Democrats Abroad France Normandy Chair Comments on French Health Care System

I just thought I'd put in my two pennies worth about the French system of universal healthcare.

In fact, I am a person who avoids doctors like the plague and only seek medical care in an emergency. Even so, I'd much rather be in France than in the U.S. when that emergency happens.

Medical emergencies
In 25 years, our family has only had two major emergencies and in both cases, the medical care was exceptional and cost us nothing. The first was when our 5-year-old daughter caught her foot in the spokes of my bicycle while in the carry-on seat. She almost lost her heel. The neighbor rushed us both to the emergency room of the nearest medical facility, a private clinic. We were met by a surgeon and she went straight into the operating room. We both stayed in a private room for a week. I had a cot in her room, could stay with her 24 hours a day, and had meals in the room with her. All we had to pay was for my personal telephone calls. Everything else was covered between social security and our teachers' mutual insurance. To this day, whenever any medical person sees her scar, they are amazed at the terrific job the surgeon did - she was within one centimeter of losing her entire heel.

The other occasion was when the coffee machine exploded on me and burned both hands and arms up to the elbow. Again I rushed to the same medical facility, was met by the same surgeon, and received instant top care. Again it cost us nothing. In fact, we then contacted our mutual and asked for household help, because I could not use my arms or hands. That same day, a specialized caregiver arrived on our doorstep, and was there to do anything that needed doing -- housework, meal preparation, driving.... She came every day for three weeks, until the burns were fully healed. Today I have no scars whatsoever, although at the time, all the flesh of my inner right arm had disappeared....

Giving birth
The French system has positive and negative points. One is that because everything is free, people tend to go to the doctor on the slightest pretext. They are also heavily over medicated. Each time I was pregnant, I was required to have an examination every month, plus an ultrasound at four months and another at 8 months. These experiences were traumatic for me -- they felt like a violation of my privacy and not necessarily good for the child. However when it came to delivery, I, like every other woman here, was kept in the hospital or clinic, for a full week after giving birth, and again, at no cost other than my phone calls. I have been told that in the U.S. costs for staying in the hospital just overnight after giving birth are astronomical.

Mental Health
When discussing medical coverage, we need to include mental health. When close relatives have needed mental health care, they have been able to walk straight into a clinic, and receive counselling, therapy, and psychiatric care at no cost. No identity papers had to be shown, no forms filled out. The care continued as long as needed.

Alcoholism is treated as an illness. One member of the family went to his doctor, confessed the problem, and was sent to an alcohol specialist who treated every aspect of the problem -- physical consequences, addiction, psychotherapy. If necessary, the person would have been sent to a reatreat -- however in this particular case, other solutions were found. The entire attitude towards alcoholism was very enilightened and effective -- and the person was charged nothing.

Similarly, when another member had a mental breakdown, she was able to go to a psychiatrist in a socio-medical center and follow therapy without ever laying out a dime or filling out a form or even showing an id card.

Pros and cons
The French social security system is much more comprehensive than anything in the U.S. The way it is financed contributes to the economic gridlock of the country, because social charges are so high that employers can't afford to hire additional personnel. Furthermore, the employer has to pay these charges whether or not s/he has had any income at all. This problem is being addressed in a variety of ways, as the government tries to find more flexible means of financing social care. In terms of medical and mental health care, as I mentioned, people tend to abuse the system -- going to the doctor for a sniffle, overmedicating, and not taking responsibility for their daily life.

Nonetheless, as I stated in the beginning, I'd rather be in France in an emergency than in the U.S. Furthermore, healthcare and a wide variety of childcare facilities were major reasons for staying in this country when the children were small.

Christine Rolland
Chair
Democrats Abroad France Normandy

Don't Believe What You are Told by Republicans

An American in France responds to a CNN story about Health care.
It starts with this:
"As an American living in France I speak about government health care based on experience. Don't believe it when you're told you won't be able to choose your doctors or treatment."

Watch the video here
http://www.ireport.com/docs/DOC-268771

Blog posted by Linda
Video by Sally in Paris

Prostate Laser Surgery for the Equivalent of $1500

I'm a permanent resident of Japan and therefore am an automatic Japanese National Health Insured Payee; I had the latest laser surgery (as per date of surgery) for prostrate complications, for around $1,500 on February 5, 2008. Period!!!!! It's called HOLEP.

I've researched the internet and wasn't able to come up with the costs in the US, but I do recall it cost almost $1000 alone to get checked in NY. And people who are familiar with this procedure are well aware that $1500 would barely cover the room costs in the US.

PJ Johnson
Tokyo
New York

In case you don't believe Americans living abroad, will you believe Canadians?

Why Make Life Worse for High Risk People

I feel that in the United States there is a general tendency to be more nervous about the government trying to "help" with health care support than one really needs to be, and those of us living outside the United States in countries with government-supported health care plans which are really helpful do have some insight into how useful such programs can be.

I retired a few years ago, and am now receiving a state pension from Austria as my main source of support - after having paid into the system for more than 30 years. (The minimum for receiving an Austrian state pension is 15 years - which I exceeded by more than a factor of 2.)
The Austrian state pension is very generous if compared to some countries like the United States, but I presume that you also pay much more into it during your working years.. (This is basically a good idea, I think.)
Being retired and receiving an Austrian state pension, if I were to be living in Austria (including perhaps certain other EU countries as well), I would still be eligible to be participating in the Austrian National Health Insurance.. But, living in Japan now more than in Austria I am not currently eligible to be in the Austrian National Health Insurance program. I am eligible however for the Japanese National Health Insurance program, which I have joined.

The impression I have is that with the National Health Insurance plans,
"everybody" is eligible, irregardless of whether you have the "bad luck" of falling into a high-risk group or not. But, when there is no National Health insurance program, and you must get health insurance from a "private" group, or have none at all, these companies may well discriminate against high-risk people, and they may be left "out in the cold". These people are in an "unlucky situation" anyway, and to make the situation for them even harder, that is something one should want to avoid somehow, if possible. By including a substantial fraction of the entire population of the country in a National Health insurance program of some kind, one can spread the risks over a very large number of people, so that individual people do not need to be "singled out" for difficult situations.
This is even more true in countries with large populations like the United States.

Jim McNaughton
Japan/Austria

Moving Abroad for Treatment of Genetic Illness

Several years ago, a reporter told my story in the WSJ (http://online.wsj.com/article/SB119515792495794643.html) about how my husband was fired (and later rehired when I was now pre-existing) when I started showing signs of a genetic autosomal dominant disease. We have a self-funded health plan through his employer. My husband was a die hard believer that the USA is best in everything, esp. health care, since his father was a doctor until he died in the early 1990's. When we lost our care, and I started going downhill fast, I suggested we go to Belgium and see what kind of care I can get there. I must add that I was previously married to a Belgian, lived there for a while and became a citizen. We went, talked to the leading geneticist in the world for the disease, and got a game plan for treatment--all for free. My husband cried. We are now trying to sell the house here in CO before I die. I am already becoming very ill, but we need the cash from our home in order to move. I was featured on a Flemish TV show as an example of how health care is issued in the USA. Also, I corresponded with several high school students in Belgium about how poor the US system is, even for those who have insurance when they get ill. I write to Obama, Max Baucus, etc., daily because this madness has to stop.

Please pray that our home sells so we can move. My Ehlers Danlos syndrome is getting worse. I can hardly walk. I was able to qualify for a free colonoscopy (when my husband lost his job. We had to pay the medical bills our insurance reneged on, we were close to being destitute and lived on my husbands unemployment and what aluminum cans my then 11 year old could pick up). The doctor doing the colonoscopy said he did not believe in Ehlers Danlso-he said it was what people who bend a lot think they have. After the colonoscopy he thought I belonged in a hospital because my colon tissue was so fragile he wondered how it still held up, and because my colon had no structure and was falling apart. He asked me never to come back to him because it took him 3x as long to do the procedure since he had to be so careful and go so slowly. He said, I don't know what is wrong with you, but is is not good.
Can't wait to sell the house and move.

Thanks for all you do for the movement of HR 676.
Barbara Calder, dying in Colorado Springs, CO
Belgium

We Urge the US Government to Implement Universal Health Insurance

My wife and I have a Japanese national heath insurance, which covers our basic needs with about $650 a month. It includes basic dental cares as well. It makes us feel secure since we are getting old. I am 61 and my wife is 48. So we urge our US goverment to implement some kinds of universal health insurance now since we get back to the US in a few years.


A. Kishida
Japan
Orange County, California

My daughter's ER care was free

On Thursday night, April 9th, 2009, my daughter (9 years old) spilled boiling water on her foot. Since I was not sure of the severity, we took her to the local hospital ER and were seen by a doctor within 20 minutes (fortunately, it was not so severe). Since we had also registered the children in advance with the city (and received the papers stating we had done so) I just had to show our insurance card and the preregistration for hospital care. Her treatment was free. We were given a letter of introduction for a local clinic to follow up her care the next day, and that examination and treatment were also free. We were told to return after two days for another examination and treatment at the clinic--again free!

There is absolutely nothing to be afraid of in changing the healthcare system in the US! It will only benefit the thousands of people who don't have access to it in the present situation.

Brooke Yamaki
Japan
Minnesota

Coming from a Conservative Family, I was Suspicious of Universal Health Care

As an American citizen, I know how it is in the states. During college, I was slightly covered by the university's student insurance plan, but when I actually needed it, it only covered a part of the costs, and I found out how little when I got the bill. I could have bought a nice car for the price. I had to use my student loan money to pay it off.

After University, I tried my hand at working independently. But with the plans being confusing and requiring a separate university degree just to understand what I was supposed to be choosing/paying for/ and getting, it isn't any wonder that I gave up on trying to be insured. I just tried to keep myself healthy and rely on over-the-counter medicine.

Then I came to Japan. While working for the government, I was first introduced to the universal healthcare plan. I admit, having come from a conservative family, I was suspicious of this system. It certainly took a large chunk of my salary, but once I was familiarized with the ins and outs of it, I grew to respect it. To be fair, I will list both the bad points along with the good points.

Bad point 1: senior citizens, who pay almost nothing for a visit to the doctor, will go to the hospitals almost every morning to get looked at for whatever ails them. However, it should be noted that there are a growing number of small clinics connected in some way to the larger hospitals, and so people can go to the small clinics, see a local (read as family) doctor to get a first look, then if needed, get a referral to a doctor in the major hospital, jumping to the head of the line when needed.

Bad point 2: Dentists here are all about painless dentistry. that means that each visit will be a week apart and last for 10-15 minutes. This will continue for 3-5 visits depending on what is needed. The first time will be about 1500 yen, which includes X-Rays, and subsequent visits will be about 6-700 yen. Detractors will say this is evidence of the dentists milking the system, but the visits are truly painless. Unlike when I had a cavity filled in my homeland of the U.S. I was given 2 hours of excruciating pain as the doctor jabbed, drilled, filled, etc. then had to deal with a lot of pain when the local anesthetic wore off. To make matters worse, the filling came out not 3 days later, and I had to pay another 80 dollars for the dentist to put it back in... (dentistry wasn't covered by my u.s. insurance at that time). I have had a root canal, and 2 different cavities filled while here in japan, and the price hasn't changed one bit.

Good Point 1: Children are free. Depending on which prefecture you live in, the government gives a subsidy in cash every 4 months to care for babies through to elementary age. And the medical visits for children to pediatricians is 100% free. that includes the medicine as well. That also includes all the shots and check ups that babies need to become immunized. All free.

Good Point 2: Medical expenses are refunded. Go the hospital in Japan? Save the receipts if you are living here, and when you go to pay your taxes, submit a form with the receipts and whatever wasn't covered by the insurance (which covers about 90% of any medical fees and medicine fees) can help land you refund money.

Good Point 3: no paperwork. Seriously. I was SOOOOO tired of filling out requisite forms in the U.S. for my insurance company I initially used when I arrived in Japan. Here I get a card. I give the staff my card, and they give it right back when I am done. That's it. I don't have to get a doctor to write forms in triplicate.


Good Point 4: The prices don't change. The premiums are the same every year. They don't change as a result of having used the insurance. Here is a negative example of what happened to my father in the States. He had a problem that required him to stay in the hospital for a few days. He remembers only receiving two asprins for pain during his entire stay. Yet when he got the itimized bill, he found that they charged him for having supposedly received pills every hour for the entire time he was in the hospital. Yes, that's right! They charged him for apparently taking hundreds of pills that never entered his room let alone went down his throat. When he told his insurer about the fraud, they told him there was nothing that could be done. They would still raise his insurance premium for having used the insurance at a hospital and cost them so much. As for the hospital overcharging him, that was explained away as the way hospitals operate nowadays. when
someone doesn't have insurance and comes into the ER, people who have insurance are charged for their medicine. The insurance companies raise the rates of the people paying money for their insurance and don't do much to stop the hospitals unless too many people complain, and then they just stop allowing their customers to use their insurance at the hospital. They don't do anything to stop the fraud itself. So in the states, those who pay for insurance pay more for paying for those who don't pay anything for their visits to the ER. Wouldn't it just be better if EVERYONE was covered, and the rates stayed the same regardless of who used them or how much was needed?

S.S.
Japan.

Lining up for Great Care in Japan

I have been in Japan for 1 1/2 years and have had nothing but positive experiences with their universal healthcare system. When I got sick with a sinus infection last year for the first time, I went to see a foreign trained doctor that does not take Japanese health insurance. I was given a bill for over $250 that I submitted to my medical insurance company in the United States. I have never heard back from the insurance company about my claim although I know that it would have been excluded or applied toward my deductible anyway. The doctor had not given me antibiotics even though I needed them. I suffered for a few weeks until I got better. A couple months later, I became ill with the same symptoms and this time I went to a Japanese clinic that was recommended to me by a friend. It was a modern facility that most Americans would be impressed with. It was very efficient with me lining up to sign in, me lining up to see the ears, nose and throat
specialist, me lining up to have my airways cleared by a ventilator, me lining up to pay and me lining up to get my medicine including expectorant, antihistamines, and antibiotics. The doctor spoke fluent English, it cost around $20 which included the medicine and took about one hour with no paper work to do or bills to pay later.

Next time I went to the same clinic to see someone about a uninary tract infection. I had no appointment and lined up that morning at the front desk where I was asked what my problem was. Soon thereafter, I was told to line up outside the specialist's office. I had another positive experience and it took a total of about one hour and cost less than $20 which included medicine and a lab test.

In October, I had a routine gynecological check up and I felt the equipment used was of a much higher caliber than in the United States with a robotic motorized table that rotated so that I would not have to scoot down to put my legs in the stirrups and the use of ultrasound to look for the presence of tumors - the was a routine procedure. Again, my doctor spoke English fluently and the care was superb. It cost around $15.

Then I saw a dentist recently for a chipped tooth and cleaning and it was covered as well under universal healthcare in Japan. The dentist has a PhD in the United States, during the cleaning the dental hygenist used an ultrasound descaler which made it much less painful, and I was charged $30. Can't beat that.

We are now in a position that we are thinking of not returning to the United States to live because of the cost of medical insurance and care since we are getting older and the cost of private medical insurance after retirement and prior to qualifying for Medicare will be prohibitive. I never thought that the USA, the land of plenty and the greatest country in the world would have an citizen like me who now must choose to not return to her homeland in order to receive better and less expensive healthcare.

Althea
Japan
California