Although the United States spends 16 percent of its gross
domestic product on health care, more than 46 million people have
no insurance coverage, while one in four Americans report
difficulty paying for medical care. Indeed, the U.S. health care
system, despite being the most expensive health care system in the
world, ranked thirty-seventh in a comprehensive World Health
Organization report. With health care spending only expected to
increase, Americans are again debating new ideas for expanding
coverage and cutting costs. According to the historian Paul V.
Dutton, Americans should look to France, whose health care system
captured the World Health Organization's number-one spot.
In Differential Diagnoses, Dutton debunks a common
misconception among Americans that European health care systems are
essentially similar to each other and vastly different from U.S.
health care. In fact, the Americans and the French both distrust
"socialized medicine." Both peoples cherish patient choice,
independent physicians, medical practice freedoms, and private
insurers in a qualitatively different way than the Canadians, the
British, and many others. The United States and France have
struggled with the same ideals of liberty and equality, but one
country followed a path that led to universal health insurance; the
other embraced private insurers and has only guaranteed coverage
for the elderly and the very poor.
How has France reconciled the competing ideals of individual
liberty and social equality to assure universal coverage while
protecting patient and practitioner freedoms? What can Americans
learn from the French experience, and what can the French learn
from the U.S. example? Differential Diagnoses answers
these questions by comparing how employers, labor unions, insurers,
political groups, the state, and medical professionals have shaped
their nations' health care systems from the early years of the
twentieth century to the present day.
Subjects: Health Sciences
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