Health reform, whether like that of Canada, Germany, England or France, you find that most in these countries accept the fact that health care, universally provided and available, helps advance the health of the people while also strengthening the body politic against division.
Put another way, health care, universally provided, helps heal the divides of any democracy; in England, it is class, in Canada, it is class and regions, in France, it is a mixed system that provides universal health provision while healing the divides of class and regions.
France, according to Dr. Tom Ricketts, of the University of North Carolina, a former student and now my teacher, and who has had much experience in France, says that beyond class region is a powerful divide in France and universal health care is part of the 'Rights of Man' which serves to bind the many facets of the French health care system. Here is more on France from Tom Ricketts:
Now to France…no, it is not classes that make the divides…the revolution lives there much more than here and the upper class lost that battle. The sense of classlessness is really dominant and runs through law and social norms. The remains of the upper class are ridiculed widely and the French view themselves as clearly “not British”--nor American, with our economic strata. What is also felt is the history of invasion, from Caesar to the Prussians (three times) and now the invasion from the colonial “experiment.” The outlying parts of France are called the “Outre Mer” which translates as “overseas” but the Outre part also means “outsider” as well as “outraged”…and the play on words is played well by the right wing who see hat Trump sees, a civilization and culture being invaded from the south.
Health insurance in France is complicated and the British notion of a nanny-NHS that brought the classes together in the system is not relevant in the former. Gallia est omnes divisa in parts…. is what Caesar wrote and gave it three regions…Waverly Root divided it into three as well, “Butter, Lard, and Olive Oil” and the “average” French person will feel his nation is divided by region (Fractious Bretons and Basques, Rude and grasping flatlanders from Lille, mumbling louts from the foothills of the Pyrenees, etc) the same average French person recognizes now that the nation is a mix of cultures and beliefs (think Arab and African, “pied-noires” and remnants of Caesar’s legions from Italy) but the sense of French-ness is conveyed by the Lycee and the universal curriculum of the schools, the police system that is centralized, the local mayors who answer to the central government, and the statement of the “rights of man” that does guarantee something like health care. Universal healthcare came to France only after the 1960s—though it was essentially universal after the WWII, but complicated and tied to employment or its lack. Access to care is now an issue and seen as a challenge to the capacity of the bureaucracy. But the local “village doctor” remains the norm, private hospitals, and clinics exist—sometime in the same building with overlapping staffs.
France sees health care as a part of the “rights of man” ideal—a contract, as it were, tied to citizenship (note the reward for the hero from Mali who saved the child in Paris this week was citizenship). Health care is a part of the French political contract that reflects “natural rights.” It doesn’t really bind classes but it does treat cultures equally. It does that while retaining a certain cultural sense of itself—French doctors are not often African, nor are nurses—this is changing very slowly—there’s a movie about this: an African who sets up a practice in a conservative village and then earns their love and respect—The movie came out in 2016 and is based on the true life of a Congolese doctor who settled in rural Picardie in the 1970s. The key point being the discussion wasn’t really had until 2016…after his son made the movie….