U.S.-France Analysis

Health Care in France and the United States: Learning from Each Other

The health care systems of both France and the U.S. face crises of unprecedented scope. Both countries possess large and growing elderly populations that threaten to push the pace of health care price increases even higher than their already faster-than-inflation rates. Observers in both countries fear that outlays for increasingly expensive medical treatments and technologies will wreak havoc on public spending priorities. In the U.S, unchecked health care inflation will imperil Medicare and Medicaid, spur ever-larger federal budget deficits, and push up the embarrassingly large number of Americans without any medical insurance at all. In France, already insufficient resources have spurred strikes and demonstrations by doctors, while health care price hikes endanger that country's commitment to its European partners to maintain low budget deficits. A delinquent performance by France could place the entire project of European Monetary Union in peril.

Beyond these impending crises, American and French health care systems share several fundamental principles. Nonetheless, a World Health Organization report published in 2001 found that France has the best overall health care system among the 191 countries surveyed while the U.S. ranked 37th behind virtually all European countries as well as Morocco, Oman, and Costa Rica. Several factors explain the differences in the rankings of France and the United States. The most prominent factor was the large number of Americans whose access to care is limited because of their lack of health insurance—estimates range between 39 and 43 million. Despite this lack of coverage, America still spends far and away the most on its health care system at 13.7% of GDP while France spends 9.8%, placing it in the fourth position.

The WHO rankings, however, do not mean that the French system is unequivocally superior to the American. In fact, both systems could profit from an understanding of the other's strengths. Toward that end, this analysis paper compares the health care systems of both countries and assesses how they can learn from each other in order to deal with their impending health care crises.