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US and French Health Care Systems Comparison


The US health care system is highly sophisticated (Holtz, 2008). However, it is ineffective in meeting the health care needs of the American population. To understand the problems of the US health care system, this paper compares the US and French health care systems because they share the same structures (Rodwin 2003). Furthermore, the French health care system is a model system because the World Health Organization (WHO) ranked it among the best health care systems in the world (Rodwin 2003). Therefore, although the French health care system appears to be structurally similar to the American system, unlike the US health care system, it is highly effective (McArdle, 2012). Through this difference, this paper compares and contrasts both health care systems by evaluating their associated health statistics, financing options, administration structures, employee plans, and inequality issues.

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Health Statistics and Costs

Holtz (2008) says America’s health care spending, as a percentage of its Gross Domestic Product (GDP), is 15.3%. Comparatively, France’s health care spending is 10.1% (as a percentage of GDP) (Holtz, 2008). America’s health expenditure per capita is $5,267 (Holtz, 2008), but France’s health care expenditure per capita is $4,118 (Rodwin, 2003). This statistic shows that health care in America is more expensive than France’s health care costs. However, the high health care costs in the US do not reflect a higher life expectancy for Americans. For example, the life expectancy in France is about 81.67 years, while America’s life expectancy is about 78.64 years (74.4 years for men and 79.8 years for women) (Holtz, 2008). Concerning the mortality rates of both countries, CIA (2014) says the US mortality rate is 8.1 deaths per 1000 persons, while France’s mortality rate is 8.6 deaths per 1000 persons. The main health issues facing the US are heart disease, cancer, and respiratory diseases (CDC, 2013). In France, the main health issues are heart diseases, stroke, dementia, and cancer (Rodwin, 2003). Comprehensively, although America’s health care system is expensive, the French health care system provides better results.

Health Care Financing

The American health care system mainly uses private financing to pay for health care costs. Many of the private financing options are employer-based. Holtz (2008) says about 70% of the population (younger than 65 years) have a private medical insurance. However, government health plans, private funds, and out-of-pocket payments finance 43%, 17%, and 5% of health care costs (Dutton, 2013). Comparatively, France adopts a private-public mix for health care financing. Dutton (2013) says quasi-public insurance funds pay for 74% of health care costs, while out-of-pocket payments, private insurance, and governments pay for 13%, 12%, and 1% of health care costs respectively. Overall, the percentage of public funding in France is significantly higher than America’s.

Access and Inequality Issues

Inequality exists in the American health care system. Holtz (2008) says the private-based health care insurance plan discriminates 16% of Americans, who cannot afford it. Comparatively, the French health care system is inclusive of all citizens. Dutton (2013) says in 1980, 99% of the French population had a health insurance. Legislative changes (introduced in the early 2000s) increased the access to health care (to 100%) by providing insurance coverage to the remaining 1% of the population (Dutton, 2013). This analysis shows that France enjoys universal health care, while the US does not.

Health Care Administration

The French health care system is centrally coordinated through the health ministry (Rodwin, 2003). Different actors, such as medical staff and health care providers implement the ministry’s directions. In America, the two largest public health insurance programs (Medicare and Medicaid) have differing administration structures. For example, the Federal government manages the Medicare program (AICGS, 2012). However, state governments contribute to the management of Medicaid programs (AICGS, 2012). Concerning private insurance schemes, different states manage private health insurance schemes (mainly employer-based) in the US (AICGS, 2012). Therefore, unlike the French health care system, it is difficult to generalize the management of the American health care system.

Health Care Personnel and Facilities

There are about 730,801 physicians in the US (2.5 physicians per 1000 patients) (Pavolini & Guillén, 2013). Pavolini & Guillén (2013) say France has about 3.4 physicians per 1000 people. Like physicians, nurses are also important health care providers. The US has about 26,669,603 nurses (9.37 nurses per 1000 patients) (Pavolini & Guillén, 2013). Comparatively, Pavolini & Guillén (2013) say France has about 8.9 nurses per 1000 people. Concerning hospital facilities in the US and France, the American Hospital Association (2014) says the number of registered hospitals in the US is 5,723 (about 4,999 of these hospitals are community hospitals). There are more private health care facilities in America than France does. For example, Rodwin & Sandier (2005) say there are 75.2% private beds in America, while there are only 37.3% private beds in France. Comparatively, France has about 62.7% public beds, while America only has 24.8% public beds (Rodwin & Sandier, 2005). Comprehensively, although both countries have differing public and private health care distributions, they have (almost) similar personnel numbers and facilities.


AICGS. (2012). Structure of the U.S. Health Care System. Web.

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American Hospital Association. (2014). Fast Facts on US Hospitals. Web.

CDC. (2013). Deaths and Mortality. Web.

CIA. (2014). Country Comparison: Death Rate. Web.

Dutton, P. (2013). Health Care In France And The United States: Learning From Each Other. Web.

Holtz, C. (2008). Global health in developed societies: United States. In C. Holtz, Global health care: Issues and policies (pp. 1-21). Sudbury, MA: Jones and Bartlett.

McArdle, M. (2012). France and U.S. Health Care: Twins Separated at Birth? Web.

Pavolini, E., & Guillén, A. (2013). Health Care Systems in Europe Under Austerity: Institutional Reforms and Performance. London, UK: Palgrave Macmillan.

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Rodwin, V. (2003). The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States. Am J Public Health, 93(1), 31–37.

Rodwin, V., & Sandier, S. (2005). Health Care Under French National Health Insurance. Web.

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