Les Jones

Health Care > Myths of European Healthcare

Sarah Berk exposes some mistaken ideas about European healthcare in a rebuttal to Michael Moore's "Sicko":

Michael Moore ends the movie "Sicko" with a lie. It may not be an intentional lie, but it is a falsehood, nonetheless. Michael Moore ends the movie saying that every European country offers "free" health coverage to their citizens and every European country provides such coverage through a "single payer" system.

Both statements are untrue. It is a sad commentary on the pathetically, uninformed state of the health care policy debate in America that health care journalists and American political leaders do not simply know that both of the statements are untrue and that they have not responded clearly and quickly to correct the error.

So what makes these statements untrue? Reality. Most European countries directly charge their citizens for their health coverage. It is not "free" anywhere. Some nations require people to buy coverage from health insurance companies that look very much like American health insurance companies. Other countries use a payroll tax on everyone's paycheck to pay for health coverage. In those countries, each citizen pays a portion of their weekly paycheck for health insurance - - just like our Social Security payroll deduction. In Germany, each employee pays 7 percent of each paycheck for health care and each employer matches that 7 percent. People also can spend additional money to buy better coverage.

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Each country in Europe has found its own unique path to universal coverage. Switzerland has no government health program at all. Everyone in Switzerland is required to purchase from one of nearly 100 competing insurance companies. (The Swiss government pays for coverage for the poor.)

What about France - - a country Michael Moore described as Eden in "Sicko?" The government uses a sales tax approach and uses that money to buy a basic (not comprehensive) package of coverage for about 80 percent of the French people. The basic government benefit coverage is somewhat incomplete, however, so 92 percent of the people in France now purchase additional private insurance to fill in the 20 - 40 percent gap in various parts of their government benefits. About 20 percent of the French people skip the government program completely and purchase only private coverage. In either case, the coverage isn't free and is not handled through a Canadian single-payer model.

I actually knew that France's system wasn't single-payer, but some of the other information in that article was new to me. And in general Europe isn't the monolith that many people assume it to be. It's a big place with a lot of different people and governments.