Tuesday, May 5, 2009

Heathy Living

Now here’s an addendum for Michael Moore’s film, Sicko: I have a French friend who is very pregnant with her second child. Due to the configuration of her pelvis, her first delivery was by Cesarean. She was all prepared to have another Cesarean, but this time around, the midwives at the hospital are turning themselves inside out to get her to give birth “naturally.” Without her requesting it, she has been treated to acupuncture, homeopathy, and something called sophrology, a touchy feely technique which I had never heard of before I came to France. By the way, she is not paying a Euro cent for any of this. While I am marveling that she gets all this free alternative medicine without her even asking, she keeps telling me that she’d rather just have the Cesarean and be done with it.

I admit, I am a major fan of the French health system. As I have mentioned before, I had brain surgery here at one of the best hospitals in Europe, and the only bill I ever saw was for using the telephone. French doctors love me. "What? You only get 23 Euros for an appointment? You deserve more than that!" They don’t get to hear that very often. In fact, there are French people who complain that 23 Euros is too much. Never mind that those 23 Euros are reimbursed by Social Security, so they don't even really pay anything. True, there are plenty of specialists who cost a lot more, and not all of their fees are covered. But most employers offer supplemental health insurance, so in the end, almost everything is covered. Even when it's not, it's a fraction of what it would cost in the US. Naturally, the system is outrageously expensive for the government, so there is constant talk of reform and then shrieks of horror from those same French people who were complaining (grumbling is sort of a national pastime here). So things change at a snail's pace, and at every tiny change, people start to say that now France is on the slippery slope and soon the health system will be like that in America. When this happens, I say "relax, you have no idea how much your system will have to change to reach that point..."

That said, the current proposed reforms regarding hospitals make my hair stand on end. I keep thinking about what happened to American hospitals a decade or so ago when our brilliant bureaucrats decided that it would be just too cool to run the public hospitals like for-profit businesses. I believe that was the beginning of the end, or perhaps the beginning of a new era of hospitals that have so little regard for patients that you don’t dare stay in one without an advocate (family or friend) to fend for you.

In France, access to good health care is considered a right, right up there with Liberté, Egalité and Fraternité. There was a mini revolution here in 1936, when social security was first established, along with paid vacations and retirement benefits. French people don’t consider themselves lucky to have a social security net, they feel they fought for it, and they deserve it. Maybe when we decide that we deserve it, it will happen in the US too.


SeekOdin said...

Great post.

I am Canadian (living in France for the moment), so I cannot compare the French system to the non-existing US one. But I have to say that, compared the the Canadian system, France's is pretty good too.

It would be a shame if the French system headed in the direction of that of the US.

Starman said...

"Maybe when we decide that we deserve it, it will happen in the US too." That will never happen.

The Bold Soul said...

The problem in America is shifting the thinking. Everyone seems to agree that health care should be a right for all citizens, but no one wants to see THEIR taxes to go up in order to pay for it; that's when that "every man for himself" thinking seems to kick in. But you don't get something for nothing. I'm still navigating the French healthcare system but have already noticed that overall, my out of pocket expenses are much less than they would have been in the US. And now that I'm hoping to have a baby, the good health care is even more important to me and my French husband.

Margie Rynn said...

I think what people don't realize is that the money they spend on higher taxes is more than compensated by lower health care costs (no more co-payments, more things covered, pharmaceuticals, etc.). And in France, pharmaceutical costs are also controlled so they are way lower, even if you have to pay.

By the way, Bold Soul, I had my son here (in Avignon) and everything went very smoothly, and I even got free pre-natal classes!

the secret life of france said...

The possibility that France might embrace the capitalist ethos when it comes to health care makes me shudder. I, like you, am a little besotted with French medicine (suppositories notwithstanding) and hope and pray that Sarko doesn't go the way of Reagan and Thatcher and start asking hospitals to be financially accountable.

Margie Rynn said...

Unfortunately, that's just what he is doing. Roselyne Bachelot, his Health minister, is trying to push through poorly thought through plan to make the hospitals more "efficient." Everyone is screaming (literally, while she was presenting her plan) so hopefully the protests will have the desired effect.

re suppositories: yes, a strange obsession...almost worth a post. And have you every had to deal with "ampoules?" Those glass thingys you have to break open without slicing your fingers off?

the secret life of france said...

I have to say Margie, I'm a convert to suppositories. I've found them very effective for treating babies and children who are delirious with fever or reluctant to swallow medicine. I suspect that it's our Anglo-Saxon protestantism that has the bum fixation and that the French simply use them because the body ingests the drug more quickly that way than through the stomach.

But I'd be happy to start an inter-blog debate with you on the subject!

(I agree that the 'ampoules' thingys are very Victorian)


Margie Rynn said...

I'm all for suppositories for children, especially babies. My son was fine with the whole thing up until a certain age, and now when I suggest the possibility he looks at me with horror. I gotta say, the first time I was instructed to take one as an adult, I thought the nurse was joking. My husband thinks they are great, but then he's French.

Cherry said...

As the wife of a French hospital doctor, I can honestly say, yes, the service is good, but the doctors are horribly exploited. He works 80 hours a week and with all the responsibility he has, plus his 12 years training, he makes only €300 more a month than a nurse! Is that fair? If you consider that the legal working week is 35 hours in France, my husband actually makes less than the minimum wage. And btw, the social security pay back 70% of a €23 consultation, so not only do you pay masses in taxes for the health system, but you also don't get 100% reimbursed. May I also add that a lot of people don't have private health insurance with their companies, and have to pay out of their pocket for any fees charged by doctors who work outside the hospital. We don't have private health insurance (yes, that's right, public hospitals don't provide coverage for their employees!), and I had to go to see a specialist the other week who charged me €140 for the consultation. The social security reimbursed about €20, and I paid €120. Maybe it's cheaper than the States, but I believe the taxes are lower there, and it's certainly NOT free here.
I really hope Michael Moore reads this. I saw Sicko, and it was mainly rubbish what he was saying about France.

Margie Rynn said...

Cherry -- first off: I will be one happy camper if Michael Moore actually reads my blog! I agree that French doctors are not paid enough, though I'm surprised to hear that anyone is working 80 hours a week. Maybe that depends on your specialty. But I'd like to point out that if the Secu pays 70% of your 23 euros, that means you are paying 7 euros for your doctors visit, which is less than an American co-payment. I don't know when was the last time you had to pay for a doctor's visit in the States, but fees here are MUCH less than in the US. As in, 120 euros for a specialist is still a huge bargain. That said, I have noticed that fees in the Paris area are much higher than in the provinces.

What you didn't mention is that hospital visits are 100% covered. As in, my visits to my neurosurgeon (how much more specialized can you get?) were 100% covered. I never even saw a bill. If just hospital fees were covered in the US it would be a social revolution.

Re taxes: there's another myth - that Americans don't pay taxes! Strangely enough, when I do the math, it doesn't look like the French pay that much more than we do. (an unscientific study on my part sees a difference of about 10-15%) Maybe that's because they don't have to pay for a vast military superstructure...