I understand that you are talking about some indicators being comparisons between apples and oranges if they aren't reported the same way. The fact that I CHOSE to not address your points about indicators was because I highlighted my intimate knowledge of France's and Italy's systems, BEYOND the matter of indicators, which is the part I highlighted that you didn't seem to understand.
Cool. I'm glad you had a good experience. None of that, however, answers the point that World Health Organization metrics that feed their ranking system include BS measurements that do not accurately capture the quality of a nation's system when it comes to the actual provision of healthcare.
What part of "I worked for 3 and a half years as a healthcare provider in the French system" you don't understand?
It's not just a personal, anecdotal good experience, dammit! It is knowing the system from the inside and understanding its day-to-day operation, and witnessing not only *my* case and my opinion, but all the colleagues, nurses, technician's opinions, etc., and the patients' opinions and satisfaction. It's *seeing* daily how the system performs. I did that for three and a half freaking years, plus another year and a half of not working in the system but being a student and a patient, for a total of five years. Yes, I do know that system pretty well. I don't need the indicators to see how good it is.
I'll tell you this, and feel free to not believe me: even if due to the apples and oranges comparisons, France's healthcare system weren't ranked #1 by the WHO, I'd still say that it *is* the #1 system in the world.
Indicators or not, they simply *are* the #1 system. The fact that being the [id]de facto[/i] #1 system is ALSO matched by having the best indicators is really unsurprising...
Reality comes before indicators. It's precisely BECAUSE the French system performs so well, that it achieves its high indicators. The latter come AFTER the performance. The latter are just the snapshot of the results of the high performance. What really counts, is that the French healthcare system *is* high-performing. The indicators, then, just follow.
Which is why I chose to ignore your lame point about the indicators, and tell you about what their system actually does... in terms of ease of access, timing of access, physician expertise, quality of facilities and equipment, affordability and funding, options and resources offered to patients, agility, continuity of care, smart hybrid system fostering widespread satisfaction and no waiting lines, low overhead costs, efficiency, etc., etc.
*Because* they perform so well, naturally their mortality rates in different age groups are lower than in other countries, their survival rates for various diseases are higher, their morbidity rates are lower, their outcomes are superior, etc. The indicators are good because the care is good to start with.
While I studied and worked there, I interacted with other American doctors there, British ones, German ones... and the nationals from other very developed countries were in agreement that the French system was superior to theirs, and they were in awe of it, just like I was.
I still miss it. When encountering in America all sorts of difficulties, limitations, and hardships in clinical practice, funding, reimbursement, and ability to do well for the patients, I often find myself thinking "oh well, if only we had a system as good as France's..."
Frankly, sometimes I think I should have just stayed in France. My wife actually didn't want to come back. For various reasons, I did. Overall I love America and I'm happy here, but sometimes when the s... hits the fan, I do remember fondly my five years in France.
My chief of service tried hard to recruit me in permanence and to get me to stay... I could have stayed if I wanted to. Oh well.
Before Trump, I used to be more certain of my option of coming back to America... now, sometimes I wonder. Too late, now. I constructed too much here, and lost touch with too much there. Even my chief of service there is no longer alive. It would be hard to restart a professional life there.
But at the time, I could have just stayed... Sigh...