Friday, September 26, 2014

One Reason Why Socialized Medicine in France Costs Less Than American Health Care

'Je suis un Americain.
Comment pourriez-vous dire?'
Does anyone care to make a rough guess of how many obese or severely obese people we saw in 8 days in Paris recently?

Mind you, we were out every day at the various parks and tourist attractions from the Eiffel Tower to the Louvre to the Jardins de Luxembourg; riding the Metro, the train or in the taxis; or just walking the streets of Paris to see the various neighborhoods from the Latin Quarter to the Place des Vosges to whenever the mood led us.

Also mind you, these Parisians eat a basket of croissants and baguettes in the morning at a 2-hour breakfast; break for a hearty petit dejeuner around noon for another 2 hours of eating and a bottle of wine or two or three; and then, after a few lattes during the day and a pastry here or there along the Rue de Whatever, they cap the day with a plate of fromages and more baguettes at 5 pm with wine only to be followed by a heavier dejeuner later in the evening such as 3 fried pork chops or a plate of hot sausages on spiced lentils. And another bottle or two or three of French wine, of course.

How many of the Parisians we saw in Paris were obese or severely obese as in America?

0. Zero. Not a single solitary one. Not anyone in a scooter. Not anyone in a wheelchair because of obesity issues at least. No one having to use any sort of device or aid even as simple as a cane to help them along because of overweight issues.

We thought we saw one late in the week but walked past him only to find out he was speaking in a Brooklyn accent that could only be from Brooklyn, New York and not anywhere else on the planet.

The only place we saw some rounded, more corpulent people was when we toured the art museums and saw a Reubens painting here or a Cezanne there with women who were decidedly not 'thin' by any stretch of the imagination.

As soon as we returned to the States, we realized that the basic shape of Americans is now a rather large pear whereas the Parisians we saw looked more 'normal' as in relatively thin and angular. Like Americans used to look 40-50 years ago.

How in the world can a society of people such as the French eat so much (and so well) and still look like the healthiest people on the planet?

We saw thousands of people, if not tens of thousands or hundreds of thousands, walking everywhere in Paris. They walked to work, to the park, the museums, the shops, church...wherever they wanted or needed to go,

Parisians seemed to want to walk over driving or riding in taxis. If their destination was a long distance away, they walked to the Metro or RER train stop several blocks away and then walked to their destination when they reached their Metro or RER stop.

If they were not walking, they were riding a bike. Paris has 1800 rent-a-bike kiosks all over the place but the first 30 minutes is free. There are 20,000 bikes, all of which seemed to be in use all the time.

With that in mind, we took a brief look at some of the readily available data comparing French health to American health conditions.

Americans are about twice as likely to develop diabetes as a typical French person. Americans are also about twice as likely to develop heart disease as a typical French person.

Know what 2 of the main leading causes of higher health care costs are in America today?

Diabetes and heart disease.

As of 2010, the per capita expenditure for Americans ran close to $9000/year which is surely much higher today.

The per capita expenditure for the average French person? Just under $4000.

The one area where the French exceed the Americans in disease is in their rates of cancer. No doubt due to the enormous amount of tobacco they consume, mostly cigarettes along the Champs Elysees as they sit and drink wine and eat fromage and baguettes and croissants and pastry and watch people as they go by.

But they do not see any obese people. We tried and we did not see any of them as we saw immediately in the US airports when we returned.

That is not surprising. 2/3rds of Americans are now considered overweight or obese. 1/3 are simply considered obese of which 6.7% are considered morbidly obese.

The US has roughly twice the obesity rate of France. Obesity leads to so many health complications, diabetes and heart disease just a couple of them.
'We're #1! We're #1!'

So what does this mean? Does socialized medicine in France keep the costs of health care down or does the more healthy lifestyle of Parisians help keep the costs down because they are avoiding the extremely expensive side effects and consequences of being obese?

We don't have all the data points academics would demand to make a sophisticated analysis of the health care comparison between the US and France.

However, based on a rather large data set that we saw with our very own eyes over an extended period of time in Paris, we saw with pretty much certainty that Paris does not have the obesity problem we have in America.

To contrast what we saw in Paris with an average everyday occurrence in America, here's conceivably a day in the life of an average American with a good job in an office building somewhere:
  • Get up. Eat some sugar-laced Mini-Wheats or Entenmann's pastries for breakfast.
  • Drive to work but go through a drive-thru Starbucks first to get a calorie-driven double-whip mocha latte with at least 700 calories in it before you put in 3 packs of 'all natural' cane sugar as if that is going to help you somehow.
  • Park in the parking deck. 
  • Take an elevator to your office.
  • Sit at your office all day long staring at a computer in an ergo-dynamically perfect office chair to take the strain off your back
  • Take the elevator down to the Burger King in the food court of your building and buy a Whopper with cheese ('Have your diabetes/heart disease your way!') with a side of greasy fries on the side. 1000+ calories at least
  • Take the elevator back up to your office and ergo-dynamically perfect office chair.
  • Take the elevator back down to your car.
  • Drive the car through a drive-thru window on the way home and buy (whatever you want). 1000+ calories minimum.
  • Sit down in front of the television to watch the news and then some favorite movie for the 10th time.
  • Eat some ice cream while doing so. Add on another 400-600 calories for sure.
Americans can go through an average work day without expending one ounce of energy on exercise or walking or running or lifting anything heavier than a Big Mac. We might burn up a fair number of calories on basic body functions such as our beating hearts and basic metabolism that keeps us alive but that is about it.

In our American Dream effort to find every comfort in life, we are literally killing ourselves by ingesting maybe 2000 calories more per day than we burn up.

No wonder we have perhaps the highest obesity rate the world has ever known outside of colonies of sumo wrestlers.

And with that, we have the highest per capita health care costs in the world. Obesity and exorbitant health care costs from complications due to obesity go hand-in-hand like two very large peas in a pod.

No wonder French health care costs are lower than America. It has less to do with socialized medicine than the fact that the French people take far better care of their bodies than Americans do.

They enjoy eating and drinking, don't get us wrong. But they seem to walk it all off whereas here in the States, we do not .

Sadly for many reasons.

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