FRENCH HEALTH CARE SYSTEM

Article on the French health care system: "A Conservative Convert to Socialized Medicine" by David Burgess. Originally published in the International Herald Tribune, 9 March 2001.

NPR Interview
To Download a Recording of the Interview, Please Click Here: NPR Interview

Medicine has made tremendous strides in the past century in treating disease. But in fact, the reason people are healthier today than they were a hundred years ago has less to do with medical advances than it does with better nutrition, safer housing, cleaner water, and immunizations... all improvements in what's called public health. And nowhere is the impact of public health clearer than among children. America suffers one of the highest rates of infant mortality in the developed world; while in France, public investment in the health of children has resulted in some of the world's healthiest kids. Frank Browning has this report. (12:30)

I. HEALTH SYSTEM AND POLICY OVERVIEW

      A. JOURNAL ARTICLES

  • Canone, François, and Jean Claude Guyot. "Health Policy in France: A Major Issue in the 1978 Legislative Elections." International Journal of Health Services8, no. 3 (1978): 509-518.
  • Durieux, Pierre, Carine Chaix-Couturier, Isabelle Durand-Zaleski and Philippe Ravaud. "From Clinical Recommendations to Mandatory Practice: The Introduction of Regulatory Practice Guidelines in the French Healthcare System."
  • International Journal of Technology Assessment in Health Care, 16:4 (2000), 969-975.
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  • Fielding, J. E., and P. J. Lancry. "Lessons From France--'Vive La Difference'. The French Health Care System and US Health System Reform." JAMA 270, no. 6 (1993): 748-56.
  • Glaser, W. A. "Doctors and Public Authorities: The Trend Toward Collaboration."Journal of Health Politics, Policy & Law 19, no. 4 (1994): 705-27.
  • Godt, P. J. "Confrontation, Consent, and Corporatism: State Strategies and The Medical Profession In France, Great Britain, and West Germany." Journal of Health Politics, Policy & Law 12, no. 3 (1987): 459-80.
  • Le Pen, Claude. "Drug Pricing and Reimbursement in France: Towards a New Model?" Pharmacoeconomics 10, no. 2 (1996): 1-11.
  • Lancry, Pierre-Jean and Simone Sandier. "Recent Changes in the Financing and Provision of Medical Services in France," Eurohealth. 43(3), (1998): 37-39.
  • Nair, C., and R. Karim. "An Overview of Health Care Systems: Canada and Selected OECD Countries." Health Reports 5, no. 3 (1993): 259-79.
  • Nestle, Marion. "Diet and Alcohol in Heart Disease Risk: The French Paradox."Contemporary Drug Problems, Spring (1994): 71-80.
  • Porter, A. M., and J. M. Porter. "Anglo-French Contrasts In Medical Practice."British Medical Journal 280, no. 6222 (1980): 1109-12.
  • Poullier, Jean-Pierre and Simone Sander. "France." Journal of Health Politics, Policy and Law, Vol. 25. No. 5, October 2000: 899-905.
  • Poullier, Jean-Pierre and Simone Sander. "Rationing Health Care in France."Health Policy. 50(1-2), (1999): 23-38.
  • Rodwin, V. G. "The Marriage Of National Health Insurance and la Medecine Libérale In France: A Costly Union." Milbank Memorial Fund Quarterly - Health & Society 59, no. 1 (1981): 16-43.
  • Rodwin, V. G. "On The Separation Of Health Planning and Provider Reimbursement: The U.S. and France." Inquiry 18, no. 2 (1981): 139-50.
  • Rodwin, V. G. "Medical Care and the State. Review Essay." Journal of Health Politics, Policy & Law 17, no. 2 (1992): 375-84.
  • Rodwin, V. G., H. Grable, and G. Thiel. "Updating The Fee Schedule For Physician Reimbursement: A Comparative Analysis Of France, Germany, Canada, and The United States." Quality Assurance & Utilization Review 5, no. 1 (1990): 16-24.
  • Rodwin, V. G., and S. Sandier. "Health Care Under French National Health Insurance." Health Affairs 12, no. 3 (1993): 111-31.
  • Sorum, P. C. "Striking Against Managed Care: The Last Gasp of la Médecine Libérale?" JAMA 280, no. 7 (1998): 659-64.
  • Sorum, P. C. "Two Tiers Of Physicians in France: General Pediatrics Declines, General Practice Rises." JAMA 280, no. 12 (1998): 1099-101.
  • Weill, Caroline. "Minimally Invasive Therapy: The French Case Study." Health Policy 23 (1993): 31-47.
  • Wilsford, D. "The Cohesion and Fragmentation of Organized Medicine, In France and The United States." Journal of Health Politics, Policy & Law 12, no. 3 (1987): 481-503.
  • Wilsford, D. "States Facing Interests: Struggles Over Health Care Policy In Advanced, Industrial Democracies." Journal of Health Politics, Policy & Law 20, no. 3 (1995): 571-613.
  • Wright, A. F. "Primary Medical Care in France." Journal of the Royal College of General Practitioners 25, no. 158 (1975): 664-9.

      B. BOOKS AND BOOK CHAPTERS

  • Couffinhal, Agnes. "The French Health Care System: Inconsistent Regulation." InHealth Policy Reform, National Variations and Globalization, ed. Christa Altenstetter and James Warner Bj?rkman, 59-78. New York: Macmillan; St. Martin's Press, 1997.
  • The French Mutualité and Social Welfare in France. Paris: La Fédération Nationale de la Mutualité Franäaise.
  • Lachaud, Claire, and Lise Rochaix. "France." In Equity in the Finance and Delivery of Health Care, ed. Eddy Van Doorslaer, Adam Wagstaff, and Frans Rutten. Oxford: Oxford University Press, 1993.
  • Lassey, Marie E., William R. Lassey, and Martin J. Jinks. "France: Centrally Controlled and Locally Managed." In Health Care Systems Around the World, 151-171. Upper Saddle River, New Jersey: Prentice Hall, 1997.
  • The Reform of Health Care: A Comparative Analysis of Seven OECD Countries. Paris: Organization for Economic Co-operation and Development, 1992.
  • Payer, Lynn. Medicine & Culture: Varieties Of Treatment In The United States, England, West Germany, and France. First Owl Books ed. New York: Henry Holt and Company, 1996.
  • Pomey, Marie-Pascal, and Jean Pierre Poullier. "France." In Health Care and Reform in Industrialized Countries, ed. Raffel Marshall W, 49-68. University Park, Pennsylvania: The Pennsylvania State University Press, 1997.
  • Powell, Francis D., and Albert F. Wessen. Health Care Systems In Transition: An International Perspective. Thousand Oaks: Sage Publications, 1999.
  • Rodwin, Victor. The Rise of Managed Care in the United States: Lessons for French Health Policy." In Health Policy Reform, National Variations and Globalization, ed. Christa Altenstetter and James Warner Bj?rkman, 39-58. New York: Macmillan ; St. Martin's Press, 1997.
  • Rodwin, V., C. Brecher, D. Jolly, and R. Baxter, eds. Public Hospital Systems in New York and Paris. New York and London: New York University Press, 1992.
  • Wilsford, David. Doctors and The State: The Politics Of Health Care In France And The United States. Durham: Duke University Press, 1991.

 II. SERIES OF ARTICLES IN BRITISH MEDICAL JOURNAL

  • Dorozynski, A. "France Emphasizes Teaching of General Practice [news]." British Medical Journal 309, no. 6961 (1994): 1038.
  • Dorozynski, A. "Foreign Doctors Strike Over New French Law [news]." British Medical Journal 311, no. 7015 (1995): 1248-9.
  • Dorozynski, A. "France Faces Radical Health Insurance Reforms [news]." British Medical Journal 311, no. 7017 (1995): 1386.
  • Dorozynski, A. "France Gears Up To Fight Health Insurance Debts [news]."British Medical Journal 311, no. 7011 (1995): 967-8.
  • Dorozynski, A. "French Doctors Protest Over Health and Welfare Reforms [news]." British Medical Journal 311, no. 7019 (1995): 1521.
  • Dorozynski, A. "France Votes For Health Reform [news]." British Medical Journal313, no. 7067 (1996): 1224.
  • Dorozynski, A. "French Doctors May Strike Against Reforms [news]." British Medical Journal 312, no. 7037 (1996): 993.
  • Dorozynski, A. "French Parliament To Control Health Costs [news]." British Medical Journal 312, no. 7030 (1996): 527-8.
  • Dorozynski, A. "New Battle Looms For France Over Health Reforms [news]."British Medical Journal 312, no. 7022 (1996): 9.
  • Dorozynski, A. "France Abandons Fines To Control Health Costs [news]." British Medical Journal 318, no. 7176 (1999): 76.
  • Dorozynski, A. "French Health Staff Strike Over Budget Cuts [news]." British Medical Journal 320, no. 7231 (2000): 333.

III. CHILD HEALTH

  • "Infant Mortality Rates in Four Cities: London, Manhattan, Paris, and Tokyo," (with Leland G. Neuberg) Indicators - The Journal of Social Health, Winter 2002-03, Vol. 02 No. 01
  • Howell, E. M., and P. Vert. "Neonatal Intensive Care and Birth Weight-Specific Perinatal Mortality in Michigan and Lorraine [see comments]." Pediatrics 91, no. 2 (1993): 464-9.
  • Knaus, W. A., J. R. Le Gall, D. P. Wagner, E. A. Draper, P. Loirat, R. A. Campos, D. J. Cullen, M. K. Kohles, P. Glaser, C. Granthil, P. Mercier, F. Nicolas, P. Nikki, B. Shin, J. V. Snyder, F. Wattel, and J. E. Zimmerman. "A Comparison of Intensive Care In The U.S.A. and France." Lancet 2, no. 8299 (1982): 642-6.
  • Mascarenhas, L., B. W. Eliot, and I. Z. Mackenzie. "A Comparison Of Perinatal Outcome, Antenatal and Intrapartum Care Between England and Wales, and France [see comments]." British Journal of Obstetrics & Gynecology 99, no. 12 (1992): 955-8.
  • Papiernik, E. "20 Years of Perinatal Medicine in France: Successes and Failures [editorial]." Fetal Diagnosis & Therapy 7, no. 3-4 (1992): 169-72.
  • Papiernik, E., and L. G. Keith. The Regionalization of Perinatal Care in France--description of a missing policy." European Journal of Obstetrics, Gynecology, & Reproductive Biology 61, no. 2 (1995): 99-103.
  • Sachs, B. P., R. C. Fretts, R. Gardner, S. Hellerstein, N. S. Wampler, and P. H. Wise. "The Impact of Extreme Prematurity and Congenital Anomalies on the Interpretation of International Comparisons of Infant Mortality [see comments]."Obstetrics & Gynecology 85, no. 6 (1995): 941-6.
  • Sepkowitz, S. "International Statistics--Incomparable [letter; comment]."Pediatrics 92, no. 4 (1993): 637.
  • Zeitlin, J., E. Combier, F. De Caunes, and E. Papiernik. "Socio-Demographic Risk Factors for Perinatal Mortality. A Study of Perinatal Mortality in the French District of Seine-Saint-Denis." Acta Obstetricia et Gynecologica Scandinavica 77, no. 8 (1998): 826-35.

IV. WEB SITES ON THE FRENCH HEALTH

  • OECD

    http://www.oecd.org/

    The OECD issues a great number of reports, working papers and publications related to its operational and statistical work. A part of this work can be downloaded from the Web site. Books and electronic products can be purchased from the OECD Online Bookshop. The site can be read both in English and French. It is searchable and references to France and French health care system can be found.
  • BANQUE DE DONNEES SANTE PUBLIQUE
  • http://www.bdsp.tm.fr/

    The BDSP has a searchable central database of publications on health care since 1980. Although the website is in French, you can search the bibliographic database in both French and English. A paid subscription is necessary to access the articles.
  • CENTRE DE RECHERCHE EN GERONTOLOGIE ET GERIATRIE
  • http://cdrv.csss-iugs.ca/
  • CREDES: CENTRE DE RECHERCHE D'ETUDES ET DE DOCUMENTATION EN ECONOMIE DE LA SANTE
  • http://www.credes.fr/

    This is a French only site that provides various data and analysis on the French health care system.
  • INSTITUT NATIONAL DE LA STATISTIQUE ET DES ETUDES ECONOMIQUES (INSEE)
  • http://www.insee.fr/fr/home/home_page.asp

    INSEE collects and produces information on the French economy and society. There is a small subsection on health that provides access to a small selection of articles on French health care and some data. It is the process of being translated and thus will be available in both English and French shortly.
  • SYNDICAT NATIONAL DE L'INDUSTRIE PHARMACEUTIQUE
  • http://www.snip.fr/
  • SECRETARIA D'ETAT A LA SANTE ET A L'ACTION SOCIALE
  • http://www.sante.fr/

    This site is run by the Direction Generale de Sante (DGS). It includes several agencies including: the state secretariat on health, AFFSAPS, the French Blood Agency and others.
  • INED: INSTITUT NATIONAL D'ETUDES DEMOGRAPHIQUES
  • http://www.ined.fr/

    Provides information in demography and in the related disciplines of sociology, economics, family anthropology, history, geography, public health, and current population movements.
  • IFEN: INSTITUT FRAN?AIS DE L'ENVIRONNEMENT
  • http://www.ifen.fr/

    This site offers statistical information on environmental issues.
  • INSERM: L'INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICAL
  • http://www.english.inserm.fr/

    The French National Institute for Health and Medical Research is a public scientific and technological organization. It is overseen jointly by the French Ministries of Research and Health.
  • STATISS 1998
  • http://www.sante.gouv.fr/drees/statiss/frames/fr75.htm

    This site offers demographic and other statistic for specific departments in France.
  • THE NATIONAL INSTITUTE FOR PUBLIC HEALTH SURVEILLANCE
  • http://www.invs.sante.fr/

    This site offers on-line publications on AIDS, pollution, tuberculosis, disease surveillance, and weekly electronic epidemiological bulletins.
  • CESES: CENTRE EUROPEEN POUR LA SURVEILLANCE EPIDEMIOLOGIQUE DUSIDA
  • http://www.ceses.org/

    This site provides data on communicable diseases, HIV/AIDS, and tuberculosis in European countries.
  • WORLD BANK
  • http://www.unaids.org

    This site provides economic data (GDP, etc.)
  • UN
  • http://www.un.org

    Provides various statistics on different countries.
  • INTERNATIONAL MONETARY FUND
  • http://www.imf.org/

    This site offers various economic countries by country.
  • FONDATION NATIONALE DE GERONTOLOGIE
  • http://www.cnav.fr

    This site provides information on the rights of older persons. Also provides a bibliography.
  • LA RETRAITE DE BASE DES SALARIES
  • http://www.gerontos.com

    This site offers information on retirement and retirement related issues.
  • WORLD HEALTH REPORT 2000 : WORLD HEALTH SYSTEMS
  • http://www.who.int/whr

    The World Health Organization's annual World Health Report, which is the first-ever comparative study of its 191 member states' health care systems. The Associated Press describes the report as a "highly contentious first attempt to compare the world's healths systems." The report ranks countries on how effectively governments spend money on health care, how they prevent illness and how fairly the poor, minorities and other special populations are treated.