LONDON — As President Barack Obama pushes to overhaul the American health care system, the role of government is at the heart of the debate. In Europe, free state-run health care is a given.
The concept has been enshrined in Europe for generations. Health systems are built so inclusive that even illegal immigrants are entitled to free treatment beyond just emergency care. Europeans have some of the world’s best hospitals and have made great strides in fighting problems like obesity and heart disease.
But the system is far from perfect.
In Britain, France, Switzerland and elsewhere, public health systems have become political punching bags for opposition parties, costs have skyrocketed and in some cases, patients have needlessly suffered and died.
Many European health officials applaud Obama’s attempt to provide health care to millions more Americans, but they also advise him to proceed with caution.
“What we can be proud of in Europe is the ground rules, that everyone has the right to health care,” said Jose Martin-Moreno, a health expert at the University of Valencia in Spain. “But the implementation has been difficult, and one size does not fit all.”
Experts say that before committing the U.S. to footing the bill for universal health care, Obama should consider what it has cost Europe.
A World Health Organization survey in 2000 found that France had the world’s best health system. But that has come at a high price; health budgets have been in the red since 1988.
In 1996, France introduced targets for health insurance spending. But a decade later, the deficit had doubled to 49 billion euros, or $69 billion.
Similar scenarios have been unfolding in the Netherlands and Switzerland, where everyone must buy health insurance.
“The minute you make health insurance mandatory, people start overusing it,” said Dr. Alphonse Crespo, an orthopedic surgeon and research director at Switzerland’s Institut Constant de Rebecque. “If I have a cold, I might go see a doctor because I am already paying a health insurance premium.”
