U.S. Healthcare ranks #37?? Not so, but the French ARE better than most.

WHO’s ranking of healthcare systems relies on a measure of performance that includes “financial fairness,” which has nothing to do with the quality of healthcare. ...not the only problematic factor in the WHO rankings... based on five factors, weighted as follows: 1. Health Level: 25%; 2. Health Distribution: 25%; 3. Responsiveness: 12.5%; 4. Responsiveness Distribution: 12.5%; 5. Financial Fairness: 25%.//Only two of these – health level and responsiveness – are direct indicators of health outcomes. Even these are... affected by things like crime and nutrition), but they’re at least relevant. But neither health distribution nor responsiveness distribution properly belongs in an index of healthcare performance....inequality (that’s what “distribution” is all about) is distinct from quality of care.
http://tinyurl.com/na7m6u
http://tinyurl.com/olzgdq
tinyurl.com/opam9s
The French system, on the other hand, appears to be properly placed at the top but it is necessary to understand how they do it. http://tinyurl.com/26g7n4 The French system—a complex mix of private and public financing—offers valuable lessons for would-be health-care reformers in the U.S.(It's not completely correct to )lump France in with the socialized systems of Britain, Canada, and Cuba....the French system is similar enough to the U.S. model that reforms based on France's experience might work in America. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self- employed, are free to prescribe any care they deem medically necessary. ...France also demonstrates that you can deliver stellar results with this mix of public and private financing...(WHO) health-care ranking, France came in first, while the U.S. scored 37th...France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S.,...average life expectancy is 79.4 years, two years more than in the U.S. ...far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S....France is wrestling with runaway health-care inflation....led to some hefty tax hikes, and France is now considering U.S.-style health-maintenance organization tactics to rein in costs. Still, some 65% of French citizens express satisfaction with their system, compared with 40% of U.S. residents. And France spends just 10.7% of its gross domestic product on health care, while the U.S. lays out 16%...how the French system works, think about Medicare for the elderly in the U.S., then expand that to encompass the entire population. French medicine is based on a widely held value that the healthy should pay for care of the sick. Everyone has access to the same basic coverage through national insurance funds, to which every employer and employee contributes. The government picks up the tab for the unemployed who cannot gain coverage through a family member....the french system is much more generous to its entire population than the U.S. is to its seniors. Unlike with Medicare, there are no deductibles, just modest co- payments that are dismissed for the chronically ill. Additionally, almost all French buy supplemental insurance, similar to Medigap, which reduces their out-of-pocket costs and covers extra expenses such as private hospital rooms, eyeglasses, and dental care.... the sicker you get, the less you pay. Chronic diseases, such as diabetes, and critical surgeries, such as a coronary bypass, are reimbursed at 100%. Cancer patients are treated free of charge. Patients suffering from colon cancer, for instance, can receive Genentech Inc.'s Avastin without charge. In the U.S., a patient may pay $48,000 a year.****The cost of American company drugs is,doubtless, lower in France since American prices subsidize the research for the rest of the world.Also, the French do ration "...assessment of medical products is done by the Committee for the Evaluation of Medicines. Reimbursement rates are set by the National Union of Sickness Insurance Funds, a group that also negotiates pay to doctors..."**** France particularly excels in prenatal and early childhood care. Since 1945 the country has built a widespread network of thousands of health-care facilities, called Protection Maternelle et Infantile (PMI), to ensure that every mother and child in the country receives basic preventive care. Children are evaluated by a team of private-practice pediatricians, nurses, midwives, psychologists, and social workers. When parents fail to bring their children in for regular checkups, social workers are dispatched to the family home.****This degree of coercion might get attention in the U.S. from the ACLU (but one never knows how they will come down on a particular issue.)****...PMI and other such programs are starting to get attention in U.S. health-care circles...."It's based on the practical idea that high-quality investments made at the start of a child's life will pay huge dividends to both the child and society in the future."
...France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don't have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their American counterparts earn. ...the French government pays two-thirds of the social security tax for most French physicians—a tax that's typically 40% of income.
Specialists who have spent at least four years practicing in a hospital are free to charge what they want, and some charge upwards of $675 for a single consultation. But ... "There is an unspoken and undefined limit to what you can charge,"...Many French doctors, in fact, earn more by increasing their patient load, or by prescribing more diagnostic tests and procedures—a technique, also popular in the U.S., that inflates health-care costs. So far France has been able to hold down the burden on patients through a combination of price controls and increased government spending,...higher taxes for both employers and workers. In 1990, 7% of health-care expenditures were financed out of general revenue taxes, and the rest came from mandatory payroll taxes. By 2003, the general revenue figure had grown to 40%, and it's still not enough. The French national insurance system has been running constant deficits...and has ballooned...why France is gearing up to make changes. It already requires patients to register with a general practitioner before visiting a specialist, or else agree to a lesser reimbursement...
The malpractice of medical malpractice: the Achilles Heel of the American system
http://tinyurl.com/mt96ok
How Other Countries Judge Malpractice The health-care systems Democrats want to emulate don't allow contingency fees or large jury awards. By RICHARD A. EPSTEIN
...President Barack Obama held out the tantalizing possibility of reforming medical malpractice law as part of a comprehensive overhaul of the U.S. health-care system. As usual, he hedged his bets by declining to endorse the only medical malpractice reform with real bite -- a national cap on damages for pain and suffering, such as the ones enacted in more than 30 states.These caps are usually set between $250,000 to $500,000, and they can make a substantial difference. Other reforms, such as rules that limit contingency fees, shorten statutes of limitation, or confine each defendant's tort exposure to his proportionate share of the harm, have small and uncertain effects.Medical malpractice, of course, is not just an American issue. And now that the U.S. is considering universal health-care systems similar to those found elsewhere, it's worth a quick peek at their medical malpractice systems -- which usually attract far less controversy, and are far less expensive, than our own.
Litigation in the U.S. has at least four distinctive procedural features that drive up malpractice costs. ...jury trials...the contingency-fee system....the rule that makes each side bear its own costs....The fourth is extensive pretrial discovery outside the direct supervision of judges...American judges frequently let juries decide whether honest mistakes are negligent. ...American courts commonly think it proper for juries to infer medical negligence from the mere occurrence of a serious injury. European judges usually will not...plaintiffs are sometimes spared the heavy burden of identifying particular acts of negligence, or of showing the precise causal connection between a negligent act and an actual injury....damage awards for lost income and medical expenses in the U.S. tend to dwarf awards made elsewhere -- ...the medical malpractice system provides incentives for plaintiffs that really do matter. Americans, for example, file claims about 3.5 times more often than Canadians.
...there are major variations in medical malpractice rules in different American states,...within states,...between juries...What is needed is the replacement of juries with specialized commissions like those in France,...the ability of our system to deter medical injuries and compensate its victims? Not much that's encouraging....the administrative expenses of the malpractice system were "exorbitant." ...errors in jury verdicts in about a quarter of the litigated cases. ...denied compensation properly due in 16%...awarded it about 10% of the time when it was unwarranted. These error rates don't include damage awards set at improper levels. (A study)...concluded that the frequency of medical malpractice in Canada was about the same as in the U.S. -- for about 10% the total cost....On medical malpractice at least, Canada does better than we do.
... medical malpractice premiums constitute well under 1% of the total U.S. health-care bill. But defensive medicine adds perhaps as much as 10%. ...malpractice costs can shut down clinics that serve vulnerable populations, leading to more patient harm than the occasional case of malpractice.
The best reform would be to allow physicians, hospitals and patients to contract out of the liability mess by letting the parties reject state-imposed malpractice rules. They could, for example, choose to arbitrate, to waive jury trials, or to limit damage recovery. Stiff competition and the need to maintain reputation should keep medical providers in line in such a system. Market-based solutions that make the private sector more responsive should in turn undermine the case for moving head-first into a government-run health-care system with vast, unintended inefficiencies of its own. Mr. Epstein is a professor of law at the University of Chicago, a senior fellow at the Hoover Institution, and a visiting professor at NYU Law School.