Should We Live Like the French?

Thursday, December 6, 2012
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France evokes myriad images for most people -- deep history contained within beautiful architecture, scenic landscapes and incredible food and wine.

For those involved in health and healthcare issues, France provides other interests as well, including what some consider the best healthcare system in the world delivered at a price tag slightly below 12 percent of the gross domestic product.

For me, having visited recently, it became clear that the country's admired health profile is like the French pastry -- the mille-feuille -- the result of a thousand layers of ingredients.

It begins with the infrastructure of cities and countrysides literally built for walking -- an advantage resulting from people living on French soil since Paleolithic times.

Food and wine are also a source of pleasure and national pride. And the French raise their children with a reverence for meals. They are taught to respect mealtimes, to generally stick to three meals a day (no snacking) and to sit down and savor their food -- in the company of others.

Placed on top of all that is the French healthcare system. The National Health Insurance program covers all citizens and legal residents for healthcare through a tax-funded, government-run program. About 60 percent of NHI's funds are derived from the income of France's working population. Almost 21 percent of an employee's compensation, including an employer contribution, is remitted to the government. The employer and employee contribute 12.5 and 0.75 percent, respectively, and the employee adds another 7.5 percent in a social-security tax.

But, alas, all is no longer seemingly perfect in France when it comes to health.

ObEpi-Roche recently released its 2012 survey results on French overweight and obesity prevalence. While the obesity rate grew only 0.5 percent between 2009 and 2012, the 15-percent figure is almost double the 8.6 percent obesity prevalence first reported in 1997. Quelle horreur!

The French healthcare system is also struggling. Despite the fact that an MRI only costs $280 in France, NHI has been in the red since 1989. And the country is struggling with similar U.S. issues such as rising drug costs, an aging population and unemployment.

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Part of France's health challenge is the changing culture. In the time between my first visit to France in the mid-1990s and now, I was shocked by the prevalence of pizza parlors. And local establishments are not driving this trend. Case in point: In July 2010, Ann Arbor, Mich.-based Domino's Pizza Enterprises became the No. 1 pizza company in France.

No one is telling France's residents to buckle down and trim up. Instead, the Ministry of Health launched the National Health and Nutrition Program, which supports nine diet, physical-activity and nutritional-status objectives based on fundamental principles, including food culture, pleasure and gastronomy.

As an HR executive, you may feel limited in how to impact rising healthcare costs through pleasure-based food and activity principles. Perhaps it's time to at least experiment with the pleasure versus buckle-down principle to address employee-health status and costs. Then we, too, may be able to say, "Vive la différence!"


Carol Harnett is a consultant, speaker and writer in the field of employee benefits. She can be emailed at


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