Un regard vers l'avenir

Yesterday's post about health care in Quebec must have been written in the stars, for the New York Times's great Paul Krugman weighed in on U.S. health care today, sparking comments from Kevin Drum, Kash and more. In short, the French system is the envy of the world - and yet it costs about $200 less per person that ours. So what gives? Could it be that the French are just much better organized at delivering decent medical care than us Canadians? Is it a population density issue? Is our crisis more of the manufactured kind? Could things actually be better than we are certain they are?

Not that the French have got it down to a perfect science. It seems that a system that encourages consumption causes, well, overconsumption - of pills and doctor visits. And, like any big government program, French health care is probably bloated and somewhat unaccountable. This primer on couverture maladie comes to the rescue of La France, highlighting the effectiveness of its blatant two-tier system. Les Français are entitled to visit public physicians and hopsitals, or pay a premium for private care. Though the system enables, and is saddled with, doctor-shopping, one assumes a small copay ($10 per visit?) would nudge patients to pick a doctor and end the browsing.

French doctors, I might add, don't appear to be unhappy with their wages and their substantial degree of professional freedom (I don't know how many would want to be stationed in Kujuuaq at the start of their careers). I can't imagine they're any worse off than my med-school friends will be in about ten years when they start to earn a living. Right now, they routinely work insane 28-hour shifts, somehow doing a little bit of learning while miraculously not butchering some straightforward procedure. In a year's time, they'll be shipped off to the far reaches of our country on an almost purely random basis.

The price of all this, though taking its toll on the country's budget, seems to be worth it to the French. I defy anyone to show me a poll saying only one in five Canadians are dissatisfied with medicare as we know it.

Yesterday's lesson was that adequate health care coverage is a fundamental human right in the developed world. Caring for each other noursihes the fundamental sensibility of our collective identity. Today's lesson, I suppose, is that it can be done.