Health care from the US to France: An introduction

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From the first moment of starting to compare between the two health care systems of the United States and France, a reasonable researcher would find that extremely unfair.

The population of the United States is about 302 million whereas that of France is approximately 62 (1). Nevertheless, when a health care system starts to prevail, one has the duty to know how the advantages provided by the French were reached and how every other country can learn from that difference.

One of the funniest comments I heard from people who visited Paris last month was the comment that people in Paris are very tense because they spend roughly 20% of their income in advance for future health care. But in return, their health care system was given a descriptive term called "Liberal Universalism".

Liberal because patients get to choose their own health care providers.
Universalism because every one on the land of France is covered under the umbrella of health services, that is, health care coverage is 100%.

Another funny but aggressive comment assay that may be because France does not have for-profit insurance companies, the French government actually wants you to stay healthy and live a very nice life. Where as in the US, insurance companies are in the business of making money, and your health and best interests are put on the back burner (2).

In 2000, health care experts from the World Health Organization tried to do a statistical ranking of the world's health care systems. They studied 191 countries and ranked them based on the number of years people lived in good health and whether everyone had access to good health care. France stood out in first place. The United States ranked the 37th.

However, some researchers said that study was unfair, arguing that there might be metrics other than the country's health care system that determined factors like longevity. So in 2008, two researchers at the London School of Hygiene and Tropical Medicine measured something called the "amenable mortality." Basically, it's a measure of deaths that could have been prevented with good health care. The researchers looked at health care in 19 industrialized nations. Again, France came in first. The United States was last (3).

Data collected over time as well as international comparisons reveal common trends between the two countries. Birth rates have fallen, and life expectancies have increased so that old people made up an increasing segment of total populations. In the United States, life expectancy at birth is estimated to be about 78% whereas it is 80% for France. Infant and maternal mortalities, the international indicators of social and health care improvement, have continued to decline in the United States but haven't reached the more appreciated levels of countries with more demographically homogenous populations like France. Some researchers claim that the American health system has some ambiguous priorities that allow discrepancies in infant mortality rates between inner city and suburban neighborhoods, that are more pronounced even than in those between some developed and developing countries (4).

My Next Topic : Healthcare from the US to France: Money talks a lot

Suggested Reading


(1). Organization for Economic Development and Cooperation, the Commonwealth Fund and the Henry J. Kaiser Family Foundation. Most data from 2005, the latest available. More recent data used, when available.

(2). Steffen M., 2010. Journal of Health Politics, Policy and Law, Vol. 35, No. 3, June 2010 DOI 10.1215/03616878-2010-003 (c) 2010 by Duke University Press

(3). Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France. Copyright 2007 by Paul V. Dutton.

(4). U.S. Bureau of the Census. Facts about Aging. Available from Accessed August 2012.


About the Author

Dr Amr Ebied's picture
Author: Dr Amr Ebied


A.R.Khan's picture

Thanks Dr Amr Ebied for throwing light on important topic. I have lot of friends in USA working in health care and have mixed opinions . They say they are happy personally (pay is good , of course stress is more) but they don't like the system when it comes to personal health care needs as it is damn expensive . :-) Looking forward to read your money talks blog
Dr Amr Ebied's picture

Hi Khan, I am really delighted that my opening blog post has gained your attention. I have been through an introductory class to the US healthcare system this summer semester. The most common feature about that class was the ambiguity with which things are run between the providers of health services, or the hospitals, and the payers of the service, or the insurance companies. It is like a hidden contract whereby hospitals try to be appealing to insurance companies, by providing better ratios, performance metrics and more services, while insurance companies try to use that to guide beneficiaries ( patients ) to use the service. As I am going to show in future posts, the major problems of any health care system world wide are actually problems of cost, access, and quality of care. By cost we mean the amount of money that is paid for the service given, whereas access means how much of the population is covered by the health care service, and of course quality is how the service is done effectively and efficiently to the patient. Countries differ as regards the magnitude with which they have gone to solve these problems. If you're not that good, you may create a problem of cost while you're solving a problem of access. The United states have gone a long way through this, and although there are still huge problems to solve but the bottom line is that much has been done by the US government in trying to patch defects in the system. Comparisons done between the US health care system and that of France are really very numerous, and are very hard to cover in just a few blogs, so I'm trying to highlight a few points to gain the attention of our interested readers. Over the rest of the blogs, I will be highlighting a few more differences between the two health care systems as regards financing, coverage, hospitals and physician charges. I hope you gain some useful knowledge from the rest of the articles, and thanks for your comment.


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