Sunday, June 12, 2016

Health Care in France

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I am continually amazed at the French health care system. 

On Friday morning, Ellen and I walked to the Vaison hospital so that I could have a cyst removed from my eyelid. The operation was the culmination of a four-month process the extent and success of which I am in awe.

When we arrived in France in February, I had developed what looked like a boil on my eyelid. My local doctor referred me to an ophthalmologist. The ophthalmologist corrected my diagnosis: I had a cyst that had become infected. He prescribed antibiotics and suggested that I should have it removed.

Before proceeding with the operation, my physician suggested that I consult with the local cardiologist which I did. The heart doctor did an EKG and an echo cardiogram and he wrote to the ophthalmologist that my heart was functioning well and there would no reason that I could not have the operation. I did not schedule anything for May as we had Lansing visitors and then a trip to Porto, Portugal.

Friday was the day. The cyst had reduced in size from being about the size of an olive pit to being only the size of a grape seed which pleasantly surprised the ophthalmologist. We met him as we were walking to the hospital and he got to meet Ellen. He told her that the surgery would take about an hour and then he asked me to follow him to the operating room.

As promised, we were walking home an hour later. I had a big patch over my left eye which covered four stitches closing the spot from whence he had removed the cyst.

This is all pretty boring stuff except when one compares health care in France (Vaison) with health care in the US. Some things jump out as differences:
  • Regular visits to a doctor cost 23 € - under $30 at the current exchange rate.
  • Visits to a specialist like the cardiologist are more expensive. I think I paid 150 € for the visit during which I had the EKG and the echo. 
  • Before going to the hospital for the surgery, the ophthalmologist had given me a list of medications and supplies that I needed to buy and bring to the hospital. All of the supplies that the ophthalmologist used during the surgery - minus the thread used for the stitches - were in the things that I had purchased at the pharmacy (about 9 €).
  • Doctors work alone. My physician does not have any office staff. If I call for an appointment, it is he who answers the phone. The cardiologist has an office assistant but he performs all of the procedures himself. The ophthalmologist performed the surgery by himself. He had no assistance at all.
  • As we left the surgery, the ophthalmologist gave me an invoice to pay to the hospital. He reminded me where the billing office was and said: “You don’t have to stop there right now if you don’t want to. Pay the bill when it is convenient for you.” (The bill for my time in the hospital surgery was under $100.) The ophthalmologist had told me that my bill for his time would be about 150 € - $175 - a bill that I won’t see until he removes the stitches.)
  • Medical school is free, so those who become doctors are not burdened with overwhelming debt. Malpractice lawsuits are rare in France so doctors do not have to spend huge sums for insurance.
I remember speaking with an emergency room physician several years ago when I had gone to the ER. He said that health care in France costs about one/tenth of what it costs in the US. (He was a French doctor who had worked as a doctor in California before settling in Vaison.)

Not only is the cost of health care significantly less than in the US, prescriptions are equally inexpensive. I had told the cardiologist about a drug that I was taking and that the copay portion that I paid was extremely expensive. He wrote me a prescription for this same drug and my total costs are now about one/third of what my copay was!

I am pleased that we finally have The Affordable Care Act in the US but when I compare it to health care in France, I know that the US has a long way to go in meeting the health care needs of its citizens. We can and must do better in the US.

Sunday, June 5, 2016


I have been reading Travels with Charley by John Steinbeck and it has made me think a lot about traveling. We traveled a lot in May. We entertained neighbors from Lansing at the beginning of the month by showing them some of the sights and sites of our area and then made a trip to Porto, Portugal to meet up with other friends for the end of the month. Traveling familiar roads with neighbors who have never seen the area forces you to adopt a different way of looking at the area based on their questions and reactions. Their visit expanded our ways of seeing and enjoying beautiful Provence.

Traveling to a different country or a different region of France I notice things that remind me that I am no longer in Provence. It is like the first time we drove to New York via Canada. Once you cross the border, you begin to notice that the houses are just a little different from American houses. It might be construction materials or decorations or maybe gardens but the houses are different. 

The same is true when we crossed the border from France to Spain. The houses south of the Pyrenees were different from French houses. Of course, the predominant culture of the Pyrenees is related to the Basque people and their customs and life style spill over to the style of their houses. Basque houses have wood beams and stucco and thus seemed similar to houses in Switzerland.

Porto and its architecture was different from what we witnessed in Spain. Many houses, buildings and churches were covered with ceramic tiles - some were geometric patterns, others were pieces in a mural. The tiles were predominantly made of shades of blue but there were other bright colors as well.

In Provence, houses are built of stone or cement blocks and covered with stucco. The roofs are orange Spanish tiles and the shutters (everybody has shutters that work and that they use) are painted in muted blues and greens and grays... 

No matter where we went, one thing was constant: local residents recognized us as foreigners - English-speaking foreigners to be exact. I thought that I would have become less recognizable as a foreigner since we have been coming here for so many years but I must have “American” printed on my forehead. Whenever we walked into a restaurant, the waiter would ask if we wanted menus in English. The landscape may change, the architecture may change but we are recognizable no matter where we are.