“Before you spend a lot of money, make sure you have 3 months’ salary in the bank.”
“Why?”
“You might get sick.”
“But I have health insurance.”
“That won’t cover everything.”
“Well, it covers 94% of my medical expenses.”
That shortened the talk.
As time passed, I became aware of differences between my American friends’ health care experiences and my own. But my understanding remained vague until I saw Michael Moore’s film Sicko about 5 or 6 years ago. An insurance company could deny you coverage? You could be told that you had exceeded your limit and would no longer be covered? You could go bankrupt paying medical bills? Really?
My education was completed during the lengthy media coverage of the health care reform debate in 2009. Republican politicians succeeded each other on talk shows proclaiming proudly that the United States had “the best health care system in the world.” “It’s not about quality it’s about ACCESS,“I yelled back.
There was accurate information available.
National Public Radio even spoke quite competently of France.
But misinformation ruled and even now many are still opposed to the reform.
When I got sick in Charlottesville in December, I got a chance to experience part of the American health care system first hand and do my own comparison.
I had previously gone to a Walk-in clinic in Charlottesville but it was difficult to get to by bus and I don’t drive. Each time I had to go, I thought regretfully of SOS Medecins in France. (Since 1966, if you need a doctor, you call the number of the local SOS Medecins. Within half an hour one comes to your house.)
This time, I consulted several friends. They decided the best place for me was the University of Virginia Primary Care Center -- a short bus ride from my house.
I called them and was told that I couldn’t see a doctor without an Initial Visit and there were no appointments available for Initial Visits until the end of December. If I couldn’t wait, I should go to the Emergency Room. I replied that my illness was not an emergency, that I hoped to be well by the end of December and that I needed to see a doctor now. I was apparently convincing. The woman started to take my personal information. When she asked which health care plan I had, I replied that my insurance was in France. She told me I’d need to call the Finance Department. When I did, the woman I spoke to asked if I had a regular income. Not in the United States, I replied, but I did have a bank account and a check book. And I was sick.
“Do you have more than $2000 in the bank?”
“Yes.”
“Then you don’t qualify.”
“I don’t want to qualify; I want to see a doctor.”
She returned me to the Primary Care department where a different woman bent the rules so I could have my Sick Appointment before my Initial Visit. (Who knew there were different kinds of appointments. I later found out there were also Well Appointments. Each of these is reimbursed differently by different health plans. And there are many. One major pharmacy boasts that it “accepts over 5000 health plans”.)
And so I finally entered the Primary Care Center.
After I had paid (payment comes first), a nurse took my temperature and blood pressure and weighed me. Then she led me into another room. Soon a young doctor came in. She was warm and thorough. She told me I had a virus that would last about two weeks. She was right.
The first day I felt well was the day of my Initial visit. After the payment and the nurse, another warm and thorough doctor went through my medical history with me and keyed everything into a computer. Payment for the Sick Visit was $126. Payment for the Initial Visit was $147. Payment for any visit in France is 30 euros (about $40)
"What about foreigners in France?" you ask. Several of my American friends have needed medical attention in Paris and have had similar experiences to Karen Fawcett, an American expatriate who gives advice about life in France.
I returned to Paris in January, held my Carte Vitale and my complementary insurance card to my heart.
I knew which country I thought had the best health care system in the world.
