Indeed, a May 15 study from the Commonwealth Fund study
comparing the quality of the U.S. system with five other countries found that
despite spending twice as much per capita, the U.S. ranks last or near last on
basic performance measures of quality, access, efficiency, equity, and healthy
lives.


“The U.S. stands out as the only nation in these studies that does not
ensure access to health care through universal coverage,” says Commonwealth Fund
President Karen Davis. Gazing across the Atlantic won’t lead Americans to a model that fits everyone’s requirements. Britain, in particular, suffers myriad problems in its National Health Service (NHS).


But in some respects, France comes pretty close to the ideal. Not only are its 62 million citizens healthier than the U.S. population, but per capita spending on health care is also roughly half as much.

France relies on a mixture of public and private funding, as does the U.S.

But unlike Americans, every French citizen has access to basic health-care coverage through national insurance funds, to which both employers and employees contribute. Some 90% of the population also buys supplementary private insurance to provide benefits that aren’t covered, and the government picks up the tab for those out of work who cannot gain coverage through a family member.

“We pay higher taxes in France, but at least we get something for our money,”



says Leslie Charbonnel, an American who has lived in Paris for two decades. The key to France’s success is that its system, like the U.S.’s, values patient choice and physician control over medical decision-making. But France does it for far less, with per capita health-care spending in 2004 at just $3,500, compared with $6,100 in the U.S., according to the World Health Organization. All told, France spends 10.7% of gross domestic product on health care, vs. 16.5% in the U.S

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