Président Hollande

For a year French opinion polls have consistently given François Hollande the forecast of a comfortable victory over Nicolas Sarkozy in the second round of the French presidential election. It seems extraordinarily unlikely that Sarkozy will pull some rabbit out of the hat in the next 10 days: the massacre by nutter-terorist Mohamed Merah in Toulouse in March played to his strengths, and didn’t change things. How can Sarkozy, with his manic and omnidirectional energy, campaign against a candidate who makes a virtue of being boring? Sarkozy’s claim to be the experienced safe pair of hands is about as convincing as one coming from Newt Gingrich. So Merkel, Cameron, Barroso and Obama had better get used to the idea of Président Hollande.

My reading is that nothing much will change for the French, unless they are rich and will face higher top rates of tax. Hollande’s essential appeal is conservative: he will maintain the French social model against Sarkozy’s hypothetical néoliberalisme. The promise to roll back Sarkozy’s raising of the pension age is limited to workers with 40 years of contributions, i.e. the small and shrinking set of those who managed to get a steady job when they were 20. The reintroduction of rent controls is likewise limited to “les zones où les prix sont excessifs”.

The main beneficiaries of his election will be citizens and governments of beleaguered Mediterranean Europe, Portugal, Pain Spain [see comments re parapraxis], Italy, and Greece. Hollande proposes a sharp break with German austerity.
Here’s point 11 of his programme :

Je proposerai à nos partenaires un pacte de responsabilité, de gouvernance et de croissance pour sortir de la crise et de la spirale d’austérité qui l’aggrave. Je renégocierai le traité européen issu de l’accord du 9 décembre 2011 en privilégiant la croissance et l’emploi, et en réorientant le rôle de la Banque centrale européenne dans cette direction. Je proposerai de créer des euro-obligations. Je défendrai une association pleine et entière des parlements nationaux et européen à ces décisions. Cinquante ans après le traité de l’Élysée, je proposerai à notre partenaire l’élaboration d’un nouveau traité franco-allemand.

This may not work, but it’s a considerable ray of hope, with a lot of ifs. The first is overcoming the predictable fuss in the bond markets over France’s own debt. Oddly, Hollande is temperamentally much closer to Merkel than Sarkozy is, and there’s a chance he may be able to persuade her that Chancellor Bruning was wrong in 1930.

Hollande will bash the banks, separating retail from investment functions (as per Glass-Steagall and Vickers). French statists like ENA graduate Hollande follow Colbert in thinking of all businesses as wards of the state. This approach happens to be right for banks, with their state guarantees and the privilege of seigniorage.

His administration will also move away from nuclear power, a sop to the Green vote. This move is looking better economics every day; even The Economist has turned sceptical.

Parliamentary elections are due in June. A constitutional reform in 2000  synchronised the presidential and parliamentary terms, to reduce the risk of cohabitation (of opposite parties) in government. However, a split result is still clearly possible this time, given the strong first-round showing of the Front National. At least the French Constitution provides a mechanism for dealing with the situation  – the Prime Minister must be drawn from a parliamentary majority – even if it’s tense and difficult for all concerned, rather than the American gridlock.

RBC readers may be curious about health and drugs in the campaign.
Here are the respective proposals.

Hollande, points 19 – 21:

Je veux renouer avec l’excellence de notre système de santé et renforcer l’hôpital public.

  • Je réformerai la tarification pour mettre fin à l’assimilation de l’hôpital avec les établissements privés. Je le considérerai comme un service public et non comme une entreprise. Pour lutter contre les déserts médicaux, je favoriserai une meilleure répartition des médecins par la création de pôles de santé de proximité dans chaque territoire. Je fixerai un délai maximum d’une demi-heure pour accéder aux soins d’urgence.
  • J’améliorerai la prise en compte de la santé publique, notamment en augmentant la part de rémunération forfaitaire des médecins généralistes.Je sécuriserai l’accès aux soins de tous les Français en encadrant les dépassements d’honoraires, en favorisant une baisse du prix des médicaments et en supprimant le droit d’entrée dans le dispositif de l’aide médicale d’État.
  • Je proposerai que toute personne majeure en phase avancée ou terminale d’une maladie incurable,provoquant une souffrance physique ou psychique insupportable, et qui ne peut être apaisée, puisse demander, dans des conditions précises et strictes, à bénéficier d’une assistance médicalisée pour terminer sa vie dans la dignité.

There’s no mention of drugs.

Nicolas Sarkozy :

Améliorer la santé des Français

  • Développer les maisons de santé pour garantir l’accès de tous aux soins, en nous fixant l’objectif de passer de 700 à 1500 maisons pluridisciplinaires libérales d’ici à 2017.
  • Lutter contre les dépassements d’honoraires inacceptables.
  • Continuer les plans Cancer et Alzheimer et lancer un programme de lutte contre les addictions chez les jeunes (alcoolisme, cannabis et cocaïne) et un plan de prévention du suicide des jeunes. La lutte contre le trafic de drogue à la sortie des écoles sera particulièrement renforcée.
  • Mener en 2013 la réforme de la dépendance pour proposer à nos aînés et à leur famille de rester à domicile ou, s’ils le souhaitent, d’être pris en charge en établissement dans de bonnes conditions

Pretty soporific stuff. Politically, health care is a backwater in France. Neither candidate proposes any significant changes to the French health care system. Quite right too; it’s about the world’s best, and the population is healthier than most others. Down the road, there are serious issues of cost control, but there’s no immediate crisis.

Hollande’s euthanasia proposal strikes me as a mistake. My authority is no less than the late Dame (IMHO, Saint) Cicely Saunders, who opposed changes in the British law on euthanasia as a distraction. If you offer proper palliative care and access to hospices, the demand for euthanasia, born of desperation, will go away. Palliative care is (I know from personal experience) much less developed in France than Britain, so her strategy should be tried first.

Comments

  1. Keith Humphreys says

    James wrote “The main beneficiaries of his election will be citizens and governments of beleaguered Mediterranean Europe, Portugal, Pain…

    Dr. Freud is laughing somewhere.

  2. Black cat says

    Incidentally, Portugal does not border the Mediterranean (though France does!) Can it really be called Mediterranean?

  3. JMG says

    Why? Why should terminally I’ll people be forced to endure their own suffering and inevitable demise rather than having access to aid in dying? What is the basis for this “should” of yours.

    • James Wimberley says

      All I’m saying is that the time to consider a change in the law on euthanasia is after good palliative care is available everywhere. Maybe Saunders was right, maybe not. But her observation is sound: many old and sick people want to end their lives simply because they are not being cared for properly.

      • Passing By says

        You didn’t even try to answer JMG’s question. Let’s agree on the desirability of offering “good palliative care”. Now … explain why the law should continue to deny people control over this most-difficult and personal decision about their own lives until that happens?

        • James Wimberley says

          Given your stipulation, the answer is no. But as I said, the stipulation is counterfactual. In current circumstances the bad unintended consequences could be large. Do you really want voluntary euthanasia as a cheaper substitute for palliative care?

          • Passing By says

            Yes, of course, I want voluntary euthanasia available; and I want better palliative care available. You’re the one who believes that one is somehow a “substitute” for the other, not me. Suggest that you make an argument for that belief of yours, rather than simply asserting it.

  4. says

    On the palliative care vs euthanasia question, are we talking mostly about the proper allocation of political and policy capital? If assisted suicide costs a lot to pass and implement (in terms of time and attention) then it would make sense to push palliative/hospice care and pain management just because you’re helping more people. If it’s cheap or free in political/implementation terms, then it seems to me essentially irrelevant (except for the small mean-spirited group who will stint palliative care because suicide is available.)