My program for a better France
ok, I am an etranger, so no way I can run for the French Presidencial elections Still, I think I lived long enough in this country to have my own opinion on what could be done to improve the welfare of its citizens, in a gagnè-gagnè way that increases efficiency and make everyone better off.
So, these are my points.. I'll be very quick - time is a scarce resource - but if I'll have more time I'll expand it:
Split Pole Employ functionalities
With my great surprice a candidate of the left primaires said yesterday that he favour a regionalisation of Pole d'Employ! That's my primary point! Pole Employ is a waste of resources and time. Nobody can seriously pretend it is useful. And my poiint is that the primary reson is that it is trying to put together two things that require a different model of governance.
The first one is the management of the allocation chromages. To avoid people have their rights, not less but above all not more, managing a benefit require a certain rigidity of the system. But France has already organisations that are specialised in dealing with benefits, the Casse Allocation Familiaires. My point is that the allocation chromage should just be dealed by the CAF rather than Pole Employ.
The other function of Pole employ is so help the demand and the offer of jobs getting closer, including professional training.
But job markets are mostly local, not national.. and also this “job” should be handled in a much more flexible way that what it is now under the constrain of a national watchdog for benefits frauds (that's what is now Pole Employ). Without the management of allocation chromages and with a governance much more decentralised (related with the individual departments), Pole Employ could finally fulfil its mission to put some “oil” in the job markets.
More taxes within the general income taxation
Generally speaking, and France doesn't make exception in this, income taxes are not proportionals: it is ethically established (and has economic efficiency reasons to) that the poor people pay proportionally less than richer ones.
The problem with France is that the general income tax is something somehow “residual” in your income. A very large part of one's salary is already taken away from your pockets for tens of specialised taxed (benefits, transport.. even some old war expenses). The problem is that this taxes are in large part proportionally to your salary: the rich and the poor pay the same quota.
My idea is instead to simplify the taxation system and to include much of these taxation toward the general income taxation so that we can better address equity concerns.
A simpler, more efficient Universal Public Health Care
Here French people will hate me (so, any how, I would never win the election, even if I could candidate myself as President ). They are bombarded with what I believe is a romanticizing of the real situation: everywhere it is stated that the health system is one of the best in the world. No, it is not. It is just a middle, average one for developed countries (take as parameter for example the child mortality at one year). What is it true is that it is instead one of the most expensive one. The OCSE claim it to be the thirds most expensive after the American and Duch ones.
The problem for me is that between the doctor and the patient there is a way to excessive “intermediate” sector dealing with administrative (or bureaucratic if you prefer) matters.
Mutuels are companies. They offer they services but they have to pay their staff. Big staff, and many shops.
I am confident that a system with a unique, national, universal, public health care is way more efficient. After all we are not choosing to be unwell!
To be feasible, the public health care should be act like what people want from an insurance.. protect her from big, unpredictable risks.
So, for relatively affordable health expenses (that constitute the majority of the expenses) a quota of the costs should still be put charge to the patients, especially for optionals, but the public care should guarantee that those with serious conditions, chronic diseases and low incomes doesn't have this burden on them.
The idea is that people should be guarantee that while they may have to pay a bit of pocket money for they minor health problems, when things start to be serious or resources are not sufficient, the public health care is there.
ACTUALLY IT IS NOT MUCH DIFFERENT THAT WHAT EXISTS NOW
But the problem is mainly a communication problem. All people I knew of, they have a mutuel because they don't know how the system works! The system is so complicated that even health professional doesn't well know how it works. Many people think that if they have to go to an hospital without mutuel their life will be buried in debts.
So, my point is mainly to simplify the rules so that everyone is reassured that when they have serious health problem, the State is there.
A simpler, more efficient State
The problem of too big administrative layer is not unique to the Health system, but is virtually everywhere in the State's functions.
The health system is very expensive, still doctors are paid very little. The education system is very expensive, still teachers are paid very little.
I could continue the list.
France has one of the highest public workers share in developed countries. This would not be a problem if they are productive positions, but as I said most of these positions are “administrative” jobs. And the problem with numerique, is that really, much of these are nowadays redundant.
No-one want to sack people and increase unemployment. Even just stopping to assume people in the public sector is a inter-generational ethical problem and private the public system of new, young energies (we saw the damages this policy has done in countries where it has been implemented, as Italy).
My idea instead is that we should encourage people, trough life-long learning and qualification policies, to move on to more productive functions while fulfilling their own ambitions. Going beyond the traditional full cycle of studies to get a profession, many people could achieve professionalisation with a shorter, part time, curricula. They will not become a doctor, but they may well doing thinks more useful (and more personally rewarding) than putting stamps on a piece of paper.
Discussion
Among the debat of yesterday:
L’écologiste François de Rugy a critiqué le principe d’une assurance-maladie universelle, qui remplacerait les complémentaires santé : « Il faudrait retrouver 42 milliards d’euros », a-t-il déclaré pour justifier son refus. «Je défends un système mixte », tel qu’il existe aujourd’hui, a-t-il expliqué, pour défendre « le système mutuel non lucratif, qui facilite l’accès aux soins, avec 2 500 établissements, 15 000 employés ».
That's the whole points: 15000 employès that unfortunately, really are not needed. Should an economic system creates job just to employ people, or because these jobs produce goods or services to the society?