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.



Documents for France

Sometimes I feel like I’ve gathered my life into this 3-inch folder. And it keeps getting thicker.

The process of entering a new country seems never-ending. Once I’ve crossed a hurdle, there looms another. This week it was my cart de sejour. What a relief! But now I need to start thinking about changing my driving permit.

Sometimes I haven’t had the papers I’ve needed, and it’s more difficult to get them once you leave the States, or more expensive to have them delivered, so I had the idea to create a list of documents I’ve needed or thought I might need. I’ll add to it as needed. And if anyone has other suggestions, feel free to comment and I’ll add them to the list.

Oh, and sometimes you need these translated into French.

Documents from Country of Origin:

  • passport (and many photocopies)
  • birth certificate (many photocopies)
  • social security card
  • driver’s license
  • medical records
  • vaccination records
  • proof of address in country of origin (phone bills, electric bills)
  • financial statements: retirement accounts, bank accounts, insurance, tax documents, pay stubbs for 3 to 6 months, proof of income
  • health insurance records
  • marriage certificate, divorce papers
  • diplomas, transcripts, French language certificates or other proof of language study
  • resume or CV
  • work contracts
  • important phone numbers
  • contracts, agreements, records for any outstanding properties or other incidentals in country of origin (for example, I needed to have my contract for my storage unit with me so I could renew over the phone; car title; house or mortgage records).
  • Demande De VISA Pour Un Long Sejour (application for long-stay VISA)
  • Demande D’Attestation OFII (this document must be certified by the French Consulate in your country of origin and presented to the OFII in your French prefecture in order to obtain a carte de sejour)
  • Prepaid Flat Rate Mailing Envelope (for return of your passport and long-stay VISA)
  • head and shoulders photo (size differs in France, so read all instructions carefully for requirements)
  • Power of Attorney (I left these in case I needed someone to deal with business in the States in my absence. It turned out to be necessary. If you have real estate, you need a separate POA that states very specifically the liberties of the person in your stead, and must be notarized and filed in the precinct where the real estate presides; at least this was the case in Virginia.)

Documents in France:

  • proof of address (It’s a good idea to put a cell phone or some other bill in your name at your French address. Everything was in my husband’s name, so it was often complicated.)
  • proof of income (work contracts, pay stubbs, bank statements)
  • French bank card (open a bank account in France as soon as you can)
  • Livret de Famille (if you married in France)
  • Acte de Mariage (equivalent of a marriage certificate; certified by the local Marie)
  • Titre de sejour (record to show you paid taxes upon entering France; required for carte de sejour and auto insurance)
  • Certified D’Attestation OFII (this document must be certified by the French Consulate in your country of origin and presented to the OFII in your French prefecture in order to obtain a carte de sejour)
  • long-stay VISA
  • national identity card of spouse (if you are married to French national)
  • passport of spouse (if you are married to French national)

More helpful information: French Moving Planner

An Official Resident in France

It’s official. Another stamp in my passport to prove it. I am now recognized by the French government as a permanent resident in France. Yesterday, after a long day in Marseille, I received my carte de sejour.

If you’re not familiar with this tiny piece of paper (for which I prepared many, many not so tiny pieces of paper in order to receive), it’s absolutely necessary to apply immediately upon entering the country, because you have to have it within 3 months of your entry date, or they make you return to your home country and apply for another VISA. We don’t want to do that again!

And if you find yourself in this situation, make sure you get your passport stamped upon entering France or the European Union. You’ll need to photocopy this entry date in your passport and send it to the OFII (the office that issues carte de sejour) in order to even get an appointment.

Speaking of appointment–mine was yesterday; at least part of it was yesterday. It’s a little overwhelming when you receive your summons documents in the mail and read all that they require of you on this day. For those of you who may be facing this day with a mixture of dread and hope, I’ll walk you through my experience, and perhaps relieve some of the anxiety.

To start at the beginning, when I received my VISA, they also stamped my paper to apply to the OFII for a carte de sejour. Make sure you have this paper when you go to apply for your long-stay VISA. You need this paper stamped at the French Consulate in your country of origin. You can not do it by mail. You must be there in person.

I almost made a mistake in that I didn’t apply for my carte de sejour immediately upon arriving in France, and the information on the website clearly says apply immediately. I didn’t remember this part. I only remembered that I had to have my carte de sejour within 3 months of entering the country. I mistakenly thought it would be a matter of making an appointment and showing my paper.

Wrong. I miscalculated French bureaucracy, which like good wine and cheese in France, is not a myth.

Upon reading the instructions more carefully, I learned that I must send a few documents, along with a copy of my passport stamp with date of entry, just to get the appointment. The French officials were polite enough to send a confirmation letter saying they had received my documents. That took about 2 or 3 weeks. The next envelope arrived another 2 weeks or so later with several pages of information about the day of my appointment and what I needed to bring.

Let me say here that I prepared a portfolio that was almost an inch thick. I basically brought everything I had needed to date for my marriage and my VISA. I didn’t need most of it; but I do think it had something to do with my situation: first, I think Americans are not scrutinized as well, second I am married to a French national, and third I’m educated and employed. As my husband say, the government wants make sure you aren’t going to live under the bridge. What he means is that France has a social government where everyone is entitled to health care and social benefits. The government doesn’t want people immigrating to France in order to take advantage of its generous social system.

Be prompt for your appointment. There are many people with the same appointment time, and some I suspect, with no appointment, and you all go through the process together (but privately, one by one). It take half a day, at least. You watch a video, have a general medical examination, and spend some time with an interviewer.

First, you watch a video about France and the “four formations” you must complete in order to receive your carte de sejour. These formations are the heart of your application, so I’ll describe them:

You must speak French. If you do not speak basic French, they send you to French school. Don’t be too frightened by this. My French is basic, and the kind lady determined this by asking my questions, in French of course, that were part of my application: What is your phone number? What is your address? Do you have a secondary degree, such as from a university? What is your profession and do you have a job? She was very patient with me.

You must understand French culture and sign a contract saying that you agree to integrate (this includes accepting issues of equality, etc., important because many persons of Arabic descent immigrate to France, and equality of men and women is stressed). Not a problem for this American.

You must understand the Republic of France. This is basic civics, and it’s the only formation from which I was not exempt. No one is exempt from this formation. Everyone is required to take a one-day lesson in French civics. So, I must return to Marseille in one month for this class. They will provide an English interpreter, and I think it will be interesting, so no complaints.

You must be employable. For me this was not a problem. I have several degrees and a job with a U.S. company. I also do a good bit of consulting and freelance projects. I was exempted from yet another day of training, which I think is similar to the American job preparedness system.

And so, I received three certificates and one appointment for a class in civics.

But I had that little carte de sejour stamp in my VISA before I left. The looming civics class did not prevent my immediate access to permanent residency.

All things considered, the experience wasn’t as bad as I expected. But I wouldn’t recommend taking it lightly. For example, I had to produce proof of residency in the form of a bill for telephone or electric. I have nothing like that in my name, but they accepted my marriage certificate and my husband’s telephone bill. But I was distinctly aware that had I not been able to produce this one document, I would not have received that desired carte de sejour. Also, the letter I received asked for many other documents concerning my health, education, proof of employment, etc. I had all of these documents ready to present, but was not asked for them. Again, I suspect my American nationality smoothed the way.

Here’s the catch: in 9 months, I have to do this all again. Yep, that’s right. The carte de sejour is good for one year. And you need to apply 3 months before it expires. I understand from another American, and I think someone said this in French yesterday, that after a few years I can get a 10-year carte de sejour.

By the way, I’ve decided to keep my American passport.

Here’s a great site with helpful information about moving to France: French Moving Planner