill?

Breakdown of contributions : 

Breakdown of contributions

CONCLUSION… : 

CONCLUSION… France has achieved the status of… “Best overall healthcare in the world.” 1.) physicians serve both private & public hospitals and/or clinics 2.) all funds for services are collected by the Social Security Organization 3.) limitations of the system remain true to the ethical equation of the rich receive more & the poor receive less

UNITED STATES APPLICATION OF HEALTHCARE LEARNED FROM FRANCE MIGHT INCLUDE: : 

UNITED STATES APPLICATION OF HEALTHCARE LEARNED FROM FRANCE MIGHT INCLUDE: FRANCE: 1.) All working people pay a portion of their income into a “health insurance fund.” 2.) Rates vary according to services received. 3.) Social security pre-set rates for managing funds for family plans-- UNITED STATES: 1.) US could use this type of pay portion from their income.2.) US could adjust health care rates so they were even across the board. 3.) US insurance companies could work towards offering lower premium payments for all.

POLICY RECOMMENDATION… : 

POLICY RECOMMENDATION… Several elements of French Health Care that consideration by the US would be well grounded. The proven techniques the French government has implemented, could improve our health care system. Slow changes could make a difference. Workers, regardless of income, funding a national health care system sounds fair for many. Funding, rate decisions and other miscellaneous requirements being decided per state governments This is a sound change in operation which has worked well for the French and might do the same for us.

Slide 28: 

Central Intelligence Agency. (2009). The World Factbook, France. Retrieved from the Central Intelligence Agency website:https://www.cia.gov/library/publications/the-world-factbook/index.html Central Intelligence Agency. (2009). The World Factbook, United States. Retrieved from the Central Intelligence Agency website:https://www.cia.gov/library/publications/the-world-factbook/index.html Vrangbaek, K., Durand-Zaleski, I., Busse, R., Klazinga, N., Boyle, S. & Anell, A. (2008). Descriptions of health care systems: Denmark, Germany, the Netherlands, Sweden, and the United Kingdom. Retrieved from the Commonwealth Fund website: http://www.commonwealthfund.org/Resources/2008/Mar/Health-Care-System-Profiles.aspx Legido-Quigley,H., McKee, M., Nolte, E., & Glinos, I. A. (2008). Assuring the quality of health care in the European Union. A case for action. Observatory Study Series No 12. Copenhagen: European Observatory on Health Care Systems, 2008 Retrieved from the World Health Organization website: http://www.euro.who.int/__data/assets/pdf_file/0007/98233/E91397.pdf Picis Group (2008, October). Patient Satisfaction with Healthcare Systems: Do Different Funding Models Lead to Different Results? Accessed from http://www.ehealthserver.com/picis/48-patient-satisfaction-with-healthcare-systems-do-different-funding-models-lead-to-different-results United Nations Childrens Fund (UNICEF) & World Health Organization (WHO). (2011). Immunization Summary. Retrieved from http://www.who.int/immunization_monitoring/data/en/ References

References : 

References