I have been meaning to write a diary about French healthcare for a long time now, and nyceve's excellent diary as well as betson08's finally convinced me that it was time to do it.
I'm 32 years old, I was never very sick, and I'm among the lucky few (knock on wood) who almost never had to face serious illness among their friends and family. And let's say it: I am not a specialist in the French healthcare system. In fact I know pretty much what anybody knows here when it comes to being sick, needing to see a doctor and getting a treatment.
But here I mean to tell you more about this supposedly best healthcare system in the world of ours because ignorance (mine in this case) can be cured with a little research, good factchecks and hard work. Let's just hope all this work won't get burried too soon.
Short overview of the historical background.
During WWII, the National Council of the French Resistance adopted plans to create a universal social security (not to be confused with what Americans call Social Security, in France, it is the name of the Healthcare Plan) program to cover all citizens, regardless of class, in the event that sickness or injury made them unable to work.
This took effect right after the war, with two ordinances (October 4th and 19th 1945). French healthcare would be financed by both employers and employees and be administered and managed by all social partners, typically employee unions and/or companies.
The new constitution passed in 1946 would even include in it's preamble that it was the State duty to help people financially if they were to be exposed to the most important social risks, notably the children, old workers, and women.
Numerous add-ons and changes have happened since 1946. These changes were mostly made to help more people (not only workers and their families) to get insurance. One of the last big changes is called CMU for Couverture Maladie Universelle (Universal Healthcare)which aims at helping abslotuley EVERYBODY to get insurance. In a few words, it means that, even if you are extremely poor, if you're homeless for instance, you get insurance.
Not so fun facts
As all of you here I've been hearing conservative talking heads speaking of "socialized healthcare" like it's a terrible thing that will not only destroy America but probably the whole planet, if not the galaxy.
I also heard that the Obama administration as a great plan to create death panels that would kill as many Americans as possible if not always willingly, at least throught incompetence and bureaucracy (let's hope they hadn't plan to vote for him in 2012). Because you know, democrats love to kill people (and probably kittens too) but since they usually don't cling to their guns the way Republicans do, they have to find despicable ways like democratic vote to be able to do it.
I've also heard people like Glenn "Weepy" Beck and Bill "I'll do it live" O'Reilly force feeding their audiences with... humm, I guess the right word here is LIES, about a little fun fact which is that the United States has the best healthcare system in the world and therefore if it ain't broke don't fix it and so there.
If millions of lives were not at risk each year, this could be the funniset running gag in TV and the Internet history.
But here is another fun fact for them:
60% of the people insured are insured by their employer,
14% BY Medicaid,
13% By Medicaid/SCHIP,
9% Directly Purchased their Health Insurance,
4% Get Health Insurance Through The Military,
16% or 45.8 million Americans are uninsured.
Americans also know pretty well what insured means. Basically that there are insured as long as they pay AND don't get sick.
So, socialized healtcare anyone? Here is what my very decadent country (think, we drink wine and eat blue cheese), is offering her citizens (and basically any foreigner in need, yes, this could happen to YOU!).
First, let me address the daring question, is socialism that bad?
Believe it or not, we have socialists here (or at least, that's what they call themselves). This is what is left of the once left wing party (now more in the soft center) that, in 1981 decided for instance that death penalty should be abrogated (against the opinion of most people if you look at the poll numbers from back then).
Well, these socialists really are not scary, they defend our Republic, and Democracy. The funny part is that French communists defend the exact same thing.
Socialism, really is just a word. What matters is how you envision the job of a government.
For instance, most of you know that we (at least some of us) elected Nicolas Sarkozy two and a half years ago and that this guy is the most right wing president we ever had. (And the most tacky but this is another story).
As much as I dislike his political actions, here is what he announced a few days ago: A new plan to reduce discrepancies in the treatment of cancer so that you get treated as well in Paris as in the middle of La Creuse (least populated place in France, think Wyoming). That's right, the right wing guy (who by the way is still trying to make people pay more for their healthcare with private insurers or reduce the number of hospitals) announced that the government would spend €750 million (roughly a billion dollar!) for expensive equipment like catscan machines and so on.
And he can't be described AT ALL as someone who cares much about people unless they are powerful, believe me.
So what is the cost of health here?
It is often said that healtcare is free in France. But we all know this isn't true. It is very expensive, as anywhere else. The thing is, because it is taxed indirectly (taken from our salaries before we get it), we just don't feel like we pay for it. Healthcare cost here is 9.5% of the GDP so it amounts in euros to roughly 200 billion. On average, this is 3300 euros per year and per inhabitant.
It is so expensive that, actually, we have a phrase to describe the huge deficit that results from our expenses. That's right, we can't even balance our health checkbook. This phrase is "le trou de la sécu", the "healthcare hole" (it's like a black hole, healthcare money is attracted to it and can't escape its gravitationnal power). This year's deficit is about €12 billion (around $16 billion). This is a real concern here. How to finance such an expensive thing, and administration after administration, the government comes up with new plans (mostly ineffective) to save the system from itself. But it is still going on. Becaus if it stopped, it would start a tea par... I mean a huge riot, or a revolution.
In practice, here is what it is typically to go see a doctor here. You make an appointment, you pay your doctor with your own money and you get reimbursed. Except that we have a magic card called "carte vitale", "the vital card" that helps you getting reimbursed faster. The last time I saw my doctor, I wrote her a €28.5 check and she plugged my carte vitale into a specific terminal. It's a personal card but your kids can be taken care of by it too. As a result I had €27.5 (one euro is never reimbursed) on my bank account 48 hours later, long before my check was cashed.
Then I went to the pharmacy. I gave them my carte vitale and didn't pay for anything (part was paid through my carte vitale directly by the French healthcare, part through a private insurer. But since my private insurer has a partnership with most pharmacies, they deal with it too and I didn't have to give any money in advance).
Same thing if you get rushed to the hospital, first you get the treatment you need, then they figure out the money issue if there is any. And it doesn't matter much which hospital they rush you too because they all work the same, you won't pay more money if there is no partnership with your insurance company, this simply doesn't make sense here.
Right now, a new carte vitale is being introduced and guess what, most people are not happy with it. Why? Because there is your photo on the new one. As long as there was not, it was sort of easy to get healtcare even if you were let's say illegal in the country. You just needed some sympathetic person to lend you their card. Even doctors, députés (our congressmen and congresswomen), and senators opposed the new card. They argued that it was cheaper and better as a matter of public health to treat someone who is in France illegaly let's say with TB, than not to treat him and having to treat a whole bunch of legaly insured people he/she might have contaminated. Suck on that Fox News! And they were not even getting started on the humanistic side of this thing!
Part of the healthcare money here also goes to prevention. Countless number of ads on TV, the Internet, street signs, radio, newspapers to inform people about free screening tests for let's say breast cancer, or to tell people about STD's and that condoms is the safest way to have sex and the only way not to catch one. (Btw, nurses in highschools can give free condom to teenagers here, usually they add a flyer with advice to have safe (and happy) sex, and guess what, highschools didn't turn into anything weirder than highschool because of this, sorry to disappoint some of you but there are no orgies going on there, even with a free access to contraception, abortion and morning after pill).
Now, don't get me wrong, our system isn't perfect. It works on three legs, it creates a huge deficit annualy that isn't going to get better any time soon and, as painful as it is to admit it, we also have our healtcare horror stories (albeit, much more rarely and almost never regarding money issues).
So, yes, socialized healthcare(if this is the way some people want to call it) can work. And being taken care of by such a system won't turn you into a communist. So you kosacks have to work hard on this one. And then work harder on this one.
Will it cost a lot of your tax dollars? Heck yes!
Is it worth it? Heck yes too!
Guys, I'm just a French dude, so you might think I don't care about the States or the way you get your healthcare, well I do. First of all because I have a lot of American friends including some with health insurance problems. Also because as most French people, I love America (don't let anybody tell you differently, we might not agree on everything, but we love you guys), I love France too of course, in a passive agressive way, but hey, it's my country after all; but I also remember growing up living in a house built by American soldiers after WW2 and, from time to time, passing by a row of American graves from both WW in the local cemetery. These kids were mostly less than 23. They were heros, they freed my country, and they were the true victims of the Nazis. Our country will be forever in debt regarding the US sacrifice during these wars. So, Glenn f*** Beck and all your friends, why don't you shut your pie hole while you can and stop comparing your president to Hitler?
Thanks for reading, comments appriciated.