I’m still behind on my blog, but I’ll start off with a recent Nate-story related to a health scare I experienced a few days ago since it fits in with the subject matter of this post.
I don’t have anything in particular against the desert. However, after this most recent event, let’s just say that I’m unlikely to retire to the desert Southwest. You may recall from this post that I was unceremoniously stung by a scorpion while visiting Terra’s grandmother in Arizona. And that would be enough desert pain for most people in a lifetime. But I wasn’t content – I wanted more.
Recently we purchased a petite floral arrangement with a cactus at the center which we placed on our dinner table. One evening, while eating bread and cheese (I mean, that was probably the meal since we are in France!), I aggressively swatted at a fly. So aggressively, in fact, that one of the cactus needles became lodged deep into my pinky finger, just below my nail. Was it as painful as it sounds – yes!
Unfortunately for me, that wasn’t the end of the story. The pinky started swelling a bit, so I did what you do in France – I stopped by the pharmacy to ask them what my next steps should be. The lady I spoke to was very concerned and told me to go instantly to an SOS office (the equivalent of US Urgent Care) so they could forcibly remove it.
I didn’t really like her answer, so I decided to go for a second opinion, which turned out to be a receptionist at a doctor’s office. She said it was no big deal and I just needed some disinfectant. So, I went to another pharmacy to get a third opinion; this pharmacist sided with the receptionist and told me that it should be okay if I dip it in a solution for a few days.
Oh, in case you’re wondering, the needle is still ‘in play’ but the situation appears to be improving. But I digress…we came here today to talk about what happened in April.
The Dumpster Fire
You may recall my blog relating my first experience in the French health system. Consider this the second installment of the series…and I hope there is not a third. I wish I didn’t have so much insider knowledge on the French health system at this point in my journey, but since I do I feel that it’s my duty to report on what I’ve learned.
Apparently, when we were roaming through medieval French towns in March, I picked up the plague (I’m only kind of joking as there was never a definitive answer as to what I had). I subsisted on applesauce and flat Coke for three weeks and visited the infectious disease unit of my local hospital several times. It was a definite low moment.
At one point, my doctor called with blood results and said “You have to go to the emergency room immediately,” followed by “first you need to stop by my office because the system doesn’t allow me to transmit your results to the emergency room.” In France, technology is not always your best friend (more on that later).
We Uber’ed to her office and I immediately starting throwing up (which didn’t feel like the proper French thing to do). Then afterwards we walked out into the scene below – a dumpster fire. Aside from being a bit unsettling it also caused our Uber driver to flee the scene. Terra and I immediately realized that what we were seeing was an apt metaphor for how the day was going, as well as foreshadowing the next few weeks.
After a lengthy recovery I finally got back in the groove. My hero of this month was Terra – she ran her business like a champ, took care of me and our dog, and did all the chores, cooking, and cleaning – all while getting my medicine and accompanying me to the doctor. What an amazing woman!
Now that I’ve had such extensive experience in the French system, there are a few specific things that I like and a few that I don’t. Of course, having spent some substantial years in the US system, I’ll also comment in each section about how it compares.
What I Like About the French Health Care System
- Others are more concerned about costs than I am – Each step of the way, everyone (doctors, nurses, administrators) knew the costs of various treatments and always tried to protect me from incurring unnecessary ones. Costs are standardized, clear, and quite low in comparison to the US. One example: I was relieved to find out that my ultrasound was only going to cost 70 euros (around $80). The receptionist was confused as to why I would think that’s cheap – she exclaimed, “I didn’t say 17 euros, I said 70 euros”. I explained to her that this was, in fact, quite cheap compared to what I would pay in the US. (As a side note – this point also applies to our dog Cammy’s medical care.)
- I don’t feel like a ‘them’ – I am not a French citizen; I am a US citizen in France on a visitor visa. I expected to encounter at least a little bit of resentment that I was utilizing their services, but it was quite the opposite. At every step, people went out of their way to help me figure out where to go or find somebody who could communicate with me in English. The doctors worked just as hard for me as they would have for a French resident. Yes, because I wasn’t French I had to pay a bit more – but I was happy to. Simply put, the ‘us’ vs. ‘them’ mentality doesn’t appear to be baked into the French system (quite unlike the US) – the entire concept is that it’s for everyone, which brings me to my next point.
- Health care truly is available to the poor – Upon entering to the hospital the first thing that stuck out to us were how many poor people were there as compared to what we’ve seen in US hospitals. It may seem intuitive that poor people would need to utilize hospitals more, but my observation is that is not the case in the US. Again, the French system is for everyone. My understanding is that a check-up for a French citizen would likely be free and certainly wouldn’t cost more than five euros.
- Fewer parties involved makes the system simpler and less financially risky – Please don’t misunderstand – I’m not saying that working my way through the French system was ‘simple’. At one point I couldn’t even figure out how to pay for my appointment. However, the layers upon layers of stakeholders in the US simply don’t exist here. You don’t have to worry about insurance companies denying you coverage. You don’t have to worry about whether your doctor is ‘in network’ or ‘out of network’. You don’t have to worry about whether you should go to this hospital or that hospital. You don’t have to worry about whether you’ll be stuck with a unimaginably huge bill down the road. In the US there are many reasons – other than medical – not to go to a doctor. In France, you simply find a generalist who, if needed, will refer you to a specialist. And yes – that could take awhile. But in my case I was able to see an infectious disease specialist within 48 hours…not too bad.
- Pharmacies, pharmacies, pharmacies – Pharmacies in France are like your mother in a box. First of all, there is one on almost every corner – so they aren’t too busy and there is at least one pharmacist who has as much time as is needed for you. Secondly, they aren’t afraid to give advice and help you get to the next step. I’m not saying this advice is always spot on or even consistent, but most of the time you walk out with an actionable solution. And they are more than happy to recommend specific doctors to you if needed as well. I have a particular affection for pharmacies, because when I was sick Terra went to our neighborhood pharmacy, where a pharmacist questioned whether a medication prescribed to me by my doctor was too strong (something I was concerned about as well since it is also used to treat anthrax poisoning). He proceeded to call the doctor twice and got into quite an argument with her before ultimately standing down. When I heard that story I felt so grateful and protected – there are some amazing people in this world!
What I Don’t Like
- Sometimes processes are followed that don’t make sense – I think this is part of the French culture, not just the medical field. I’ve mentioned in this blog in the past that we’ve heard many times something is ‘not possible’ that clearly is possible (just not desirable for them at that time). Conversely, there are times when I am asked to do something that is a complete waste of time and makes no sense. For example, when I was extremely sick I made the effort the walk 20 minutes to get my blood drawn. My assumption was that, once my blood was drawn, it would just be sent to my doctor who would call me. But the nurse was insistent that I come back in person to see the results before she sent them to the doctor. I told her my own version of ‘it’s not possible’, and eventually she dropped it and I didn’t have to return. But there have been a few other situations in the medical system when I’m thinking ‘what you are asking me to do makes no sense.’
- Technology needs serious improvement – I cannot for the life of me understand why first-world countries like the US and France cannot get their act together and digitize health records so that all of your health information is available to any care provider. I would rather not, for example, have to Uber to the doctor so I can carry my blood tests to the hospital. I won’t comment more about this, except to say that we all need to take a look at what Estonia is doing in this area. The second issue that I’ve struggled with in France (not just in the medical field) is the complete lack of any coherent user experience when it comes to websites. With my medical situation, you would not believe how difficult it was to pay my bill online. And (speaking to the French website gurus now) stop requiring me to fill out a French phone number when I do things like purchase opera tickets!?! Getting anything accomplished online is a real challenge in France! Of course, it must be noted that I feel this way partially because of my desire for instant gratification, which is usually possible in the US.
For many in the US, the idea of the French system represents something unworkable, unsustainable, and unfair. While I recognize that the system is not perfect, my experience has been quite good – less expensive, packed with fewer unwelcome surprises, and at least as effective as what I’ve received in the US.
It will be interesting to see what happens in the coming year with US health care, but it’s clear that so much of it is not working. Why not learn from countries such as France in this area?