Princess Diana's Death Offers Lessons for Health Care Debate, 12 Years Later

The team set up a mini-emergency room and, for 45 minutes, ran an EKG, did CPR and began medication for a heart attack.

Without full emergency room diagnostics, doctors had to make an educated guess on the drugs. They were right, he survived but, had he ruptured an aorta, the drugs could have caused more problems or death. "You make judgment calls," Jois-Bilowich said.

The French emergency care reflects the overall health attitudes of that nation -- delivering basic primary care and health education to everyone will mean fewer expensive emergency room visits and hospitalizations later on.

Amid the health care debate here, some Americans are taking notice.

The French, at 10.7 percent of the gross domestic product, spend less than Americans do on health care at 16 percent of their GDP, according to 2009 Organization for Economic Cooperation and Development health data.

French Health Care Tops World

The World Health Organization recently rated the French system as the best in the world. By comparison, the United States rated 37th. The average life expectancy in France is 79.4 years, two years fewer than in the United States.

Both countries are struggling with rising drug costs, aging populations and unemployment, but about 65 percent of all French citizens, compared with 40 percent of all Americans, are happy with their medical care, according to the Organization for Economic Cooperation and Development.

The French can choose their own doctors, see specialists and have access to some of the most sophisticated research and medical technology in the world, according to Victor Rodwin, professor of health policy and management at New York University.

"The American and French system share similar dimensions," he told "They are both based on fee-for-service practices, there is a large element of private provision and they also have a small equivalent of the gap supplement insurance like Medicare. It's a public-private mix."

In France, everyone is covered, regardless of their ability to pay, with an emphasis on primary care to prevent long-term illness.

"What we do is quite different," Rodwin said. "We take care of people, but not everyone, and we do it once they get very sick. We take diabetics with flare-ups and asthmatics in the emergency room, but we don't do primary care or health education as well for the poor.

"Our population is much sicker compared to France," according to Rodwin, whose research finds that Americans have the highest rates of avoidable hospitalizations -- two and a half times higher than the French -- for treatable conditions like pneumonia, asthma, diabetes and congestive heart failure.

That's according to a 2008 study from the National Institute of Public Health and the Environment. "The French have a term -- solidarity," Rodwin said. "Since World War II, the system is grounded in the philosophy that everyone should have access to health care. That doesn't mean everyone is treated equally. There are those who are more educated or higher socio-economic groups that use more specialty care and probably have access to better quality care, but everyone has access to the minimum."

Mary, a freelance writer who did not want to use her last name, lives in Paris and is a "big booster of the French system."

The school nurse called the fire department after her son had an asthma attack several years ago.

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