Friday, March 14, 2008

Health Care in the United States (actually France), part 2

Read part one of this post here...

I have seen the movie, Sic.ko, and while I don't particularly like Micha.el Moo.re, I do agree with much of what the movie says about health care in France...

It really is that good.

We were not in the socialized medical system in France, since we did not pay French taxes. But, most of our friends were part of the system and I have first-hand knowledge of many French families and their situations. They weren't just wealthy families who could afford private health care. We had friends from the lower middle class. People who lived in studio apartments and didn't have much for extra luxuries, especially not private medical care. In other words, we had a broad view of people and situations from which to draw conclusions about France's universal health care.

Almost everyone I talked to was happy with the system in France. The thing I obviously heard about the most was childbirth and obstetrics, since most of my friends were around that age. Not only did they have all the same tests that we have in the States, they actually get more specialized ultrasounds with an obstetric radiologist. They also have better postnatal care, with uncomplicated births staying in the hospital for 4 days and woman who have had c-sections staying in the hospital for a week. Cost is not important in the length of the hospital stays- patient health (mother and baby in this case) is paramount.

My husbands job is very concerned about the Americans who work for them and our health care while we're living overseas. They will pay to send you back to the United States if a serious medical issue comes up while you are living overseas. From most countries where we could live, being sent back for even minor surgery is expected. But that's not always true in European countries, especially France. We knew two different people who were treated for cancer there. One woman, after being diagnosed with ovarian cancer that was spreading, stayed even though she was perfectly fine to travel. She explained that the hospital in her French neighborhood was a well known cancer treatment center and people came from around the world to use their new treatments. This is further proof that the care we received there was not at a lower standard that what we would've received in the United States. I had my daughter there and had a great experience as well.

People always ask me about two things regarding the medical care in France. First, they ask about private doctors and "don't you have to pay extra to get good medical care?" Public doctors, who charge the same as what the government will reimburse, are very good. Having gone to a few of them myself, including a dermatologist and family physician, I can say they were professional, very knowledgeable, and many did fellowships with hospitals in the United States or United Kingdom. Most people I knew had regular doctors (who are completely FREE) and all still received an amazing standard of care. Public hospitals (again FREE) are the same standard of care as we have the United States and I assure you, are very nice.

Private doctors can charge a little more than what the government will cover, and the patient pays the balance. They may become private because they have more experience, but often they just charge more for being in a better neighborhood, having a nicer office, or speaking a second language for those who can't speak French. They also get the privilege of practicing at private hospitals. Private hospitals are amazing- with gourmet chefs, extra comfortable linens, private rooms, and they often have massage therapists and beauticians on staff.

The other thing people ask is about cost. Yes, the French pay around 40% of their income as taxes. This sounds high, until you realize that Americans pay around 25% to 30% in taxes and if you are wealthy, even more than that. When you add the cost of your health insurance premiums (which come out of your salary before you even get your pay check) and co-pays, emergency room cost, and dental cost, which are usually not covered well by insurance, most Americans spend another 10% of their salary, on average, for health care. Suddenly, our costs look very similar to the French. And they have other amazing social programs. Help with daycare costs for working mothers, and special tax breaks for having more children. If you own a small business or are a small farmer, the French government helps you out with subsidies if you have a bad year. They take pride in small business, family, and their tremendous social programs.

But don't worry... those who work hard and do well are still allowed to be wealthy. My husband has a few high school friends whose parents are doctors or own successful businesses. I've been to their 5 or 6 bedrooms homes, with pools in the back, and seen their 3 or 4 cars parked in the driveway. Being socialist does not mean taking from the rich and giving to the poor. It simply means that everyone is taxed at a slightly higher rate, so the government has a cushion to protect those who fall on hard times.

Susan had comments on my last post about socialized care in Germany and the issues there. I recommend going to the last post and reading what she has to say- she clearly knows the issues in Germany and what troubles they are facing. I've also heard about some issues in Canada with waiting months for treatments. These are definitely things to consider and read with care. As for France, I have to respectfully disagree with anyone who says it isn't working there. It really does work. Carrie had a post about universal health care, inviting discussion, and I hope this will answer concerns of some of her commenters that universal health care has never really worked. It does, but obviously all the elements have to be there.

Now let me just say on thing before you go crazy- I'm not saying the French have it all figured out. Some things they do are infuriating and they have plenty of problems in their country and goverment. I'm also not saying that we should immediately switch to nationalized health care, but I just want to illustrate that in one place, the system runs smoothly. Just some food for thought. It will definitely be on my mind when I vote in November. What do you all think? What scares you about socialized medicine? Do you think we should at least provide care for children? What obstacles must be overcome before we attempt this?

1 comment:

Susan said...

Abby,
I think many Americans would be ok with a Universal System if it is good. It would be nice to have fair coverage.However nobody dares quote how much is costs to afford doctors and nurses paid 3 times those in Europe. Have you heard of anything? With a nation in a financial crisis, basically they want to talk about money...