In France Health Care is a Right

There’s a very significant aspect of living in another culture: you learn, you grow, your perspectives change. You see some things in a different light because you have new experiences.
As you probably know, France supports a socialist government. Socialism is a term feared by some Americans and championed by others, at least it’s ideology. But I’ve come to understand that while (like Americans) not all French people support the socialist ideology, they mostly share in common the philosophy that health care is a basic human right. While they debate other issues of socialism, health care does not seem to be one of them. They believe every person deserves quality health care. Yes, I said quality. An American friend posted this (I only reprint a portion of the entire post here) after the U.S. elections:
“Everyone might have Health Care in the future, but the question is will it be quality care and how long will the lines be to receive it! … Time to get on our knees cause no human can get us out of this mess but they sure can make a contribution to making it worse. May you all be Blessed with good health or with the patience to persevere if you don’t……In time, we will begin to understand the “Hurry up and Wait Theory” that our fine men and women in the Armed Forces have learned to understand… How many are going to want to be doctors if their jobs go from taking the time to make the correct diagnosis to one that feels like/ resembles pushing cattle through a gate.”

I once shared this fear about socialized health care. And if not governed properly, this could happen. But I live now in a country that practices socialized health care, and I have been relieved and pleasantly surprised by my experiences here. I’ve never waited more than 15 minutes to see a doctor, and that’s with no appointment. I just show up at the waiting room and wait my turn. And when I see the doctor, he’s very thorough, kind, and helpful. In fact, I have learned more about my particular health conditions since living here because the doctors are so well-informed and have taken the time to explain things to me. I’ve found a doctor I prefer because he speaks some English and wants to learn to speak better, so he’s asked me to speak English with him. In short, I don’t feel like cattle being pushed through a gate. It costs me 23€ for a visit (about $30 US), and that’s with no rights as a French resident or citizen. For French residents, it’s reimbursed.

The pharmacists are equally helpful. You can’t just grab over-the-counter meds from the counter in France. You have to go to a pharmacy (and there is one on nearly every corner), and ask the pharmacist. You either tell them what you need, or you can explain your symptoms and they go behind the counter and take what you need. Same for prescription and non-prescription drugs–all are behind the counter. Of course, for prescription drugs you need a prescription from the doctor. Again, I pay full price for my meds. People here are often shocked by that, because they see health care, especially for long-term health issues, as a right. For three medications I pay 16€ per month. The last time I was in the States, and because I no longer have insurance there, I bought those same medications for $100. With a French residence card (I’m working on paperwork for this) I would pay nothing in France. There’s one pharmacy that’s particularly busy because it’s in a mall. I’ve waited in line there before (not more than 15 minutes), but I usually avoid that one. At all other pharmacies I’ve visited, there are several–sometimes as many as 5-7 persons–working and I don’t wait at all.

For over-the-counter meds, I’ve taken something for headache, stomach upset, and allergies. I do not believe I am exaggerating, because my son, who has severe allergies here, has said the same: the quality of the medications is excellent. The allergy medication he takes here starts to work almost immediately, and he continues to be surprised by this. I can say the same. Several of the meds are dissolved in water, and they work quickly and well. I’ve never had these kinds of meds in the States. I’m very pleased with such quick relief from a migraine or upset stomach, as you can imagine.

I’ve had less minor illness since I’ve lived here. In France people eat healthier, they walk more, and in general, are in better shape and thinner (I’m still working on the “thinner” part). There are strict laws about what can be added to foods. Chemicals and preservatives are less common; therefore, the foods are healthier. The French eat lots of meat and vegetables, but the meats have more of a wild taste due to the fact that laws do not allow farmers to sell meats from heavily vaccinated and chemically injected animals. It’s so easy to find “fresh” fruits and vegetables here. The French eat LOTS of bread, but they buy it everyday, fresh. It doesn’t last more than a day or two because it is not loaded with preservatives.

I was surprised by a comment from a French radiologist the last time I had bloodwork to regulate my thyroid medications. He asked if I was American, and I responded, yes. He said thyroid conditions in France are rare, but very common among Americans due to the preservatives in foods. I’ve never heard this before, but some research indicated that he was probably correct. And by the way, I walked into a lab, had bloodwork done with no waiting, and picked up the results before 2 p.m. the next day.

I’ve been bitten by a dog and a spider since living here. The dog is a vicious beast owned by an equally non-personable neighbor. The spider was one of the many that live in our old stone home and was obviously hungry one night. Both bites became infected. In both cases I showed up at the doctor’s office with no appointment (night hours and weekends are common), and received in one case an antibiotic and in the other a topical cream. No further issues. In the case of the dog bite, the doctor informed me that by law I could request the dog owner to take the dog to the vet TWICE and send me written verification that the dog was without disease. I did this and received two letters within the next couple of weeks from the vet. Since the spider was among my own inhabitants, I had no recourse.

For the French, “Sécurité Sociale,” which refers to their medical benefits, covers most care. In some cases they do pay 70%, but many French people have supplemental health care insurance (privately, not through an employer), that covers the remaining 30%. In this case, the French pay nothing for care. And the premiums for this supplemental insurance are very low–about 20€ per month–depending on the situation and needs.

And finally, one of the most impressive aspects of French health care: for persons with terminal, long-term, or serious illness, security social covers 100% and these critical patients receive priority, highest quality care. In other words, the French believe in taking the best care of those who really need it. I have a daughter with Type 1 diabetes. She lives in the States and pays about $100/month for diabetic supplies, and that’s WITH great health insurance. In France she would pay 0€.

My aim is not to attempt to convince anyone to change their political views. I simply want to provide another perspective, and a true experience. So often our views and ideas are based on our narrow experiences, and we fear and reject that which we don’t understand. Here’s an excellent article describing the French health care system accurately:

Next time, I’ll depart from the serious and entice you with photos from my trip on the French Riviera.

Taxing Times

This post, Taxing Times, by Catherine Higginson caught my attention today. On this site dedicated to helping foreigners in France (like me) adjust to life here, she compare the benefits of high taxation in France to her home country.

She’s British, I’m American, so our comparisons are different, but she makes some excellent points regarding the benefits France offers with regard to healthcare and education in relation to higher taxation.

I don’t agree with all aspects of France’s social system, but my brief reply was to agree with Catherine: France may tax its citizens higher than some countries, including my own native home, but France’s citizens also have the comfort of knowing they will be taken care of health-wise and their children will receive free education (or a less expensive private education). This, I champion.

As an US resident, I was opposed to a social system; and while I don’t say I’m completely in favor of it now, living in France has opened my eyes to some of the issues, and some real benefits.

As of yet, I have not had opportunity to take advantage of free healthcare or education. I pay full price for my healthcare here in France and my son is in private school. But I can tell you that even at full price, I pay 1/4 for both healthcare and private education here in France compared to what I paid in the US. My point, even as a person who is not completely benefitting from the social system and yet paying higher taxes, I still feel I’m getting a benefit. If I were still living in the States, I would be paying taxes, plus insurance premiums, plus private education expenses. In France, I’m paying higher taxes, but paying much, much less for healthcare and private education. And I’m not paying medical insurance premiums.

So, maybe it’s a wash, at least for me.

Here are a few examples:

In the States it may cost (generally) $120 a month for health insurance (my portion, employer paying half or more). With insurance, it would cost me $20-$30 dollars to see a doctor and $60/month for some regular medications I take. In France, I have no insurance premium to pay, and I pay €23 (about $30 US) to see a doctor, and €16/month (about $20 US) for medication. Wow. That’s a big savings.

In the States, my son’s private school cost almost $10,000/year. In France, he’s attending an excellent private school for €1,100/year (about $1,400 US). And if he were in public school, it would be free.

Ok, taxes are significantly higher in France. Without doing all the math, at best I’m coming out ahead. At worst, it’s a wash.

What about quality? My experience so far has been that France’s healthcare providers are very knowledgable. In fact, I’ve been impressed. I’ve learned some things about my own conditions that were never told to me by a US doctor. I’ve taken some over-the-counter meds that worked far better than anything I had tried in the US. And I’ve never waited more than 15 minutes to see a doctor or get an x-ray (and the results of the x-ray were ready next day). I should also mention that going to a pharmacy here is almost like going to a doctor. Pharmacies here (unlike grocery stores) are well-staffed and the personnel are very knowledgable and helpful. Tell them your symptoms and they’ll offer you relief, as long as it doesn’t require a prescription, of course.

As far as the private school my son is attending, well, I can’t say enough about the high quality and the progressive and proactive philosophy of the school. Every student is required to have an iPad. Teachers send them notes to their iPad to reference in class and some of the textbooks are on iPad rather than hardcopy. I love it, and so does he. The students take notes on their iPads and then can share their class notes easily. Teachers encourage this. It helps them all have a better understanding of the material.

My purpose is not to say that one country offers better than another. They’re different. Our choices are different. Our experiences are different.

And our differences are what make us interesting.

Thanks to Catherine for that great post. See Catherine’s blog.



Moving A Child to France 2: School

I made the first inquiry in March about how to get my son enrolled in high school in France. They told me to call back the end of August.

They weren’t kidding. August 30 is when everything opened back up after the summer holidays, and school started just a few days later. So I thought a visit to the school, a few papers, and within a few days he’s ready to go to French school.

No, I didn’t really think that. This is Southern France.

During August the entire country (I exaggerate only slightly) is on holiday and nearly everything that resembles administration of any kind is closed. With school only a few weeks away, I was surprised and frustrated that I could not find one person available to answer questions about where to start–until Aug. 30. And then there was an exam to be taken to determine his level. The exam was scheduled for Sept. 14. School started Sept. 5.

Yep. Thats about how it goes here. I mean why should I expect that he would start school on the first day? much less in the first week? Because after the exam, then they have to find a school. Oh, yes. It’s not as simple as going to the local high school.

On the day he took the exam, the examiner told me to local high school was full. We’d have to find another in a town somewhere close, hopefully. This was from the man who runs CASNAV, and organization with the goal of helping children newly arrived in France get adjusted, settled and enrolled in school.

You’ve got to be kidding me, I thought. But I was ahead of the game. While waiting for the exam, I had been working to get him into a private school.

I’m happy to report that he was accepted to an excellent school, and I couldn’t be more pleased. Education in France is free, including universities; of course, private schools are not. Because France has this mentality of education for all, even private schools here, or at least the one’s I’ve seen, are relatively inexpensive compared to private education in the States. 110€ per month for tuition, and another 93€ per month for him to eat everyday in the canteen. I don’t think I could feed him at home for the cost of tuition and lunch at the school.

I’m not sure if the public school would have required different paperwork, but I think this is standard: vaccinations, proof of residence in France, and liability insurance.

All students in France need liability insurance in case something happens to another student as a result of some action, like another kid trips in the aisle over your kid’s foot. Bizarre, I know. But it was only 13€ for a year, so I didn’t even groan.

And so, he boards the bus every morning at 7 and gets off the bus every evening at 7. Schools in France have longer days than American schools, but more and longer holidays. School usually starts around 8 am and end around 5 pm, except on Wednesdays, when most schools close at noon. There are lots of breaks in the day because classes seem to work more like an American university with regards to their schedules. On Thursday mornings he has a 2-hour break, so that’s when he takes private French lessons.

He had one year of basic French in the States. Not enough, but at least it was an introduction. If we hadn’t worked out a certain type of arrangement with the school, he probably would have had to start back a year or two, at least until he picked up the language. He’s doing ok in physics and math, but the philosophy may as well be taught in Greek. He doesn’t understand a word. But then again, he says the French students in the class don’t understand a word of it either. English is, of course, is easiest subject, and I think they like having an American in the class. It enhances the other kids’ English studies.

So in the end it worked out better than expected. And Friday night he spent his first night out with his new friends. They threw him a birthday party.


French Red Tape

Translation for my non-french-speaking friends:
And us also, we are French?
But yes, everyone in the universe is French.

There’s a reasonable explanation as to why the French have a reputation for bureaucracy–they’ve earned it.

As I’ve learned after a year-and-a-half of trying to get anything official done here, there is no such thing as official. Just because the official government website says it’s so, doesn’t mean it’s so. If you speak to a government official and they tell you it’s done a certain way, don’t count on it. The next official you speak to will tell you something quite different. And who’s right? Why, they both are.

Take my recent experience trying to exchange my U.S. driving permit for a French permit. According to the official website, my state has an exchange agreement with France. I’ve learned not to count on the official website, so I went directly to the Marie annex to get the appropriate paperwork and the answers for my locale. The lady handed me a written list of everything I would need to submit. Great, I thought. I have it in writing.

So, I gathered everything on the list. One item asked for an official translation of my original permit OR an attestation of validity from the US. Notice I capitalized OR. In actuality, the instructions were in French, so it said OU. Ok, that means I need one or the other.

I traveled to Marseille, gave the US Embassy $50 and they gave me a paper that says it is an official translation and attestation of validity of my permit. I included it in the portfolio of other documents required. I was ready to get my permit, or so I thought.

The translation/attestation of validity, I was told, was not acceptable. I needed both, the lady said. I pointed to the “OU” and said, the paper says I need one or the other.

Are you ready for her answer? She put an X through the “OU” and said I need both.

And such is the arbitrary French system. As carefully as I have tried to plan for every scenario, when I show up with exactly what I think they want, they arbitrarily change their minds.

I didn’t stop there. I called the US Embassy to see if I could get another type of paper. I was told that is the paper the US gives out to meet France’s requirements. What else can we do, she asked? It’s a translation and we stamped it with our seal to say it’s valid.

And so I told this to the not-so-kind lady at the French bureau. Her response: It’s not acceptable. And so I just stared at her for a few minutes, and finally asked, in French, so give me a solution. She shrugged her shoulders and moved back to her desk.

Technically, I’m supposed to get a French permit after living here for a year. At least that’s what the official website says.

So, what am I going to do? I’ve decided to adapt to the culture and make my own rules. I’m going to keep my US permit.