Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 111

France, ranked as having the tenth best health care system in the world, spends 11.3% of its GDP on health care Papanicolas, (2018). This is almost one‐half of what the United States spends on health care per person. Comprehensive health care is guaranteed for all citizens and legal residents in France. Similar to the United States, health care in France is provided through private and government insurance. Unlike Canada and Britain, there are no lengthy wait times in France. Unlike the United States, everyone is insured in France, and there are no additional patient charges for health insurance plan deductibles (Shapiro, 2008). Employed residents are covered by a national health insurance plan, referred to as Sécurité sociale, which includes spouses and children. Another plan, couverture maladie universelle (CMU), provides coverage for those people who do not qualify for the sécurité sociale program, and is free to some people whose income is below a certain level. The national health insurance plan is funded through private and public means, with employees paying up to 21% of their incomes to the national health care system and employers making similar contributions. By comparison, Americans pay fewer taxes but pay more for health care (e.g., through paying health insurance premiums and other out‐of‐pocket expenses not covered by their insurance plans). In France, costs are dependent upon the type of provider seen; for example, a general practitioner is less expensive than a specialist. Likewise, it is more expensive to seek treatment at night, on the weekend, or on public holidays. Hospital care is reimbursed through the national health plan, and a percentage of the cost of prescription drugs is also reimbursed to the patient. Essentially, the sicker a person is, the more coverage is allowed, including for expensive drugs and experimental cancer treatments. Reducing cost and improving efficiency are the challenges for this system. Waste, such as doctor shopping, whereby a patient seeks treatment from more than one health care provider for the same ailment, and overuse of prescription drugs, are partly responsible for high health care costs in France (National Coalition on Health Care (NCHC), 2008; Shapiro, 2008).