French medical system

[sarah]

Regarding the French medical system which works extremely well, I feel it should be considered as a model to look at for the US. I live in France, have HER2 cancer and have been treated in both the US and France. The big difference for me, is no insurance company to hassle with.
Brenda, as for costs, in France it's not 18%; it's 8% after a deduction of about $10,000 (8,000 plus euro) per person. At the end, I've attached the French Republique site and the paragraph if you want to check.
Additionally you pay about 40% for prescriptions and doctor visits. Prescriptions are cheaper here and my GP costs 22 euro per visit. so for non-cancer related visits, she costs me about 6 euro. My US GP cost $360 a visit.
I don't know how much you all pay for your insurance but the lowest price I've had friends tell me they pay is $15,000 a year and I have many unfortunate friends without any insurance - luckily they seem to be quite healthy!
Since I have cancer, I'm taken in charge for 100% (drugs, doctors, treatment) for anything related to my cancer. The sicker you are, the less you pay.
While we didn't move to France because of its medical system, I'm very happy I'm here now that I'm sick again.
In the US we paid around $10,000 a year in 1999, plus $20,000 for uncovered expenses for my cancer. I wasn't given chemotherapy, radiation or Femara at that time. Luckily California, where I lived then, had strict regulations otherwise who knows what would have been "allowed."
The surgery in the US was very well done as has the surgery done here been.
I know my Canadian sisters would also defend their universal health - it's not a communist plot - it's the humane and less complicated.
Brenda for you:
Taux et calcul de la cotisation
Elle s'élève Ã* 8% des revenus perçus au cours de l'année civile précédente, déduction faite du plafond annuel de 8 644 EUR .
Elle est calculée annuellement, pour la période allant du 1er octobre au 30 septembre de l'année suivante.

Rates and calculating the contribution
8% of income earned during the previous calendar year, minus the annual ceiling of EUR 8 644.
It is calculated annually for the period from October 1 to September 30 the following year.

http://vosdroits.service-public.fr/p...%20base&l=N428

[AlaskaAngel]

This past summer, National Public Radio did a series on health care systems in other nations to try to identify their strengths and weaknesses. This link lets you choose to listen about systems from several countries in western Europe:

http://www.npr.org/templates/story/s...oryId=91971170

One quality that is hard to quantify between systems is a question about values. If people in an area tend to generally adhere to better health prevention practices (their tradition includes more exercise, or families are smaller, or they don't smoke, eating less toxic foods, etc.) that alone would represent major cost savings for any system. Some cultures put higher values on those things than others do. European nations have particularly high standards for some food production and won't even let certain foods from the US be imported. All of those can make some difference in how well people and a health care system do function in terms of dollars/euros.

AlaskaAngel

[caya]

I think in general, most Canadians are very happy with our universal health care system. I have talked about this before, and I will once again say, it is not perfect - nothing is - the US system is certainly not good for the many millions who are uninsured.

We do pay higher income taxes here - but then most medical care and treatment is covered. Any Canadian cititizen can go to any doctor they want - no insurance company denying coverage, or telling you "that dr. is not in our network, HMO." You do need a referral from your GP to see a specialist, but that is a routine office visit.

When I was diagnosed with BC, my GP had appointments for me booked with the onc. and the breast surgeon at the leading cancer hospital in Canada - Princess Margaret Hospital - one of the top 5 cancer hospitals in the world, within a week. All tests were done in a timely manner - no forms to fill out, no arguing with insurance companies - my drs. and I decided what tests to do, not the government, as many US opponents of our universal system will tell you. It is just not true. And believe me, as you all know, when you are diagnosed with a life threatening illness, the last thing you need to be doing is filling out endless forms and arguing with an insurance company about your treatment coverage. You need all your strength and focus on getting your treatment, not the stress of dealing with insurance companies. And BTW, Herceptin for early stagers was approved in Canada before in the US.

My husband was diagnosed with a brain aneurysm in January 2006, (actually he was misdiagnosed in Florida, he had his first black out incident in Boca Raton, the drs. there tested him for cardio, sent us home) and within 2 hours we were talking to 2 neurosurgeons at a top hospital in the metro Toronto area - my DH had successful surgery the next morning, was in the neurology ICU for 6 days, came home , and had weekly visits from the county physical/occupational therapist for about 3 months to work with him on cognative therapy.

All this was covered by our health care system. No question about if you have insurance, what level etc. - every Canadian is covered, at all times - it is not job related. It is equal for all - the poor, the rich, the unemployed. No one has to be afraid that if they lose their job, they lose their health care. No one is stuck in a job they hate because they are afraid to lose their health care. No one is mortgaging their homes to pay for medical treatment. NO ONE.

Yes, there are sometimes delays in getting some surgeries, - but that happens in the States too, I believe, especially if you don't have insurance. I have heard of women taking older chemo treatments because they are cheaper, or not getting Herceptin, or stopping Herceptin because their coverage ran out - that would NEVER happen in Canada. There was a woman from California, I believe, who had no health insurance - she was advertising in the Canadian media for a husband, so she could get her treatment.

Yes, some people do go to the States to get hip replacements and other surgeries ... but these are the exception, not the rule. Don't let those fearmongers whip you up into a frenzy that your entire medical system will fall apart if you go universal - and again, as I have said - it is not perfect here... but it is fair and equal for all - I just think that is the morally right way to be, JMHO. The insurance companies and HMOS, who probably have powerful influencial lobbyists in Washington will lose out, not the public.

Yes our system could use improvement, and we will continue to improve it. But there would be a national revolt here if universal health care was ever threatened.

all the best
caya

[hutchibk]

I feel that there are many good qualities to many health systems around the world. Just as there are many great qualities to the US system. At the same time, most health systems around the world are struggling with inherent problems that threaten them and their existence in their current form. France and US included. All systems work in many ways and don't work in other ways. Each population is different in what they will accept as a system and payment scheme. Each country has governments that run differently and social programs that run more and less efficiently. What seems to work for one country will not necessarily work in another. That is fantastical thinking. Good ideas can be garnered from many corners of the earth, but I believe it is time for the brilliant thinkers and visionaries (NOT THE POLITICIANS) to tackle these questions and create a model that turns the private insurance system and the universal govt healthcare systems on their heads. I know those visionaries exist and I think (and pray) they are working feverishly toward that goal. All health systems in all countries are under some kind of stress. If you do the research, you will find the info. I don't think this is the time to be running the horse to the stable, and copycatting a healthcare system of another country. The US has a population of 301 million. It would be implausible and insane to try implement a government universal single payer system used in a country of 60 million. The living and breathing dynamics and forces that are different between countries and societies of such divergent sizes are magnigicent, intricate, complex, and labyrinth.

[Paty]

I think we all have been blessed in one way or another by the scientists and medicines that are available out there in one system or another. I think Canadians and French are blessed with their systems (I lived in Canada for some years and I know Caya, how your wonderful medical system works. In fact some of the current surgery methods for Breast Cancer were developed in the Princess Margaret Hospital in Toronto). Even when I can not say the same for my country Mexico, I was very lucky to have the support of great doctors, hospitals and an insurace company. The private medical system in Mexico is pretty good, unfortunately just a very small sector has access to it. The government system is terrible not because of the quality of doctors or equipment, but because it is unsufficient for 100 million people in this country, due to our little resources. I do not want to get you tired with how our system works but I would like to say that we all here are blessed with the informations and treatments that we have received, many women out there do not even know what Her2neu is. I hope than in the short term, governments and politicians put more emphasis in people´s health needs around the world. After all Health is our biggest treasure.

Love you all,

Paty

[sarah]

Caya, I know you and I love and appreciate our health systems and I would have a hard time finding fault with the French system which even though the English (big feud centuries old between the 2 countries!) think it's going bankrupt, it wouldn't go bankrupt, it may change slightly but the French are hypocondriacs!
in the US, I agress health care people should be involved in the solution but they should definitely look at Canada and France. Malpractice insurance is too high and the paperwork is insane and fewer talented american students are becoming doctors. The industry that has to be "attacked" is the healthcare insurance industry. California stated that to be an insureer there, the insurance companies had to cover certain preventive screenings: mammos, pap smear, psa, etc. well the insurance companies threatened to leave California and California said fine, we'll set up our own insurance system (they did it for fire insurance) well the insurance companies caved in and are still in California unfortunately. Too bad California, a leader in many forward thinking practices (such as car emissions), didn't do it. that might have proved to america that "universal" health isn't the scary thing they think it is. What's scary to me are the HMOs - I was in one and frankly they should have seen my cancer 2 years earlier. Luckily I changed to a PPO (limited doctor choice) system that immediately found the cancer.
Let's face it, the Clinton's blew the opportunity. So america pull up those boot straps and look out for yourselves! you're right the politicians aren't brave enough or smart enough to solve it.
oh for George Washington, Thomas Jefferson and Benjamin Franklin.
stay well, it's the only solution!
sarah

[StephN]

I agree that asking the Feds to come up with a one plan fits all is like asking for the sun.
We have 50 states and they each have their own state-run health system for poorer and uninsured people.

In my state we don't have an income tax - only a sales tax, but that does not include food items.

Our state is now in the hole and the "rainy day" fund has been spent. Our county is cutting jobs by the dozens in each department. Our Sheriff announced job cuts last week.

Since we depend on the sales tax and people are buying less, the state has less money for its current budget, let alone next year.

Hubby and I made a Costco run last night and I have never seen the lines so short or the carts with so few items! We even spent less than $150.

Hope the Smart People can figure a way out of this one.

[hutchibk]

Interesting article comparing Canadian and French health systems. http://www.cmaj.ca/cgi/content/full/177/10/1167?ck=nck

[sarah]

Thanks Brenda, great article on canadian and french health systems. I see my oncologist now twice a year, I can see him more often if I want to, I haven't for years now and if I need some oncology advice or oncology prescriptions I ask the chemo doctor, who I see every 3 weeks. My super big deal oncologist gets an honorarium fee which means I pay him out of pocket an extra $40!!! He of course accepts people who can't afford this.
I like being able to chose who I want to see and not having long too wait to see people or have tests. A year or so ago we were all asked to pay out of pocket an extra euro per GP visit, honestly I think if it's not for a major illness that needs more than once a year visits, I think they should add an extra fee per extra visit per year and up it each "extra" time because the french are hypocondriacs and go to the doctor too much. Luckily here, health is considered a right not a luxury and that won't change.
I hope someone will come up with a good idea for the US and whatever it is shouldn't be called socializwd or univeral --- maybe just United Healthcare!!!! something with less paperwork and cheaper malpractice insurance and health insurance.
here's hoping.
sarah

[AlaskaAngel]

In the little corner of the U.S. where I spend most of my time, the biggest indicator to me that the problems are getting significantly worse is that the doctor I know who has stayed the most stubbornly determined to make cuts in just about any other aspect of his practice in order to continue to accept medicare patients, has finally had to stop taking medicare patients. In an isolated area like mine with very few health care providers, where are medicare patients going to be able to go?

A.A.

[StephN]

Yes, A.A., I have heard of doctors who carefully screen new patients because they only want a certain percentage to be on Medicare. My uncle in Spokane moved to Moscow, Idaho to be closer to his son and grandchildren after my aunt died. He had the worst time trying to get on with a new doctor and when he was finally accepted into a practice the doctor was quite young and did not have the experience with heart patients that my uncle wanted.

My uncle ended up moving BACK to Spokane and is very happy to be with his prior doctors.

And my cousin in Florida has to drive four hours to see her specialist - one that takes Medicare patients with her rather rare problem.

Sarah - I know firsthand about the French medical system. My inlaws were frequent users. But my mother-in-law would go in for a complaint and come out with more pills than she could carry!! Those doctors can really be DRUG PUSHERS. She would end up with problems from the interactions and her doctor here would take her off half that stuff and she would feel much better.
The worst thing is that so many French women are addicted to sleeping pills. We did not know that about my mother-in-law until she had a hospital stay here and had the withdrawal signs. The nurses here identified it and asked what all she had been taking. We found them hidden in her bedroom, and showed her doctor who was quite shocked and said those pills had been actually doing her more harm than good.

I like to tell you about my experience in Canada. For routine mammogram you wait 3 to 4 month but in the case of emergency there is no waiting time. I went to see my GP on December 24, they did the mammo and ultrasound the same day, 1/2 hour later I saw the oncologist and eveything started right away. I've talked to other people and they have the same experience. I live in Vancouver, it may be a little delay if you live in small town, becaue you have to travel, they even provide plane for travelling. I agree the number of Doctors are not enough for population and this is the law that Doctors passed, because they want to make more money! I'm sure they can improve the system much bettter. I think as human being we have the right to have health care system for all, and when you are dealing with serious illnesses nobody should be worried about to pay for the costs.

Also I want to tell you about my experience with private insurance. We have extended benefits for our company and I am the administrator. Six month after my Cancer, our monthly fee trippled. I called to find out why, after talking to so many people finally, the manager of our plan told me "off the record, you have an employee with Cancer, get rid of her and we decrease your fee" and I told him "on the record that employee it's me bastard", I should have sued the SOB.

I just wanted to show the difference.

[caya]

Unregistered - I have never heard of anyone waiting 3 or 4 months for a routine mammogram here - granted I live in the Greater Toronto Area - GTA - maybe in some remote places you would have to wait that long. That is one problem with Canada - because we are so vast a country, it is difficult to service everyone in the more remote areas in a timely manner. That may contribute to our lower scores in some areas, as these things are averaged in.

I still believe in the fundamental right of equal access to good quality health care to all citizens. I think most people do, it's just a matter of how to go about it.

[Rich66]

"on the record that employee it's me bastard"
I doubt he speaks off the record anymore.
Ah..if only you could have seen his face

[naturaleigh]

Caya, the type of American insurance you described, I am there. I am a "state" employee and have been for 23 yrs. So many times I have wanted to find a private sector job in hopes to find something less miserable. Everytime I talked about quiting the state for something else, every one kept saying, "you need to stay with the state for the wonderful benefits they offer, plus you will have affordable insurance for the duration of you life.

Well, I have been working in a toxic building for the past 11 yrs. I knew the building was making me ill, but never dreamed I would get cancer. After my disability was denied, I called OSHA to check out the building and they found out that among several other things, there was very little oxygen in the building and what was there was stagnant!! Have they torn this #$#%@# building down? NO, it would cost too much money to do anything like that.

So here I am with 5 1/2 yrs to go until I can retire with full benefits. Being low income, I will just break 15 grand. Why was I staying? Because I have severe chemo brain, which my doctors just look at me like I am crazy when I tell them that. I do not think I could learn another job at this point. To top everyhing off, I just found out yesterday from the place I get my lymphedema garmets that I am just about maxed out on my insurance. I called the insurance company today and asked what will happen when I reach my lifetime max.

[naturaleigh]

I will no longer be insured!! OH, how happy I am that I worked 23 years in awful jobs so that when and if I get to retire, I have nothing.

So does anyone know what kind of medical care I will get once I no longer have insurance?

I wish I could move to Canada or France so I would not have to worry about this insurance crap and just worry about dealing with the #$^%^# disease. I am so sick of dealing with this lousy health care that we have here I am just about to give up. If I had the money, I would buy me a camper and drive off into the wild blue yonder with my dog and cat and tell insurance what they can do with it.

Oh, while I was getting fitted for my garments, I was told that as a survivor, I am entitled to two free bras a year, because of insurance my free bras cost me $10.00 each!!

Sorry folks, I am not in a good mood and need to vent.

But, has anyone here been maxed out on insurance. What do you do, especially if you are low income.

[sarah]

Stephanie you're absolutely right that they have in the past over prescribed drugs and particularly antibiotics. When I first came here I told my doctor no antibiotics unless I'm dying! because my father, the doctor, had trained us to not take antibiotics unless absolutely necessary and in fact didn't believe a pill or a shot was the answer for most things and many of his American patients wanted antibiotics for skin problems (pimples) and diet pills and.... Now here in France they are prescribing less drugs. I remember years ago when I stayed overnight in hospital (I wanted to just go in the morning and home at night but they don't trust you not to eat or be on time!), the woman in the next bed was asked if she took sleeping pills and yes she took them every night!!! I was shocked but the sleeping pills I've been given here - which I rarely take - are mild and have no hang over affect. Still every night!!!! They need to prescribe less drugs but my doctor only prescribes my cancer related drugs plus some calcium D3 and Magnesium B6. I do think the idea here is to get the patient in to see a doctor before the problem becomes severe.
I hope the US finds a solution. After all when many people are not insured or don't have health care access, everyone is at risk of those people getting some deadly communicable disease (such as tuberculosis or worse) and it effecting a large population. If the US doesn't come up with a solution, I hope California will.
However right now we have to hope we aren't headed into a worldwide depression.
stay well and be happy
sarah

[hutchibk]

Anita, call Livestrong... they have specialists who will assist you with all of your concerns.

[StephN]

Caya wrote:
"There was a woman from California, I believe, who had no health insurance - she was advertising in the Canadian media for a husband, so she could get her treatment. "

There may be more than one woman doing this, but I DO know one whose story was a bit different and she DID advertise.

The woman here I believe was advertising in Vancouver, B.C. as she wanted to be close to Seattle. Her situation is that she has been stage IV for many years and she has a hard time making ends meet on disability, with having to pay for a medicare supplement ins. and then the co-pays.

She DOES have coverage, but her treatment and followup co-pays are more than she can manage. Those of us who get disability KNOW that we could not live on that income alone, but she is single and supporting a son. Her story was a feature in one of the local papers called The Weekly, which she contributes to from time to time.

Speaking of co-pays, I paid through a stack of bills yesterday and the total for my medical was very small. For instance, for my $17,000+ angioplasty in July, my portion was only $38.00, which I gladly paid!

Co-pay amount for doctor visits is $5 for me. I have paid NO co-pay for my Herceptin EVER! Or for my scans.

[Diane H]

Steph, I think it is wonderful that you have such good insurance.

My co-pay is 40.00 and half of all lab work after meeting a deductible of 2500 + a deductible of 5000 for any hospitilization. My premium share is 268 a month. My place of employment (small business) simply could not afford to carry any better policy. I think twice and yet again before scheduling dr appts. And am now getting my AI from Canada as it is one third the cost.
I am terrified of what will happen with the next renewal period.