Public Health Systems in France, Italy Contain Costs Better than American System

Health care options in France and Italy "offer a stark contrast to those in America," most notably, "freedom from uncertainty," the Los Angeles Times/Baltimore Sun reports. In many Western European countries, people "don't have to worry about being deprived of essential health services ... because they can't afford them" or might be "ruined financially" if their insurer will not cover a particular treatment or will pay only part of the cost, the Times/Sun reports. A recent 191-country survey by the World Health Organization ranked France first and Italy second in providing "effective" health care. In comparison, the survey ranked the United States 37th. After World War II, France instituted its state-run insurance system, which now covers everyone at no cost. French residents ages 60 and older can receive medical care in nursing homes at state expense, and both "young and old alike" are fully covered for conditions considered "recurring and costly." Italy's National Health Service, fully financed through general taxes, offers full coverage for about 3,000 prescription drugs such as blood pressure medications and chemotherapy, while patients pay about 50% of the cost for a "second category" of 38 drugs, including those for stomach disorders and aching joints. Both countries fix prices for cost of care and reimbursement. Total public and private contributions for care and insurance cost $1,857 per French resident and $1,357 per Italian. According to 1998 figures, the average American spends $4,178 per year on medical care. Although the French and Italian systems are able to contain costs and provide care for many individuals, many French and Italians "would be the first to admit that their health care systems are far from perfect," the Times/Sun reports. Common "gripes" include high taxes, "slow-moving bureaucracies," red tape and "delays and inequalities." Italians, for example, pay 38 cents for every dollar the state spends to receive some kinds of private specialized care that are more prompt or reliable. Still, the Times/Sun reports that the "public system provides better care to those most in need -- expectant mothers, the elderly and people with life-threatening ailments" (Dahlburg/Boudreaux, Los Angeles Times/Baltimore Sun, 11/11).