When we think of travelling the world for lengthy periods of time, we often think of the glamorous aspects. The culture. The food. The people. New experiences.
But what about the “hard as a rock” bed, or the perfect restaurant an hour’s journey away that turns out to be closed, or…*gasp* – the bathroom that is small enough to technically use the toilet, shower, and sink without moving.
Or, even worse, what about dealing with sickness while travelling? And not just the sniffles…what about real, mysterious, protracted illness – the kind from which you can get no relief? Do you seek out help locally, in a foreign land? Do you pack up your bags and cut the trip of a lifetime short?
At Joy Adventuring, we’ve come to realize that not all adventures are created equal. Some Parisian adventures are filled with baguettes and French cheese, romantic walks down the Seine River, and live music in the park, whereas others are filled with failures (think closed restaurants), disappointment (think closed restaurants), and sickness. I’d like to tell you a story about our response to an illness abroad, some high-level differences we’ve noted between the French and US health systems, and some thoughts about the future of the US health system.
Ill Abroad: A Bad Kind of Adventure
I’m not going to bore you with the specifics of my illness, but I will say that it is a host of mysterious symptoms, including painful headaches and unrelenting tiredness; in other words, serious enough to not want to ‘wait it out’ for two months to get back to the States. Frustrated with my lack of improvement by early-August, I begin to resign myself to the unthinkable: the possibility of cutting short much of our trip in France so that I could get the medical attention that I needed in the US.
I hit my bottom physically upon our arrival in Paris on August 12th. The next day we met with our friends Stephane and Adeline, for whom we were to house sit. I explained to them (with much sadness) that we may have to cut our trip short, depending on how I felt in the days to come. Adeline had a great question that made us rethink our options – “Why don’t you see a French doctor?”
Now, if you’re not from the US, you may not understand why this is such a difficult question to comprehend, let alone answer. The US system is fraught with layers upon layers of difficulty that starts from step 1 (where and how to obtain insurance) to step 13 (expected to arrive at the appointment early when the doctor is 1 hour late) to step 26 (realizing that, despite your expensive insurance, your deductible isn’t met and therefore you owe several hundred dollars). We naturally assume every other country has an equally difficult-to-navigate system!
So, of course I said, “I hadn’t even thought of that…tell me more!” Adeline then went on to describe the ease of convenience of the French system, and how I’d be able to schedule an appointment with her doctor. I had several ‘but what about this’ questions that she answered easily, and I thought, “Why not?” (As a side note, I do want to send my sincere gratitude for the hours of research, calls, and discussions that Adeline did on my behalf. It is amazing to experience generosity like that. Thanks Adeline!)
The First Appointment
Even with Adeline’s assurance and assistance, I was still pretty certain that engaging with the French system would be too difficult, or it would take too long to schedule, or they would realize I wasn’t French and kick me out of the doctor’s office. So it was with very little faith that I created an account and logged into the system. Five minutes later I had scheduled my appointment online. “Well”, I thought, “I’m sure the difficulties will come down the road.”
An easy metro ride took us to the doctor’s office, which Terra and I walked into. Immediately, another patient said “Bonjour!” in a light, welcoming way that made me feel like I was special. We sat down, not knowing what to do next since there was no receptionist desk in this room. After a little debate of how to proceed, naturally, I opened the door with the doctor’s name on it, expecting to see a waiting room for that doctor. What I saw instead was the actual doctor with a patient. After awkwardly and profusely trying to apologize in the wrong language, I stumbled back into the main waiting area and waited patiently. A few more people started trickling in, and I noticed something interesting; every time someone came (or left) every single person greeted him or her. “What kind of amazing place is this?” I mused to myself. Little did I know there was even more amazement to come!
When it was my turn, I found that the doctor spoke fluent English, so it was easy to describe and discuss my malady. He didn’t ask for any proof of ID or my social security number. As there was no receptionist, he took calls during the appointment, and dutifully apologized after each one. All my vitals checked out fine. Out of precaution he recommended I schedule an MRI. As we were ready to part ways he told me that my charge for the appointment was 30 euros ($35). After I picked up my jaw from the floor because of how inexpensive it was, I handed over my credit card and we went on our merry way.
Can you imagine a similar story of a foreigner coming to the US and getting care in our system? Yikes!
Total cost of this step: $35
The Next Steps
The steps that came next were not easy, so thank goodness I had Adeline to guide me through them. They went something like this:
Step 1 – Make the MRI Appointment
- What I was supposed to do: Call the number of the MRI lab that the doctor scribbled down and schedule my own appointment.
- How it actually went down: I was completely unable to reach anyone or understand the message. Thankfully, Adeline stepped in and called multiple places, finding an appointment for me within a week. Better yet – she told me the MRI would only cost me around $150! Again I found myself in complete shock.
Total Cost of This Step: $0
Step 2 – Prep for the appointment
- What I was supposed to do: Print out a prescription, take it to the local pharmacist, get the prescription filled.
- How it actually went down: I hemmed and hawed for a few days before getting serious about figuring out how to find a printer to print out my prescription. Eventually I found a 24/7 print shop and ventured to downtown Paris, got distracted by the most amazing wine bar I’ve ever seen, found the print shop at the exact time that the owner was literally throwing someone out of the store, and meekly walked up and printed out my three pages. I eventually also made it to the pharmacy and got my prescription filled. After having read about a similar medical experience that David Lebowitz described in “The Sweet Life in Paris”, I was nervous that I was expected to administer the syringe myself. I could tell the pharmacist was quite amused at that question; he really missed a chance to mess with me!
Total Cost of This Step: $70 for the prescription (well, not counting the additional $15 for the wine)
Step 3 – Get the MRI
- What we planned: So now I was set. We had the metro directions, and the MRI Center was even close to the Latin Quarter, one of the most fun districts in all of Paris. The MRI was scheduled for 5pm, so I figured I’d get the MRI, be out of there by 6, and feasting on an amazing French dinner in the Latin Quarter no later than 7.
- How it actually went down (Pre-MRI): As with everywhere in Paris, it was super-easy to navigate to the location. Once we got in, however, things didn’t quite go as planned. We waited for a long time, and finally a nurse took me in to a small dressing area between the waiting room and the MRI room. She left me with vague enough instructions that I wasn’t certain which parts of my clothes (anywhere from ‘all’ or ‘none’) I was supposed to take off, so I played it safe and left some key articles on.
- How it actually went down (MRI): How many of you have ever had an MRI? I think you will understand this slightly more than those who have not. One thing is certain, I pray that each one of you do not need an MRI until they improve the technology, especially if you are at all claustrophobic. I don’t think the technology utilized was necessarily older than what you would experience in the US, but let me quickly paint the picture of what occurs. Your entire body (except possibly your feet) is shoved into a completely enclosed tube, and you cannot move for 10 minutes (aside from occasional allowances for imperceptible movements). The worse part about it? It’s got to be the noises that you are forced to listen to while you are buried alive: BEEEEEEP, WHHOOOOMP, BRRRRRRR…and on and on. I now understand how noise torture can be so effective. Oh, and all the while the French nurse was barking orders at me to stop moving. I literally freaked out for 10 solid minutes – and trust me, 10 minutes of pure freak-out lasts about as long as 5 normal hours.
- How it actually went down (Post-MRI): I probably really freaked Terra out because I came out of the MRI room looking like a crazy, paranoid person. It was really difficult to calm down after that. But I had plenty of time to relax, as we had to wait another hour or so before a doctor could see me to go over the results. I was finally taken back into the doctor’s office, where he kind of dismissively asked me why I came in in the first place and told me my brain was fine. At that point, I was obviously very relieved, but also wondering the same thing – “You mean I could have avoided that torture chamber!?!” After my meeting with the doctor, we had to wait another hour to get a packet of stuff which contained a CD with all my images and the images themselves. And it was a HUGE envelope. So basically I was carting around my MRI document in the chic Latin Quarter for the rest of the night, thinking to myself, “Oh, how I wish I were cool just one time in my life!”
The good news? There was a happy ending. We ended up at one of our favorite restaurants from the entire trip, La Vieux Bistrot (as detailed in this post). And I calmed down eventually…
Total Cost of This Step: $150 (note that I think they could have charged an extra $250 for not being a French citizen) and five hours of my life
General Thoughts on the French vs. US Systems
So all in all, without any trip insurance or even an ID card, I was able to 1) schedule an appointment with any doctor within a week’s time, 2) obtain the prescription that I need (side note: pharmacists in France are ALL very friendly and helpful), 3) schedule an MRI within about 10 days time, and 4) get my results within an hour of completing the MRI. And all of this for the grand total of $255 (well, $270 with the wine). And, as noted, all within 3 weeks.
Imagine a different scenario: what if we had decided to fly back to the US to get all of this? I mean, I’m sure with our extremely expensive insurance it would have been faster and cheaper? Of course, I don’t know the full answer because we didn’t go that route, but I don’t think any US citizen would disagree that, even with ‘great’ insurance, the result would have been both more expensive and less timely.
Now, this is not to say that the French have a perfect health system. I’ve heard that French doctors are pretty quick to prescribe medications, for example (although this also occurs in the US). Also, as with our experience, it’s clear that waiting times can be quite extreme. And I’m sure there are many, many more issues. No system is perfect (even the French one). But in my time of need the system stepped up and delivered without making me feel discriminated in any way, despite the fact that I was not a citizen of France or the EU. Shouldn’t we expect that out of any system?
So that brings us to the current state of affairs in the United States. There are thousands of people that spend their entire lives analyzing various aspects of our health care system, so I’m not going to try to get into detailed policy discussions. The main differences between the French and US health systems is this – the French have a more democratic system. Yes, they pay higher taxes. Yes, they are relying on the government to administer their health programs. But if you are poorer (or an outsider, like me) you don’t have the same disadvantage you have in the US. It’s not uncommon for a simple medication to cost in excess of $2,000 in the US. How do we expect anyone except those with great insurance to get well? Doesn’t our current system go against the basic tenets of any of the great religions, which include compassion, charity, and love?
And because I can’t help myself, below are some of my ideas for how we, as a country, need to move forward to move our system into a better place:
- We have to get away from the hyper-partisanship of our government. Perhaps it’s time for the US to form a new party or two (as Macron just did in France)? I know a great candidate named Bill Grassie in our very own 8th Congressional District. (Full disclosure: My mother is his campaign manager. Go mom!)
- We need to hold our President accountable for any efforts to sabotage the Affordable Care Act. That Trump is trying to do this is not an opinion; on many occasions he has indicated that he would like the current plan to fail, and specific actions have shown the lengths he is willing to promote Obamacare failure. His sabotage efforts mean that he is now responsible for the people that won’t be able to afford to be healthy, many of whom will die. History will certainly not judge this kindly, and we shouldn’t either.
- We need to seriously look at ways to be more proactive vs. reactive in our individual and collective health efforts. I’ve found that naturopathic medicine is much more oriented around a lifestyle approach. Let’s not give someone a pill for everything that ails us. Food is medicine – let’s explore ways that we can get ahead of all of these health problems so that our later years are not spent in the hospital. But then our food sources would have to have integrity and that is a whole other can of worms. I digress.
- We need to decrease the power of the ‘powers that be’ and how they are affecting policy. I have two sub points on this one:
- The Pharmaceutical Industry. Do I need to say more? The worst offenders are those like Martin Shkreli, who seems to take joy in causing pain for others and is truly a sad excuse for a human being. But even beyond that, this industry now has so many billions under it’s belt that there seems to be no stopping it. Have you ever really watched one of the pharma commercials with the kids and parents frolicking, all while the background voice over is spending a full minute detailing all the ways you could possibly die from their pill that will fix X problem? Well, I think we’ve even become numb to that since it’s so prevalent. Our addiction as a nation to pills is not normal, and it’s certainly not healthy. We have to determine ways to decrease the power of this industry.
- Health Associations like the AHA (American Heart Association) are too slow to 1) change their official stances on what ails us, or 2) apologize for years of pushing the wrong information that has caused millions of people into diabetes and other diseases (many of which are preventable). I could go on and on about the damage that the SAD (Standard American Diet) recommendations have done to our collective health. While this is certainly my opinion, it is shared by an increasing number of people – and is backed up by my own personal experience.
- Although government is part of the problem (see points 1 and 2), we need to stop whining about the government. I am so tired of my fellow American’s whining about government. Government is not inherently bad, the ‘deep state’ is not trying to get us, and all news is not ‘fake news’. Private sector involvement in our health care solution seems to be driven by greed. That is why I believe we need to look into all solutions, including a ‘Medicare-for-all’ of some kind of single payer system. Or…here’s an idea – why don’t we study and learn from other countries like France who are clearly doing a better job in this area? American Amnesia is a great book with historical perspective on this point.
I don’t pretend to be an expert; I can only describe what I see and experience. I hope you’ve enjoyed learning about my overseas health journey. I’m sure there will eventually be more posts on Joy Adventuring about the topic of health (and in particular my journey), but for now let’s just say that there have been a number of fortuitous events, both in Europe and here in the US, that have led me on the pathway to an amazing recovery. I’m so very grateful we were able to start that process in Europe, and that, as a result of timely care, we weren’t forced to come home early!