Pulling In The Reins

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PARIS: The French government announced sweeping changes to its health care system as part of an ongoing effort to reform a social safety net that is close to drowing in red ink. The system, which provides the French with health care, retirement pensions and child support for the poor, is running a deficit expected to reach $9 billion this year. "Something had to be changed," TIME's Bruce Crumley says. "The population is getting older so there are fewer people paying into the system. Between now and 2005 the system will break down unless there are significant changes." The new measures step up efforts to monitor patient's costs and call for punishments to doctors who surpass budgets for the care and prescriptions they provide. The government's goal is to keep medical bills from rising more than 2.1 percent this year, after an increase of nearly five percent last year. "The government is trying to get doctors to change the long-established mentality that as long as the government is paying for it, we might as well prescribe something," Crumley says. "This will make people think before acting." Some doctors warn that this is a step toward managed care that would eventually lead to reduced services for patients. Crumley disputes that contention. "The system won't be as generous, but it can't be," Crumley says. "It will however be generous by American standards. The quality of care won't be affected. What will change is that waste by doctors will be tightened." Yet some people, who are used to the current system of unlimited health care, are wary of the changes to the social security system. "France is schizophrenic. Everybody knows there is a problem, but when the government announces cutbacks, people get upset," Crumley says. "A small number of unions are protesting the changes. They see this as a last stand as they continue to lose influence. But generally, people are resigned to the changes."