"Believe me," Dr. Tamalet summed up, "if you wanted that operation in France, you could get it" Which is, of course, the boon and the bane of France's health care system. It offers a maximum of free choice among skillful doctors and well-equipped hospitals, with little or not waiting, at bargain-basement prices [in out-of-pocket terms to the consumer]. It's a system that enables the French to live longer and healthier lives, with zero risk of financial loss due to illness. But somebody has to pay for all that high-quality, ready-when-you-need-it care--and the patients, so far, have not been willing to do so. As a result, the major health insurance funds are all operating at a deficit, and the costs of the health care system are increasing significantly faster than the economy as a whole. That's why the doctors keep striking and the sickness funds keep negotiating and the government keeps going back to the drawing board, with a new 'major health care reform' every few years. So far, the saving grace for France's system has been the high level of efficiency, as exemplified by the 'carte vitale,' that keeps administrative costs low--much lower than in the United States."