[Evolution of health care in France: comparison elements with foreign countries]

This article reviews the financial growth reports of five health systems: France, Germany, United Kingdom, United States and Canada. It is designed to provide descriptive elements related to expenditure: medical demographics and health care professionals in general, hospital densities, availability of sophisticated medical equipment, medical approach to evaluate the needs for specialists, responsible for ordering expensive technologies (especially cardiologists). The results are presented in summary table form and show that debates on health system reforms too often forget these basic descriptive elements able to diagnose a crisis situation in the system, whether it is financial and/or social and consequently the possible remedies than can be applied. Finally, these discussions also often forget the significantly different epidemiological situations observed between rich countries, as illustrated by the situation of cardiovascular diseases in the countries used as examples. In conclusion, the data presented provide a basis for reforms of health systems, which have been converging since the beginning of the 1990s: closure of short-stay hospital beds, control of medical demographics, specialties and technical procedures, attempts to take the morbidity of the population into account.