Thursday, September 6, 2007
I'm not a policy wonk, and I'm certainly no expert on healthcare. But with the subject getting alot of recent attention, and with Michael Moore's SiCKO just opening here in Paris, I thought it might be interesting to American readers if I offered a couple of anecdotes on my experience of the French medical system.
The first occured on my very first visit to France in 1999, when a case of "water on the ear" clogged my ear canals, leaving me barely able to hear a sound. I'd had similar experiences in the States after swimming a few times before (although never to that degree), and I'd always used some over-the-counter eardrops that chemically dried out the ear canal within days. So I went off in search of some at the local pharmacy, only to find out that they don't exist over here. Of course, my first reaction was to grumble and rail about the superiority of American medicine, until my future ex-wife's family convinced me to do what is perfectly natural for any French person, but is the last resort for an American: go see the doctor.
I called a local ear doctor (an otologist, for any persnickity wordies out there), who gave me an appointment for that afternoon. I went over and explained the problem, and he promptly removed the offending earwax with the help of a funnel-like instrument and filament. Total cost of the procedure: the equivalent of twenty bucks. (As a tourist, I wasn't covered by the French Social Security system, and so I was ineligible for reimbursement.)
The second occured this past winter. My son woke up one day with a slight cough, but without any fever, so I brought him to school as usual. When I went to pick him up for lunch, he wasn't looking so good, and his teacher suggested that I bring him to the doctor. After six years in France, my instinctive resistance to doctor's offices had evaporated. So I immediately walked him across the street where, after waiting ten minutes for the doctor to return from an emergency house call, he was diagnosed with a throat infection. We still had time to make the pharmacy before it closed at noon to fill his prescription. Total cost: the equivalent of twenty bucks for the medical visit, of which (if memory serves correctly) twelve were reimbursed by Social Security. The medication was fully reimbursed.
Two points I'd like to make. First, in writing this post, I realized to what extent one's experiences with a healthcare system become internalized (ie. the resistance I always felt towards going to see a doctor in the States compared to my willingness to do so here). Second, as someone with an entrepeneurial bent, I also recognize to what degree the social charges needed to fund France's generous medical system function as disincentives to initiative. But I wonder if the American system doesn't serve to hide those disincentives in the exagerrated cost of seeking care.
Like I said at the beginning, I'm no healthcare wonk. There are costs and benefits to such an affordable (to the patient) and accessible system. Some of them, like these two anecdotes, don't translate very well into statistics.