Before You Move to France, or Even Cuba

by Pearl Hahn


Yes, it’s true that the United States is one of the few industrialized nations in the world that does not have some form of nationalized health care.  Thank your lucky stars.

If you move to France, you would be moving to a country whose health care system has been ranked number one by the World Health Organization. You would also be paying close to 20 percent of your income for health insurance.  Despite this sacrifice, as of 2006, the French system was running at a 10.3 billion (in euros) deficit. This shortfall has been the single largest driver of France’s national deficit, which has grown to 2.5 percent of its GDP.

On top of paying nearly 20 percent for health insurance, you would also have to contribute a copayment between 10 and 40 percent for most services. This comes out to about 13 percent of health care costs paid out-of-pocket, which is no different than the percentage U.S. consumers pay out-of-pocket.

The burden of government-imposed cost containment has fallen onto the shoulders of French physicians. The average income of a French physician is around $55,000 a year. The average income of a U.S. physician is roughly three times that amount, and more than that for specialists. Yet, even with this low salary, French physicians are facing threats of lower reimbursement rates to save on costs. This has led to strikes and protests.

Meanwhile, our sanctioned neighbor, Cuba, also boasts a nationalized health care system. Many hail Cuba’s low infant mortality rate, among the lowest in the world and lower than that of the United States.

This hardly signals a superior health care system. Few measures are as misleading as the infant mortality rate (IMR).

In calculating its IMR, Cuba (in addition to several other countries) leaves out both infants that are born dead and premature infants, a group that experiences a high percentage of fatalities. In fact, Cuba waits to register infants until they are several months old, neglecting to record infant births following the first months of life.

How’s that for skewed statistics?

Meanwhile, the United States records the mortality rate for both infants born dead and premature infants. The U.S. has among the most intensive systems of emergency procedures to save infants plagued by a variety of conditions ranging from low birth weight and respiratory distress to congenital malformations and hemorrhages.

The U.S. records the survival rate of infants who are born as early as the 20th week of gestation. Yet in Cuba, such infants rarely stand a chance of survival and are not even recorded.

The next World Health Organization ranking of infant mortality rates should include each country’s definition and method of calculation. Without such information, people continue to run the risk of comparing apples and oranges.

Pearl can be reached at pearl@grassrootinstitute.org



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