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What do the French think about U.S. health care?

MURRAY — When the four visitors from France touched down in Salt Lake City, they skipped past the ski resorts and Sundance festivities.

Instead, they headed straight to the hospital.

The visitors — two senior French health officials and two French health care journalists — are spending a week touring Intermountain Healthcare facilities and meeting with its top executives.

So what do representatives of the French health care system, widely regarded as one of the best in the world, have to learn from Utah?

In the words of Christian Foury, a senior French health official on his third visit to the Beehive State, "it was a chance for us to start the preparation — and we need to prepare because we are facing the same problems."

That includes an aging population, overcrowded hospitals and rising costs.

"The problem is not fraud," Foury said. "The problem … is to fight against waste."

Utah and France boast similar statistics when it comes to the percent of gross domestic product spent on health care (relatively low) and the health of its population (relatively good).

Of course, Utah — and Intermountain — are often seen as an exception to the rest of the U.S.

The U.S. spends more on health care — both per capita and as a percentage of GDP — than any other developed country, according to a 2015 report from the Organisation for Economic Co-operation and Development.

Per person, the U.S. spends about $8,700 on health care every year — more than twice as much as France ($4,100) and the organization average ($3,400).

And yet, by many measures, health outcomes in the U.S. are worse. When compared with other developed countries, the U.S. has below-average life expectancy, above-average obesity, fewer doctors and yet higher spending on advanced tests and equipment like MRIs.

By contrast, the vast majority of French citizens are pleased with their health care, said Dr. Jerome Vincent, an internist and health journalist for Le Point magazine.

“We know that we spend high and our results are high," Vincent said. "The question is how to do better with the same price.”

France's mixed public and private health care system is regarded by the World Health Organization as the best in the world for its efficiency (the U.S. ranks 37th).

In France, virtually every citizen is covered by the national health insurance system, which reimburses 50 to 70 percent of the cost for common procedures and 100 percent of the cost for serious illnesses or calamities. Many people also pay for supplemental private insurance.

On Wednesday, the French delegation — including Annie Fouard, the medical adviser of the French National Health Insurance Fund — were loud in their insistence that health is a universal human right and that access should be equal.

But Foury said he and Fouard are on a five-day fact-finding mission.

They have questions like: How do you manage your electronic health records (something that France doesn't do very well)? How do you get all your caregivers and administrators to commit to the medical home model (a concept that hasn't quite taken hold in France)? And how do you keep prices low while investing in research and innovation (something that the U.S. excels at in comparison with other countries)?

Vincent, waving toward Intermountain Medical Center, said he wasn't necessarily impressed by Intermountain's facilities.

"We have the 'Transformation Lab,'" Vincent said. “We have telehealth. We have big hospitals."

What's unique to Intermountain, he said, is what he sees as its discipline for research and evidence-based practice.

For example, Vincent said, France has no history of collecting clinical data from its patients to assess the quality of its care. Intermountain is known for its advanced electronic records system and tracking its results to develop new standards of care. Boosting use of electronic health records was also a key feature of the president's health care law.

"It's because we are French," Vincent joked. "We are not American."

Foury said he was also impressed by how closely doctors, nurses and administrators work together in the U.S.

In comparison, France is attempting to give nurses more training to take the burden off overworked doctors, according to Foury. But many physicians resisted those reforms, and in 10 years, nurses have gained only the permission to give flu shots, Foury said.

The delegation also highlighted issues they saw in the U.S. health care system.

"In America … it's very expensive because a lot of people don't have access to care," said health economist and journalist Francois Malye, adding that inequality in the U.S. is "a big problem."

The French delegation will continue touring facilities for the rest of the week, including a visit to McKay-Dee Hospital on Friday and a trip to Intermountain's robotics labs.

Earlier, they also toured one of Intermountain's specialized outpatient clinics for complex medical cases and the "Transformation Lab," where researchers test and develop new technologies.

Even as the Affordable Care Act moves the U.S. closer to the French system — most notably with its requirement for everybody to have health insurance — the French could borrow some ideas from the U.S., Foury said.

He said many proposed reforms to cut costs in France have been met by resistance from doctors and inaction from lawmakers.

But it's like the Titanic, moving slowly toward an iceberg, Foury said. Slow-moving politicians have a choice: Go left, go right or stay on course.

"It is time to change," Foury said.

Part of the difference in the French and U.S. health care systems may be rooted in culture, the delegation noted.

When asked if they believe health care is a human right, the delegation erupted.

"Yes," they insisted. "Definitely."

Email: dchen@deseretnews.com

Twitter: DaphneChen_