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The French economy and health care system

The French economy may be messed up in many ways, but at least you can't complain about their health care system.

So wrote one MR commentator, that is my paraphrase I can't find the exact quotation. 

It is worth noting that the French health care system and the failings of the French economy are closely linked.  The French economy is notorious for its resource immobility.  It is hard to switch sectors, hard to switch jobs, and hard to switch regions.  The upshot is that when government taxes factors of production, or caps the price they command, those factors usually have nowhere else to go other than to consume more leisure.  This makes it easier to cap health care prices and doctors' wages: everything is frozen in place. 

The more mobile American economy would find it much harder to tax skilled labor and doctors.  For related reasons, American transfer programs tend to be more expensive per dollar of redistribution, less easily based on the provision of quality services at low prices, and they require more complex bells and whistles.  NB: This is an argument for not trying to copy Europe, not an argument for trying to copy Europe.  Call it a cost of resource mobility if you wish.

The more a European government takes advantage of immobility, the harder it is to break a vicious economic circle.  Instituting French factor mobility, even were it possible politically, would cause low-price, low-wage sectors to decline in quality.  Factors would flee to more entrepreneurial sectors.  In the meantime, pushing everyone into more leisure lowers wealth and makes it harder to finance a "grand bargain" of palatable economic reforms.  The economy will remain stuck, stuck, stuck.  Some sectors will enjoy a captive audience of skilled labor.

I have spent several months of my life in France, and I do understand that life there is truly splendid in many ways.  But it is hard for me to believe that the French system -- viewed as the organic whole it is -- is the best way forward for the United States.

Posted by Tyler Cowen on March 27, 2007 at 07:38 AM in Medicine | Permalink

Comments

I think I'm the commentor in question. Under "French health care," I wrote "God knows many things are dysfunctional about France, but the choice to splurge on a healthcare system that, ceteris paribus, isn't that screwed up, isn't."

Your point that the French health care system is connected to the French econonmy as a whole is very interesting. I agree, but I'm not sure it's the case to the extent you make it out to be. You seem to be saying, basically, that if the U.S. gets French-style healthcare, the rest of its economy will go French. I think that's a big stretch.

The French healthcare system doesn't rely that much on immobility. High public sector spending and regulation? Yes. Immobility? Not really.

Posted by: PEG at Mar 27, 2007 9:06:28 AM

It is more accurate to say that until the U.S. economy goes French, it won't get French-style healthcare.

Posted by: Tyler Cowen at Mar 27, 2007 9:23:10 AM

Of course it's superior. If 15,000 elderly French people get in the way,
just kill 'em off in the next heatwave!

Posted by: beloml at Mar 27, 2007 9:34:29 AM

If that were the case, wouldn't health care costs just rise much more slowly (as doctors die off and few people choose to become doctors in the future)?

Posted by: John Salvatier at Mar 27, 2007 10:28:27 AM

Maybe it's just because I'm a libertarian, but I find Tyler so much more compelling, exciting, and just plain interesting when he's not rebelling against his George Mason liberty-nest.

Tyler For Safety-nets: weak sauce
Tyler Against Single-Payer: tYlAr r00lz!!1

Posted by: Octagon at Mar 27, 2007 10:35:38 AM

The French healthcare system doesn't rely that much on immobility.

Peg, given the differential in pay between French and American MDs, I don't think you can make that claim unless you're also claiming that French MDs are warmer and fuzzier than ours. :^)

Posted by: Bernard Guerrero at Mar 27, 2007 11:30:02 AM

Actually, that's not true. French MDs can always go to the US... Oh, wait, no, they can't. And neither can Indian MDs or Mexican or Swedish or German MDs. Maybe this explains why American MDs earn 4 times as much as Swedish MDs (Sweden is wide open for EU citizens + the Nordic countries).

Posted by: Dan Karreman at Mar 27, 2007 2:08:27 PM

I'm curious about this French economic immobility. Are we talking about labor and capital immobility within France, or the freedom to move labor and capital out of the country, or both? Is this immobility an empirical observation -- the French don't move around a lot or change jobs much -- or are there particular legal requirements that keep resources where they are?

Posted by: johnrobert at Mar 27, 2007 2:39:43 PM

As of 2003, the average income of a French physician was estimated at $55,000; in the U.S. the comparable number was $194,000.

Posted by: Mr. Econotarian at Mar 27, 2007 6:03:47 PM

Just to keep things in perspective, the French payroll tax for national health insurance is 20% of wages (counting both employer and employee sides)

Posted by: Mr. Econotarian at Mar 27, 2007 6:25:07 PM

I was subjected to orthopedic surgery in France. I should've been worried when I noticed the lighter-soot graffitti on the roof of the elevator on my way to the OR.

The surgery was an unqualified failure. Without going into too much detail, I almost lost my leg from a botched tib-fib open reduction/internal fixation (plates and screws in my leg). The screwed (pun intended) everything up -- the plates, the bones, the screws were out of position, the ankle was left pointed vice at 90 degrees, and the sutures cut off circulation and caused a massive loss of tissue.

My advice to anyone travelling to Europe: if you get a heart attack or a hangnail--pack it in ice, fly home.

Posted by: Anon E. Mouse at Mar 27, 2007 7:54:23 PM

I was subjected to orthopedic surgery in France. I should've been worried when I noticed the lighter-soot graffitti on the roof of the elevator on my way to the OR.

The surgery was an unqualified failure. Without going into too much detail, I almost lost my leg from a botched tib-fib open reduction/internal fixation (plates and screws in my leg). The screwed (pun intended) everything up -- the plates, the bones, the screws were out of position, the ankle was left pointed vice at 90 degrees, and the sutures cut off circulation and caused a massive loss of tissue.

My advice to anyone travelling to Europe: if you get a heart attack or a hangnail--pack it in ice, fly home.

Posted by: Anon E. Mouse at Mar 27, 2007 7:54:45 PM

If France is so immobile, why is their productivity growth so high?

And that stuff about the elderly dying in heat waves is silly. Is 15,000/year a higher rate than the US or a lower rate? Well, here in the US we don't care so we don't count so we don't know. When people bother to count, they get high numbers.

Posted by: Ragout at Mar 27, 2007 8:58:27 PM

If France is so immobile, why is their productivity growth so high?

They only "bother to count" the employed in this figure, who happen to be a smaller portion of the population in France. Especially among the young.

Posted by: Eric H at Mar 27, 2007 10:55:01 PM

If France is so immobile, why is their productivity growth so high?

Another reason- because many live off tourism. They are off the books in the offseason, work like animals during the season & safe up money,....

And maybe they don't count hours when they go on strike??

Posted by: priscieve at Mar 28, 2007 7:05:39 AM

High productivity?

In addition to having to know who and how this is measured, it is also affected by inefficiency.

If your economy is inefficient and your unemployment is rising, then by definition, it is the least productive jobs and employees being lost. Measure those jobs that are left and they will have high productivity.

Posted by: AvnerUWS at Mar 28, 2007 9:18:05 AM

I agree with AvnerUWS concerning the productivity growth. If we said that half of the US economy, for example, had very high productivity growth relative to other countries, but forgot that the statistic didn't include the other half of everyone working/interacting with the US economy, this is not necessarily anything to be happy about. Statistics can be very misleading if you don't know exactly how they are computed and what is being measured.

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Posted by: 謝文豪 at Apr 1, 2008 11:02:15 PM

I'm debating this topic for my high school debate team and i have come to the conclusion that the french system for healthcare is NOT what the United States needs. Our Economy is failing already and I'm sure this wouldn't help.

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The surgery was an unqualified failure. Without going into too much detail, I almost lost my leg from a botched tib-fib open reduction/internal fixation (plates and screws in my leg). The screwed (pun intended) everything up -- the plates, the bones, the screws were out of position, the ankle was left pointed vice at 90 degrees, and the sutures cut off circulation and caused a massive loss of tissue.

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