Brussels, Belgium ? Pierre Berthelot enjoys a golden sunset in the south of France, despite the aches and pains of his 83 years.

Happily, paying hefty medical bills is not a big worry.

“Just about everything gets reimbursed at 100 percent,” the former diplomat chuckled. “It is tough to think of a better system.”

Europeans have long been proud of their cradle-to-grave public health systems and critical of the U.S. approach — under which 40 million people lack health insurance.

Earlier this week, Congress approved a sweeping overhaul of Medicare, created in 1965 to provide public health support for the elderly.

The changes introduce a new prescription drug benefit for 40 million older and disabled Americans and create competition between traditional Medicare and private plans beginning in 2010.

Supporters say the reform was long overdue, while detractors worry it could place the elderly in the hands of private companies more concerned with profits than quality medical care.

Europeans also are debating the costs of health care and the role of private insurers as government finances are strained in caring for a growing elderly population.

“We are slowly getting away from the principles of the European social model that health care was a right and that the community made treatment available,” said Anne-Sophie Parent, the director of the European elderly people’s platform AGE.

Government drives to cut costs risked “an approach where you end up with different classes of service, where those that can afford it have the best care and health becomes just like any other service you can buy,” she said.

But in most of western Europe, health care is still available free or at low cost.

To pay for it, Europeans have some of the world’s highest taxes.

“We are prepared to pay more and have the best services,” Parent said.