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France as medical care icon? Not.
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Obesity Kills. www.cnao.fr
The poster says "Obesity Kills". It's part of a campaign by the National Collective of Associations of the Obese in France, designed to make the point that obesity-caused diseases are deadly. Why such a poster in France, home of the eternally svelte? Because French women (and men and children) do get fat. And when they do, they get the same diseases overweight Americans get. And those diseases are expensive.
The overweight/obesity rates in France don't approach that of the US yet, where 2/3rd of adults are either overweight or obese. But the Population Reference Bureau, which publishes obesity data on 10 European countries, doesn't hesitate to sound an alarm: "Rising rates of obesity can explain 27 percent of the growth in real health care spending between 1987 and 2001." According to a recent report on NPR, the national health system in France was $9 billion in debt last year. At the moment, French workers are required to contribute a whopping 21% of their income into the medical care system. Employers cover about half of that cost, but the result of that enormous expense is that employers are loath to hire more people. Every new hire represents another huge expense in taxes.
Meanwhile the $9 billion debt from last year caused the Sarkozy government to start charging more for many medical services, while investigating other ways to cut costs and charge more. Sound familiar? But you've been to France and only seen thin people sunning on the Mediterranean beaches or strolling in Paris. There's an explanation for that. Rates of obesity are higher in less glamorous regions, such as the northeast of France. Large cities and Mediterranean regions have the lowest rates.
Why care? During the 2008 US presidential election campaign, you'll hear plenty about the need to reform the US medical care system. France will be held up as the ideal: a population that's healthier thanks to the low-cost single-payer system. The logic is exactly backwards. The French people have enjoyed good health because of a healthier lifestyle, not because they get "free" (21% of paycheck) medical care. But now the healthy tradition of wholesome food, small portions and more physical activity in daily life is changing. As the obesity rate rises, the system is going into debt trying to keep up with the increased demand created by obesity-related diseases. In France, at least, the government is taking the threat seriously. Obesity doesn't just kill individual people. It can kill off the medical care system.
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