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It's Called Context. Try Using It.

The Atlanta Journal-Constitution recently ran a column critical of the French health care system--and urging Americans not to use it as a model for reform.

The article's author is French, which gives the piece more legitimacy than most of the commentary you read on foreign health care systems these days. And it accurately points out some real flaws in the French system.

But it also leaves out some very important context. There is, for example, a great deal of complaining about bureacracy and physician autonomy. What the article doens't say is that French physicians still have far more autonomy than their American counterparts.

As for bureaucracy, the French system is far simpler for patients--and doctors--to navigate. Indeed, every survey I have ever seen suggests the French are far more pleased with their health care system than Americans are. And while they worry about losing what they have--and there are actually some good reasons why things must change--they wouldn't dare trade it for a system like we have in the U.S. 

The other odd thing about the article is the discussion of cost. The whole point of the article is that reform hasn't allowed the French to bring medical costs under control. And that's true enough. Their nation's health care bill keeps getting more expensive, year after year, inevitably exceeding whatever budget they set. 

What the article doesn't say--and this is a truly mystifying omission--is that the French still spend less than Americans do. A lot less. 

Here, again, is the relevant graph:

The tall line on the left represents spending in the U.S. The much shorter line two to the right represents spending in France. Yes, it's about half as much, if you measure this way. (The gap is a bit smaller, but still significant, if you measure by percentage of GDP.) 

Bottom line: The French health care system is far from perfect. And, overall, it's still far better than ours. 

I'll have more to say on this whole subject soon. In the meantime, for a more cursory treatment, here's an aritcle I wrote for Politics magazine after a reporting trip to Europe last year.

--Jonathan Cohn