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Recursion

(56,582 posts)
Mon Feb 17, 2020, 11:40 AM Feb 2020

I'm going to miss French healthcare when I leave

My wife and I both had a really bad cold this weekend, but mine got better while hers settled in the lungs. So we called the SOS Médecins line. It's like 911 but for urgent care rather than emergencies; it was rolled out to reduce needless ambulance usage. It's funded by the cities and towns along with fire, police, etc.

Anyways you call and describe your symptoms and they send a doctor to your house within three hours. He usually just writes a prescription or tells you not to hold your arm like that or whatever, or he might decide you need to go to the hospital, so he calls the ambulance. (You can always call the ambulance yourself in an emergency.) He listened to my wife wheeze and wrote her some prescriptions. It cost €120 (I think 20 of that was because he prescribed; if you want to go to your GP who prescribes for free you can do that). The course of antibiotics was about €50 at the pharmacy, and they had everything in stock (I'll grant that is mostly just luck). Those are the uninsured costs, since we're not on the French insurance system.

I was trying to come up with what it would take to get US healthcare like that and I'm stuck. There's not a single magic bullet. They still have private for-profit insurance that most people get through their employer, they still have something like Medicaid for the poorer part of the population. They still have something like Medicare for the elderly and something like the VA for veterans.

This is what I find so frustrating. It's like France and the US started with the same set of Lego blocks, and they built this elegant theme park, but we built this absolute God-awful monstrosity that is simultaneously falling over and catching on fire.

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Merlot

(9,696 posts)
2. "absolute God-awful monstrosity" best description of US health "care" system
Mon Feb 17, 2020, 11:51 AM
Feb 2020

Yes, we have the best medical services, but only the rich and well insured can take full advantage.

The rest of us get "alternative medicine" and go-fund-me pages.

hunter

(38,264 posts)
11. The U.S. healthcare "system" kills and maims plenty of wealthy people.
Mon Feb 17, 2020, 12:30 PM
Feb 2020

By the numbers our healthcare is not the best for anyone.

Medical care is frequently grotesquely expensive and dangerously inappropriate, especially for the wealthy.

U.S. Americans think "We're Number One!" for a lot of things because they never leave the country.

3catwoman3

(23,813 posts)
3. Our pediatric practice in is the greater Chicago...
Mon Feb 17, 2020, 12:02 PM
Feb 2020

...area, in the far northwest suburbs. We have 3 locations. We have people who come to us from just over the Illinois-Wisconsin border, and from at least 4 different counties.

In the office, we have equipment with which to do rapid strep, flu and RSV tests. No way to haul that stuff around with you.

House calls would be completely impossible.

Recursion

(56,582 posts)
4. Yeah, I think you just illustrated part of the problem
Mon Feb 17, 2020, 12:04 PM
Feb 2020

The doctor didn't use any equipment that hasn't been around for a century or so. He listened to her lungs with a stethoscope and looked at her throat. Then he wrote a prescription.

3catwoman3

(23,813 posts)
5. You can diagnose pneumonia by listening - it sounds like...
Mon Feb 17, 2020, 12:13 PM
Feb 2020

...Rice Krispies when you pour the milk on.

You cannot diagnose strep by looking. Sometimes there are characteristic visible signs. Often, the throat doesn’t even look red.

Recursion

(56,582 posts)
7. And yet France is not overrun with strep
Mon Feb 17, 2020, 12:17 PM
Feb 2020

That's what I mean, the providers here just don't have that uber-defensive mindset.

3catwoman3

(23,813 posts)
13. Perhaps the French do not have the litigious bent that...
Mon Feb 17, 2020, 04:55 PM
Feb 2020

...unfortunately, IMO, characterizes much of American health care. My boss just shared with me an 18 page list of things our practice’s malpractice provider thinks we need to include in every visit so as to “protect” ourselves against potentially unhappy patients/parents. 18 goddamned pages! Our schedule allots 15 minutes for a sick visit, and 30 for a well visit. When the hell do I have time to document 18 pages worth of crap?

With the advent of electronic medical records, I spend more time documenting what I do than doing what I do. When charting an after-hours phone conversation I must type out the name of the parent with whom I am speaking in my narrative, even though I have already clicked the box with the name and # of the person I am calling in a different part of the chart. We must include, at the end of every note, what I have come to call the “CYA statement,“ to the effect of “every question answered to parental satisfaction, and I thought of questions the parent should have asked bit didn’t, and answered those anticipatorily.“

If we recommend a specialist visit, and the family doesn’t go, our nurses are supposed to call them 3 times to remind them that they really, really should make that appointment. If they “no show” for an appointment with us, the front desk staff is supposed to call at least twice to find out why they didn’t show up and offer them a new appointment time.

Every work day, I spend 2-3 hours of my own time, in the evening, completing my documentation, because there is not enough time to get it done during a patient visit, with the thoroughness and attention to detail that I demand of myself.

I have loved my job for most of my career. Not so much the last few years. So much of what we do and how we do it is insurance driven. I care about the patients and parents I see being happy with what I do. I don’t give a rat’s ass about what the insurance companies think of me, but I have to, because that will not pay for the visits of we don’t do things their way.

Recursion

(56,582 posts)
14. I'm sorry to hear that
Mon Feb 17, 2020, 04:57 PM
Feb 2020

But, I mean, Medicare coding isn't exactly fun either, right? Every other country's system seems light years simpler than either our public or private ones.

Response to Recursion (Reply #4)

bullwinkle428

(20,626 posts)
6. France supposedly spends 11.3% of GDP on health care, compared to 17.1%
Mon Feb 17, 2020, 12:17 PM
Feb 2020

for the U.S., and yet, the outcomes are apparently better in France (in my opinion).

https://en.wikipedia.org/wiki/Health_care_in_France

Recursion

(56,582 posts)
8. Yup. It's why I get irritated at "single payer is the best way"
Mon Feb 17, 2020, 12:20 PM
Feb 2020

It's like we have these giant blinders on and can only look at financing and nothing else, even though that isn't really the problem. France has private insurance sold by for-profit companies. That isn't the problem.

CountAllVotes

(20,854 posts)
9. I had great care in Hungary
Mon Feb 17, 2020, 12:23 PM
Feb 2020

It was several years ago and I was in sad shape after the flight.

The hotel called a doctor for me and he came to my room with an assistant. He spent about and hour with me and gave me several options for the problems I was having.

The cost was about $125.00 and my insurance here in the USA reimbursed me for it when I got home believe it or not.

Not only was the care wonderful, the doctor was very good looking!

I'm glad to know you received good care in France!



marlakay

(11,370 posts)
10. I got sick at end of my 3 month
Mon Feb 17, 2020, 12:23 PM
Feb 2020

Trip to Ireland when I was in Dublin, I heard best way to find doctor was ask at pharmacy so I did, they were connected to a doctors office which doctor had a few min free and saw me within 5 min. Gave me prescription for 3 things, I was having major stomach problems.

Then I went back into pharmacy and total bill was 80€ including visit to doctor and drugs.

Recursion

(56,582 posts)
15. Huh. Apparently NYC has this too
Tue Feb 18, 2020, 02:29 AM
Feb 2020

I've lived there and I had no idea. But there are like 5 different same-day flat-fee physician housecall services.

GoneOffShore

(17,309 posts)
16. I'm sure you will. We moved here permanently in late 2018.
Tue Feb 18, 2020, 05:26 AM
Feb 2020

We got our Carte Vitale's after 5 or 6 months and got a 'mutuelle' at the same time.
Regular office visit with our GP is, as you know 25€ and we get 17€ back. Specialist visit a bit higher.

Two weeks ago I went to the cardiologist because I had had a couple of fainting fits. He did an in-office ECG, blood pressure at the beginning of the exam and at the end, etc, etc and when finished told me everything was 'Impeccable'. I handed him my Carte Vitale, and my bank card and the charge was 77€. There was a secretary outside handling the waiting room for the practice and scheduling, but that was the extent of the office staff. Billing handled centrally.

I like the system here.

a la izquierda

(11,784 posts)
17. I had similar experiences in Spain and England.
Tue Feb 18, 2020, 08:44 AM
Feb 2020

I had a horrendous case of strep in Barcelona two years ago. The doctor came to my hotel. No the doctor didn’t do a strep test. Instead he talked to me and I informed him that I have had at least one case of strep every year since I was about 4. Two injections and two Rx for 200€. It would have been cheaper had I walked to a clinic, but I felt awful.
I got strep again in England. I went to a pharmacy that had video conferencing with a doctor. Again, I explained that I always get it, £40 later I walked out with meds.
Both doctors told me to get my tonsils out. Both suggested it might be cheaper in Europe even without being on the NHS or Spanish medical system. My insurance won’t cover the removal unless I get three cases IN A CALENDAR YEAR.

Recursion

(56,582 posts)
18. I just feel like other countries give a shit and we don't. It's what worries me about MFA
Tue Feb 18, 2020, 09:07 AM
Feb 2020

Because "MFA without giving a shit" isn't going to be particularly nice.

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