Health care reform is on everyone’s mind these days. New proposals  are coming from the Senate and from the House. President Obama has made  reform a priority. Universality of access to health insurance is the most pressing issue. Universal health care simply means coverage for all eligible residents of a political area. The United States is the only industrialized country that has not implemented a universal system for citizens under age 65. Universal health care can be implemented in several ways. In some countries the government directly manages the health care system. This is usually called socialized medicine. In most countries universal coverage is achieved by a mix of public and private funding. Taxation is the primary source of funding but is supplemented by private payor arrangements.

In 2000 the World Health Organization (WHO) produced a report which ranked all the health insurance systems used by its member countries. The is the report usually quoted when discussing both the good and bad features of a health insurance system. It should be noted that the WHO has indicated it will no longer produce a ranking table because of the complexity of the task. The criteria for ranking the health care systems was based on a wide variety of findings, including but not limited to, life expectancy, infant mortality and cost. Many people know that the United States ranked 37th out of 198 countries and that Canada ranked 30th. But do you know what the top 10 best health care system in the world are? » Read more: What Are the Best Health Care Systems in the World?

How did the French manage to achieve a system that has the advantages that American love but still gives everyone coverage? The French legislature realized that they would need the cooperation of 2 groups if they were to get the kind of national health insurance they wanted. First they needed the doctors; second they needed the private insurance companies. French doctors only agreed to participate in a compulsory health insurance program only if

• A patient’s free choice of their doctors was protected by law
• Doctor’s maintained control over medical decisions

Next the French legislators overcame insurance industry resistance by permitting the nation’s already existing insurers to administer its new healthcare funds. France’s comprehensive health insurance provides coverage for all or part of the following healthcare categories:

• Hospitalization
• Non-Hospitalization Benefits
• Prescription Drugs & Medical Equipment
• Medical Evacuation & Repatriation
• Dental & Optical Cover
• Emergency Healthcare is provided to everyone

But the Sécurité Sociale’s health insurance plan covers only about 70% of actual medical fees. The balance of the bill is paid for through private insurance called assurance complémentaire. Private health insurers are central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market. Working with these 2 groups, France developed a program of universal health care that demonstrates that it is possible to achieve universal coverage without a “single-payer” system. » Read more: The French Healthcare System is Universal

As the United States struggles toward a system of universal health care, many have looked at the Canadian health care system as a model. Only a few have looked toward France. That’s a mistake for at least 2 reasons.First, according to the World Health Organization (WHO), France has the best health care system in the world . It has been widely reported that the WHO found the French system to be number 1 while the Canadian system is number 30 and the U.S. number 37. It should be noted here that the WHO rankings actually contain multiple rankings and the numbers generally quoted are the ranking based on the measure that the WHO calls the OP ranking. OP is said to measure “overall performance” adjusted to reflect a country’s performance based on how well it theoretically could have performed. When reporting the rankings of 1 for France, 30 for Canada and 37 for the United States, it is the OP ranking being used.

Why did the French system do so well in the WHO rankings? The French system excels in 4 areas:

• It provides universal coverage
• It has responsive health care providers
• Patients have freedom of choice
• The health and longevity of the population

Second, we should be looking more closely at the French system because it has more similarities with the U.S. system than either the Canadian or British system. Many Americans assume that the French system is like the system in Britain. Nothing could be further from the truth or more insulting to the French. Exactly like the United States, the French system relies on both private insurance and government insurance. Also, just like in America, people generally get their insurance through their employer. What is different is that everyone in France has health insurance. Every legal resident of France has access to health care under the law of universal coverage called la Couverture maladie universelle. Under the French system, health insurance is a branch of Social Security or the Sécurité Sociale. The system is funded primarily by taxing the salaries of workers. An employee in France will pay about 20% of their salary to fund the Sécurité Sociale. These taxes represent about 60% of the cost of the health insurance plan. » Read more: France Has the Best Healthcare System in the World