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France's next president

Faces tough decisions on health
Whoever wins France's presidential election in May will have to tackle some difficult problems in the country's efficient but hugely expensive health system. Kim Willsher reports from Paris. link

In a drop-in clinic in a raggle-taggle area of north Paris, half a dozen mothers are waiting to have their babies weighed and measured or their toddlers vaccinated. The large, bright waiting room is decorated with drawings and colourful posters and filled with toys being energetically employed by a group of infants. A doctor is doing health checks and jabs, while other staff are on hand to give advice and support to mothers who feel isolated or depressed or simply need help with the multitude of anxieties facing new parents. Many of the women they see are poor; some are immigrants with a tenuous grasp of French; others are middle-class parents seeking reassurance. All get the same consideration and care, and the treatment is free.

The French maternal and child protection system, known as PMI, began in 1945 with the principal aim of ensuring each child, whatever their social background, was given as healthy a start in life as possible. Today it is just one of the many pieces of the jigsaw that is the French health system; a system consistently declared one of the best and most generous in the world.

It is a system that has helped give the French life expectancy of an average of 81 years, infant mortality rates of 3,9 per 1000 livebirths, and 3,3 doctors per 1000 population, according to the latest figures available from the Organisation for Economic Cooperation and Development (OECD). It is, however, hugely expensive. Now doomsayers warn that unless France gets to grips with runaway health spending it is heading for disaster.

Philippe Even, an adviser to the French health ministry, and president of the Institute Necker, a Paris-based think tank and funding institute tied to the Necker Medical School is a fierce critic of the French health system that he describes as “exorbitantly expensive and utterly wasteful”, and requiring structural reform.

His diagnosis is damning: hospitals do too many unnecessary operations, procedures, scans, and tests; doctors prescribe too many inefficient or useless at best, dangerous at worst, drugs; and the system is heading for a catastrophe.

“Studies have shown that 30% of operations in French hospitals serve no purpose whatsoever, people stay in hospital far too long, and there is a gulf between the prevalence of high-tech equipment and the availability of personnel qualified to use it. Doctors are also performing unnecessary tests to cover everything…because they fear being sued”, Even told The Lancet.

France spends 11,8% of its GDP on health, the third highest in the world behind the USA and the Netherlands, which adds up to US$3978 (around €2985) per person, according to the OECD. With the onset of the global economic crisis, pressure was already on the French authorities to wrestle with public spending to get its budget deficit back on track. Today with the loss of the country's AAA credit rating, and with the state health fund, the Assurance Maladie, €14,5 billion in the red, the need for belt-tightening has become even more imperative. Although everybody agrees the French health system cannot go on living beyond its means, nobody has come up with a magic solution to cut costs without also hampering the quality and depth of services.
Kim Willsher , Lancet, 20.04.12



Blogger e-pá! said...

"...nobody has come up with a magic solution to cut costs without also hampering the quality and depth of services."

Só foi possível produzir esta asserção porque o articulista não conhece os 'artistas' da João Crisóstomo onde, a cada corte nos custos corresponde, no mínimo, a 'garantia' da manutenção da qualidade (das prestações), quando não, à sua melhoria...

Este será um novo 'produto nacional' - a mistificação dos resultados - que poderá ser direccionado para a exportação, p. exº., na 'mágica' arte de bem fazer (ou tentar vender) omoletes sem ovos...

9:17 da manhã  

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