Summary: France, Germany, and Japan achieve near-universal health insurance coverage with health care systems that, while extensively regulated, share three major traits with the U.S. system: (1) medical care is provided by private physicians and public hospitals, and patients are free to choose their physician; (2) most people receive health insurance coverage through their workplace; and (3) health insurance is provided by multiple third-party insurers. This report describes these countries' methods of providing universal coverage through their health insurance and financing systems, their policies intended to restrain increases in health care spending, and the effectiveness of these policies. While GAO does not endorse the specific health systems of the countries reviewed, the strengths and weaknesses in these systems could be instructive in helping resolve U.S. health care problems. GAO summarized this report in testimony before Congress; see: Health Care Spending Control: The Experience of France, Germany, and Japan, by Lawrence H. Thompson, Assistant Comptroller General for Human Resources Programs, before the Senate Special Committee on Aging and the Senate Committee on Governmental Affairs. GAO/T-HRD-92-12, Nov. 19, 1991 (eight pages).
