February 26, 2013. That’s the date the eternally angry lady at the sous-prefecture slid my French carte de sejour across a desk–her brows wrinkled and lips tight–and turned away without so much as an aurevoir. I picked up the newly minted, crisp piece of plastic with my photo and French credentials, smiled wide enough to catch the attention of the soured fonctionnaire, and kissed my card with a loud “smack.”
No reaction. No smile. No felicitations. Nothing. Not even a nod in my direction.
But her bad day, bad year (I suspect, bad life), could not spoil my moment. I had waited nearly two years for this day, and I was finally holding, in my hands, an official piece of plastic that identified me as a resident of France.
If you’re not familiar with the carte de sejour, you have no idea of the power it holds for an étranger. With this card, I can finally get health insurance (sécurité sociale), declare myself as an autoentrepreneur (self-employed), pay French taxes… okay, so it’s not all wine and cheese.
So why has it taken nearly two years to get this gem? The short, not-so-sweet answer is The French Government. The long answer is more complicated and requires some explanation of the process.
First comes the visa. And this is very important. You must obtain a visa, regardless of your situation, to enter the country if you plan to stay more than 90 days (for Americans). As soon as you enter the country you must immediately start applying for the carte de sejour. I cannot stress this enough. It take 3 months, at least, to get this document, so you need to start the process as soon as you arrive.
The first carte de sejour is not really a cart de sejour. It’s a sticker in your passport that basically validates your visa and allows you to stay in the country for one year. While there’s lots of paperwork, getting this authorization is not too difficult. But don’t get comfy; the next year they get really strict.
Three months before your one year is complete, you must again start the process for obtaining/renewing the carte de sejour. This time the paperwork is different, and the process is more strict. Now you have to provide proof of your ability to stay in the country: income, proof of residence, proof of marriage (in my case), etc. And it’s not as simple as it sounds. Only certain documents are accepted.
In my case, for example, they wanted to see everything in both names of me and my spouse. I had no idea of this and so had not prepared. I moved to France to marry a man who’s lived his entire life here. Everything was in him name and we saw no need to change that… until we visited the sous-prefecture in Arles. The next few months were a mad scurry to get everything in both names. Warning: nothing happens quickly in France.
In addition, they questioned why I did not have security sociale. Well, the folks as security sociale wanted the carte de sejour. This merry-go-round is very common in the French administration.
Long story, short: it took six months to get the card after the initial visit to the sous-prefecture.
So, finally, I have my piece of pink plastic, and even the sour-puss admin at the sous-prefecture could not squash my enthusiasm. France was now open to me! Then I arrived home to show the card to my husband. The card is marked “temporary.”
And, the issue date is Feb. 26, 2013. The application date is July 1, 2012, and the expiration date is July 1, 2013.
I can rest for one month–paperwork and sous-prefecture-free–and then I get to start the process all over again.
As they say in France, c’est la vie!
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: http://www.medicalnewstoday.com/articles/9994.php
Next time, I’ll depart from the serious and entice you with photos from my trip on the French Riviera.
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.