Friday, April 20, 2007

Health Care in France

Jerome a Paris is a Frenchman who blogs on Daily Kos as well as the European Tribune. He has a 4 year old son who was diagnosed with a brain tumor 2 years ago. For a while, after surgery and chemotherapy, they thought he was cured, then last fall, it was discovered that the tumor had returned.

Today he wrote a diary about the numerous tests and surgeries and aftercare his son has been through; how his wife had to be available to take the boy to all his various therapies and how it was all paid for.


So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.

An interesting twist to that story is that we do have private healthcare insurance in France. Basic healthcare is covered by social security, but only partly: except for the poor (under a certain income level), there are co-payments for most expenses like medecine and doctor visits, and doctors are also allowed to charge you more than the official tariff (and you have to pay the difference, in addition to the co-payment on the official price).

Thus many people buy private (or mutual) insurance to cover that difference partly or fully. Such insurance is often provided by your employer. But whenever you have "major" expenses, you switch to 100% coverage of expenses by the public system - except that, if you had a private insurer, it has to pay to the public entity a portion of the costs.

In my case, as I had a good insurance via my bank, this is what's happening, and thus the private sector bears a portion of "catastrophic risk." (And they have no say in what care is provided. They just pay an agreed fraction of it.)

Thus there is solidarity across the sytem.

:: ::


This is not to say that all is well in French healthcare. As in other countries, costs are barely under control, spending increases every year, and there are many ways the system could be improved for doctors, nurses and patients. But the fact remains that if you are badly ill, you will be taken care of; you will not need to give up your job (or if you do, you're helped); you will not need to sell your house; and you will not be denied healthcare (see my second comment below).


It's been tough enough to deal with a sick child; I simply do not want to imagine what it would have been like if I had to beg for care or to scurry around for money in addition. It's just inconceivable. And thus, I was happy to pay taxes before, and I'm really, really happy to pay taxes now to provide that level of care for those that really need it.

For many American, trying to cope with an illness is devastating. Trying to then cope with, figure out and stay on top of all of the paperwork and fighting with insurance companies that result is simply impossible. It is past time to change the American system to one of Universal Health care for all.
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Some more perspectives from comments in that diary:

My wife was pregnant in Vancouver in 2005. She'd had health issues with her reproductive system and wasn't supposed to be able to get pregnant, so we counted ourselves lucky.

Then we hit the health system.

*  Three ultrasounds.

Three visits to the OB/GYN to prep.

Four visits to the family doctor.

Parenting and childbirth classes every Wednesday for two months.

Two visits to the hospital - both false alarms, but both resulting in half a day of bed time.

Two dedictaed nurses at hand during the delivery, plus the OB/GYN, plus an anasthesiologist.

When complications arose, the head of surgery came around to discuss a C-section as an option.

She had the C-section, with eight doctors, nurses, specialist, etc in the room. No problems, baby healthy.

Five nights in hospital after giving birth - private room.

Post-natal instruction from lactation specialist and parenting consultants.

Once home, weekly visits by nurses, further visit from lactation specialist, just to be sure all was well.

All vaccinations and several visits to the family doctor to ensure the baby is developing well.

For all of that, no charge. Nothing. Nada. No private health insurance required.

So what was our horror story? A month after we were out of hospital, we got a bill for $25 for the TV rental in my wife's room.

$5 a day for a TV! Outrageous!

Posted at: http://www.dailykos.com/comments/2007/4/20/1179/27363/184#c184

From Denmark:

Family member diagnosed with leukemia at age 11. Got cutting edge treatment at no cost. Mother got a stipend for one year to stay home as caregiver. We are seven years out and he is cancer free. I believe he is now allowed to consider himself cured.

No bake sales, no agony for the family, no huge deductibles and co-pays. Just the dignity of quality medical care and the freedom to focus on getting well. His dad used to like to bitch about the high tax rate (it's sort of a national past-time there) but he sure knows it was worth it.

And best - as this young man approaches adulthood - no worries that he's tapped out the limit on a policy, his medical history has not caused his father's small business to die under the crushing weight of increased premiums due to his medical history or worse to have their insurance cancelled as would have happened here. And he has no worries that he'll be tagged with the dreaded label "uninsurable" for his entire adulthood.


Another...

My brother in law spent 14 months in hospital...

In the UK. He had Guillame Barre syndrome. Fourteen months in hospital. Two complete blood transfusions. Months of intense after care. Cost: nothing. Estimated cost in USA $3-4million, no insurance death. You Decide.

Healthcare coverage in Norway

Is very similar. The co-pay for all residents of Norway maxes out at around $200-300 per year. Medicines for most chronic ailments are also covered by this co-pay. Life-threatening illness is covered %100 from the get-go.

Kids under 12 have full coverage and no co-pay. The poor and the elderly have good plans as well.

Comparisons between the French system and that of the United States:

Real growth (adjusted for inflation) in health care spending per annum
United States: 3.2%
France: 2.3%

Total health care funding (public and private) per capita
United States: $4,631
France: $2,349

Health care spending as a percent of GDP
United States: 13.9%
France: 9.4%

Life expectancy in healthy years (women)
France: 73.5 years
United States: 68.8 years

Life expectancy in healthy years (men)
France: 69 years
United States: 66.4 years

Infant deaths per 1,000 live births
United States: 6.43
France: 4.31

One can take virtually any health care statistic you want: If it's results, we do worse than just about any other developed country, but if it's costs, we pay more than any other developed country.

Source: http://www.nationmaster.com


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