“Healthier Odds in Paris, But Who’d Rather Live There?”
Today is scheduled for my annual check up with the doctor I’ve consulted for more than 14 years in Paris. We’ve become such good friends that we make the appointment for noon so that we can go to lunch together after the usual poking, blood-pressure-checking and question-asking.
Often I am asked about the quality of health care in France, because as Americans, we have this ‘silly’ notion that we (Americans) have the best health care in our highly technical and advanced society. Plus let’s face it, we (Americans) pay for it dearly and therefore, “we get what we pay for,” no? And of course, we (Americans) were always taught to believe that no nation can do it better than we can. Isn’t that right? Do I not speak the truth?
The other notion we were taught is that “socialized medicine” doesn’t work or isn’t up to par because of a variety of reasons that have to do with ‘lack of individual care’ and ‘low-standard technical capability.’ ‘Course — I think it has more to do with the word “socialized” which is one of those concepts Americans fear will take away their personal ‘freedoms.’
All that being said, I’ve personally never had better care for so little money and realized early on how much we (Americans) are missing by not using the French system as a model. Oh, I’m sure to get lots of letters from you folks to dispute my claim, and we all know that no system is 100% perfect and that France is struggling to make the socialized medicine ends meet, but…in whose hands would I rather trust my health?
First of all, my doctor is a woman from England, who of course, obviously speaks perfect English — which is one concern an Anglophone with little French might have in order to communicate well with his doctor. There are lots of health professionals who do speak English, and here in Paris exists both the American Hospital and the Hertford British Hospital to provide English-speaking health services…so put that concern aside.
Secondly, because the cost of a visit with a physician is regulated by the government, much like an insurance company ‘schedules’ the fees, you can be assured you won’t pay exorbitantly for the services — although some do have the right to charge more if they like and you have the right to find a physician who won’t. A General Practitioner’s fees, believe it or not, are between 21€ and 26€ for a visit. Specialists may charge 28€ and a heart specialist gets a whopping 49€! And guess what? The social security plan pays 70% of that!
If you’re on the social security plan and want no out of pocket expenses, you can add what’s called a “mutuelle” policy that you pay for independently and covers 100% of your costs. Or if you’re not on the social security program, you can take out your own health insurance at a cost I’ve estimated is about one-third the cost in the U.S. with much better coverage. (Call Sylvie Labastire at Adinas Insurance and ask about the “Jefferson Plan” if you don’t believe me!: Sylvie Labastire, email [email protected], phone +33 (0) 126.96.36.199.82.)
Thirdly and most importantly is the care itself. Because the physicians are not as strangled by malpractice insurance costs and subsequent issues, they are able to actually perform their job with a lot less constraints. What I have found is that they take more time with the patient because they don’t have the same need to see many patients to cover their high operational costs. They use their knowledge and creative thought processes to diagnose because they don’t have to send out for too many tests to prove their decisions correct for fear of malpractice litigation. And because they actually have a ‘practice’ and not a ‘business,’ they can actually think more about their patients than their office operations. “Quelle surprise!”
Perhaps not all doctors in France are as brilliant as mine — but in general I have found that they ask the right questions and don’t make certain assumptions just to make you happy and send you out the door. They don’t prescribe certain medication because the pharmaceutical sales people haven’t overloaded them with free samples or sent you for tests to labs where they get a kick-back.
In an emergency situation, you’ll get whisked to the hospital by the public emergency health service, SAMU (dial 15 on any phone or visit SAMU) and taken care of without concern of insurance coverage — since they assume that you are!
If you can’t leave home, there are at-home doctor visits just by calling S.O.S. Médicins. They’re not expensive and they come within 30 minutes of your call. Can you imagine that?
And if you still don’t think the French aren’t up to snuff compared to the U.S., think again. France is ranked #1 while the U.S. is ranked #37 by the World Health Organization! See for yourself. Visit http://www.who.int and get the reports.
Now, if you want a good laugh (or cry) about how you’re being fooled by your own kind, read this online article from January 8, 2008 in the Washington Monthly and NOTE THE LAST LINE:
BEST HEALTHCARE IN THE WORLD, BABY….A pair of researchers has just published an update that compares various countries on their rates of “amenable mortality,” defined as deaths that are “potentially preventable with timely and effective health care.” In 1997, the United States ranked 15th out of 19 industrialized countries. So how are we doing now?Answer: we’re now 19th out of 19. The rest of the countries have improved their performance by an average of 16%, while the U.S., that well-known engine of healthcare innovation, has improved by only 4%. So now we’re in last place.
But there’s a bright side: at least our healthcare isn’t funded by the government, like it is in France. Keep that in mind if someone you know dies of preventable causes. Their odds would have been a whole lot better in Paris, but who’d want to live in a socialist hellhole like that anyway?
THE ANSWER: ME!
BTW, it’s not ‘socialist’ (but it does have a social security health care system) and it’s certainly not a ‘hole.’ It’s Paris!