Wednesday, June 18, 2008

Health Policy

I don't often cite Marianne, a magazine whose parti pris I find grating. But occasionally they interrupt the usual drumbeat of denigration long enough to publish a really intelligent article, like this one by Élie Arié on health policy. Arié is critical of the Left's tacit opposition to the planned closing of small hospitals, which, as he points out, may be conveniently located close to home but offer substandard care because practitioners do not see enough cases to maintain their skills. Safety is therefore compromised. He also chides the Left for failing to recognize that some drugs are ineffective and therefore should not be subsidized by state reimbursement. Instead of such futile oppositioin, he argues, the Left should pursue different objectives, and he details several flaws in Sarkozy's approach to health policy on which the opposition's fire could be more usefully traine.


MYOS said...

I see Marianne's point, but there's one big problem with the thesis:
In case or emergency, a small hospital is better than none.
Often, in rural areas, the choice isn"t between a great doctor and a country doctor. It's the country doctor or no doctor at all.

I live in the countryside and doctors are hard to find. Closing a hospital can mean having to drive for 1 hour. If I break a leg, I can't drive for 1 Hour. Roselyne Bachelot recently 'responded' to 'my' concern by saying a special helicopter could be sent but that hardly spells rational spending to me.
Finally, if a mother begins labor in the middle of the night, isn"t a substandard hospital better than having to give birth at home or in a car?

Anonymous said...

Myos (and Arthur): in fact, the debate is on closing specific services (units), not full hospitals.

A&E and maternity are bound to stay open in most places. Additionally, Myos, do not forget that the French hospital system is half-private and that public planning affects only part of the full hospital supply. Private hospitals will be under the obligation to accept A&Es under the new scheme.

The most important thing is to stop having surgeons operating stuff they see only twice a year.

Myos, if you break a leg you are under no emergency. An ambulance should come and pick you up.

Unknown said...

Yes, thank you, Anonymous, you're quite right. I should have made clear that it was services rather than hospitals that would be closed. A small local hospital may do well with common procedures; it's when they push into specialties where few cases present that problems arise. Of course the critic mentions that private clinics will pick up the slack but wonders if the government's tilt toward private medical care isn't ideologically driven.

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