Don’t Call Us…
The main goal of our trips to France along with all the reading and studying we have been doing is to make sure we are very familiar with life in France and, as much as possible, the French language. The idea is that, if we decide to move there permanently, we will really know what to expect and limit the inevitable culture shock. Through our travels we have been able to explore many facets of daily French life. We have experienced shopping at traditional farmers’ markets, local shops, and big box stores like Auchan. Norman has had a lot of practice driving on all kinds of country roads and city streets and negotiating those incessant roundabouts. Staying in gîtes and vacation homes instead of hotels for extended periods, we have lived more or less like you would if you owned your own home there — cooking, cleaning, doing laundry, etc. But there’s one important thing you can’t intentionally explore and that’s French healthcare. It’s not like you could just show up at a French hospital and ask if you could be admitted for a couple of days so you can check it out. So, if there’s one redeeming quality to our most recent experience, it’s that we got to find out what it’s like to see a doctor and go to a hospital in France. Here’s our very personal take…
It’s much less expensive. Studies show that the average cost of a visit to a primary care doctor in the U.S. is around $160 as opposed to the regulated price of €23 ($25) in France. In California where we live, the average cost of a hospital stay is $2800 a day. While in France, I had two doctor visits, spent five days in the hospital, and had several tests and procedures for a total of $2600. The hospital room itself was just $20 a day. Amazing!
Everyone has insurance. For most of my career, my employer’s insurance has covered my entire family and I have paid little to nothing for healthcare. I have been lucky in that regard because this is not the case for many Americans. My current employer only covers the employee so we have to pay $750 monthly for my husband’s coverage. In France, healthcare is extended to every citizen or resident. It covers about 80% of all costs. You can pay the balance or purchase a very low cost supplemental plan to cover the rest.
The focus is on solutions. One of the things we noticed in France was that the approach to care was very different. The French doctors seemed to be very focused on finding a solution to the problem. It’s possible that being unencumbered by insurance companies and exorbitant costs, they have much more liberty to pursue a solution or perhaps it’s just how they have been trained. American doctors seem more focused on relieving symptoms and you don’t always get answers as to the cause of your problem.
Hospital stays are common. French doctors will admit you to the hospital for very basic procedures that would be done as an outpatient in the U.S. and keep you there as long as necessary even though you might otherwise be healthy and able to take care of yourself. I was actually allowed to go home for a day during one of my stays, but my room was reserved for me and I just walked back in the next day. Had I stayed in France to complete my care, I’m sure I would have been in the hospital much longer. On the contrary, a patient is never admitted to a hospital in the U.S. unless absolutely necessary.
The doctor is the boss. French doctors are totally in charge of every aspect of your care. They make all the decisions without consulting the patient. They are the experts and the patient is expected to follow along with whatever they recommend which they seem to always claim is “easy” no matter the procedure — endoscopy without anesthesia, MRI for the severely claustrophobic, etc. I’ve deemed this the “Don’t Call Us, We’ll Call You” approach. At times, I waited for hours in the hospital without seeing the doctor or knowing what was going to happen next. American doctors work with the patient from the onset. They ask many questions, make recommendations, provide options, and then ask how you want to proceed. By the same token, you can make suggestions and requests. When you have a medical issue, it becomes a mutual effort in finding a cure.
You need to speak French! Many assume that well-trained doctors and other medical professionals would very likely speak English. It’s true that many medical terms are very similar or almost the same in French as they are in English so there is a certain amount of mutual understanding. However, that doesn’t serve to help you express or understand the details of your health issue. When a doctor is asking you specific questions about previous treatment experiences or allergies before he puts you under, you’d better be able to understand and answer correctly. We only encountered one doctor, a young intern in emergency, who spoke fairly fluent English. With everyone else we were at the mercy of our limited skills in French. Throughout the Kaiser medical facilities we use there are signs offering to provide a translator for umpteen different languages if necessary. We saw none of that in France.
Our decision to return home was not out of concern for the cost or quality of my care. It was extremely affordable and the doctors were doing their very best, but things were getting complicated and we had no idea how long it might take to figure it all out. In addition, we felt we needed to be able to communicate more accurately. And, of course, there’s a lot to be said for recuperating in the comfort of familiar surroundings. Nevertheless, now we have a much better understanding of French healthcare and will be more prepared to deal with it if and when there is a next time.