Paris Journal 2007

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Part of Notre Dame cloudy (above), then sunny (below), just minutes later. The Hotel Dieu is right next door to Notre Dame de Paris. But it is not as photogenic.

Monday, July 9 Today’s topic I’ve been saving for a rainy day. Every day since our arrival has been rainy, but today it has been very rainy. There was even a hailstorm, but it wasn’t very scary because the hailstones were the size of peppercorns. One of the owners of the apartment left us a copy of a recent column by Bill Maher in which he compares the state of health care in France and the US. While I agree that access to health care is far better in France, and it is embarrassingly bad for many Americans, he was really off base about several key points. It is too bad, because if he would stick to what is really true and valid, maybe more decision makers in the US could be convinced to do what they can to solve the gross inequities. First of all, Maher quotes a World Health Organization assessment of America’s rank in health care as number 37 worldwide, while France is ranked number 1. Yes, it is true that every French citizen has complete access to health care, and that is what has impressed the World Health Organization. But as we have learned from the times when Tom’s arm was broken by a pickpocket and when he had to seek the help of a specialist for another symptom in a different year, the French system is very much a two-tier system. First, when Tom was given a voucher to go to the big public hospital, Hotel Dieu, for his broken arm, he went through a large waiting room full of poor people waiting for care. As a crime victim, he did not have to wait there. Although the policeman back in our neighborhood had quickly determined that Tom’s wrist was probably broken, the doctor at Hotel Dieu never laid a hand on Tom, and no X ray was taken. His wrist was wrapped up in a useless bandage and that was that. This happened at the end of the summer in 2000, and since we were about to fly home, I decided we should just wait to seek further care in the US. I was certain that the wrist was broken. Sure enough, when we were home Tom went to our Ohio doctor, who quickly determined that the wrist was probably broken, and who ordered up an x-ray (immediately available in the same building). Within minutes, the x-ray revealed the break, and Tom’s forearm was put into the appropriate modern splint/cast for immobilization while it healed. The local newspapers here in Paris have coverage every summer about problems with the public hospitals – rampant infections, lack of air conditioning, lack of ventilation of any kind. Poor people in France don’t get great health care. It may be free, and it may be accessible, but it isn’t good. Only the middle class and above get the good health care in France. In another, more recent year, Tom was afflicted with a symptom very soon after we arrived. He knew it should be investigated. We contacted the owner of the apartment, who gave us the name of a specialist whose office was on the very chic avenue de Montaigne. This, we knew, was going to be an experience of a different kind. This would not be the Hotel Dieu. The specialist sent Tom off to this laboratory for this test, and that laboratory for that test, etc. We paid cash for everything, asking for paperwork that we could later submit to our insurance company. The specialist even asked for cash, which he pocketed himself. His office, while comfortable and in a chic neighborhood, was not very high tech. Later that summer, when we were home in Florida, Tom went to the same kind of specialist and had similar, but more high-tech tests. The specialist in Florida had a real staff and all the latest equipment. Neither specialist was able to determine the cause of Tom’s symptom (which, fortunately, has never recurred). But if I had to bet on one of them, I’d bet on the Floridian doctor, not the French one. And in the US, we did not have to pay cash. Our insurance was billed by the doctor’s and laboratory’s staff, and we used the credit card for the deductible. We’re fortunate; we are Americans with insurance. We have access to the best health care in the world, I believe. But the real problem with health care in the US is not the quality of care; it is the lack of insurance coverage for everyone. Maher needs to concentrate on that. One thing Maher got right: the typical American citizen is an idiot because he/she does not vote. In France, people vote. In the recent election here, a whopping 85 percent of citizens voted. If Americans did that, perhaps politicians would fix our awful problem of access to health care – and the problem that health care costs are the cause of most individual bankruptcies.. ←Previous Next→

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