But - what about Medical Care?

Somewhere in the distant past, I was fortunate to play Rugby on tour in a number of distant countries. As with only one or two physicians on the team (side), I often accompanied an injury or illness to the local clinic to help negotiate acute care. Often the local facility was challenged to say the least but not so in France. In fact, there I felt envious of the style and substance and I don’t think we were ever charged. We have been snobs about the standard of medical care in this country and with some reason, but it has always been expensive and not well distributed. Touring the Cardiac Surgery Center in Paris I was surprised to find it technically superior to our own at least in architecture.

My sense was that France advanced government supported medical care un-abashedly in competition with private care, no fear of a dual standard. The wealthy tended to stick with the private care while the majority soon migrated to the government system. The two systems were competitive. It was not long before the government system surpassed the private sector of medicine. What my teammates and I encountered while in France was immediate access to facilities, often in beautiful restored mansions with highly competent personnel, something that we could not expect even at home.

Today the EU is starting to phase out a temporary medical identification card, E111 which gives access to health care in most of the EU. A permanent card should facilitate workers migrating from one country to another for jobs. Some countries are slow to migrate to the new system notably England for reasons of cost and a concern about to easy access. The French have gone ahead however with their version of the European card. The CEAM-carte europeenne d’ assurance maladie is first free and is good anywhere in the EU. France is probably the only place in Europe where medical care is immediately available just by knocking on the door of the clinic.


In this country we have a strong bias against socialism in favor of “Liberte” while it seems, and this is just a feeling, the French embrace “Egality, Fraternity " and are accepting of a more socialistic order. Certainly, our wildly libertarian and competitive approach to business out produces other alternatives. When the excesses of this le se fair approach are applied to health care, something is lost in the application of fairness.

Attempts to achieve better affordable access to healthcare here have failed miserably. Rather than create an idealistic caring affordable system, we have brought forth and nurtured two monstrous monopolistic tyrants from the Industrial age, the Drug and Insurance cartels. In order to fix that mess we now enable the rest of big business to use their power to suppress health costs for their employees. The result is chaotic and still more expensive.

Our political solution to problems such as this involves the creation two radically differing political opinions, which are then cast as religious dogma. It is then rather easy for the Drug cartel and the Insurance cartel to play both sides against each another to the benefit of themselves. The Hospital Association and the Medical Association of course have a role to play as well, all resulting in no solution at all.

As Europe tries to develop their EHIC-European health insurance card they struggle with dissention delay and differing philosophies, while one state, has it together, that state’s card becomes sought after and eventually the standard. We might take a lesson from that example and promote comprehensive health state by state. The political climate in each state varies enough that innovative selection can come into play. Furthermore, the needs and demographics vary state by state. For instance, it may be easier to shake off the sarcophagus of insurance and drug company domination in remote western states far from insurance offices. The state medical schools have enormous academic and technical resources unfettered by Washington’s political gridlock. One might take a close look at France’s medical delivery system and ask why it looks better than ours does, and it still coexists with private care.