Letters to the editor: Hail the French

Sunday, October 30, 2011

Having lived and traveled in both France and other parts of Europe for several years, I believe that what we Americans think of as "cutting edge" reform and tools have been in place overseas for decades (See "CMS takes new approach to fraud," HME News, August 2011). Our government must very quickly revamp the current archaic system of Medicare and reimbursement. American private insurance companies are gouging the public with little coverage and huge premiums, which continue to rise without any effective government oversight.

There's a lot we can learn from the French. The French system is not what most Americans imagine, says historian Paul Dutton at Northern Arizona University, author of "Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France." "Americans assume that if it's in Europe, which France is, that it's socialized medicine," he says. "The French don't consider their system socialized. In fact, they detest socialized medicine. For the French, that's the British, that's the Canadians. It's not the French system."

France relies on both private insurance and government insurance, and people generally get their insurance through their employer. The advantage is that everyone in France has healthcare coverage. Unlike in Britain and Canada, there are no waiting lists to get elective surgery or see a specialist, Dutton says. He says the French want pretty much the same thing as Americans: choice and more choice.

The French national insurance program is funded by payroll and income taxes. Physicians have a choice to work outside this system, serving patients who are willing to pay out of pocket.

When someone goes to see a physician, the national insurance program pays 70% of the cost. Most of the other 30% is paid by supplemental private insurance, which almost everyone has. It's affordable, and much of it gets paid for by a person's employer.

Despite what appears to be a costly system, data suggest that the United States spends more than twice on healthcare per capita than most Western European countries.

The system that CMS is talking about as "cutting edge," being the introduction of a swipe card for each beneficiary, has been used in Europe in one form or the other for decades. I sure wish that we get such a system in place real soon. Wouldn't it be wonderful for beneficiaries and medical providers alike to simply swipe the card and access the CMS or private insurance databases, establish benefits and eligibility, dispense the necessary service/product and get paid promptly? Each medical provider will be responsible for keeping the necessary physician order forms, etc. CMS can perform random audits to ensure that fraud and abuse are kept to a minimum.

I'm afraid that if we don't act fast, we will see the number of medical providers across the country cut in half in less than five years. The beneficiaries, mainly the elderly needing the most care, will be the ones paying the price.

- Med Fadel, CEO, BetaMED, Inc., Bryan, Texas