French Health Care: A Different Case

The diary right below this one has raised a question for at least one reader about who does health care better. I don’t want to suggest there are simple answers, but it is worth having another case on hand from a different medical system. The one below is part of a post at DailyKos. Jerome a Paris is recounting his son’s treatment in Paris when it was discovered that he had a tumor in his brain.I’ve put in bold some of the passages that seem to give us a stark contrast with the experience recounted in the earlier diary.

He was first diagnosed by our pediatrician, a private sector doctor, who sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know. He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.Surgery – an act that the doctor that performed it (one of the world’s top specialists in his field) told us he would not have done it five years before – actually took place the next week, because emergency cases came up in the meantime. After a few days at the hospital, we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, phychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) – and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).During the chemiotherapy, if he had any side effects (his immune system being weakened, any normal children’s disease basically required him to be hospitalised to be given full anti-biotic treatment), we’d call up the hospital and just come around. Either of us could spend the night with him as needed. We never spent a dime.After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size). Of course, they manufacture braces and other specialised equipment for him and provide it free of charge to us.Check up exams take place every 3 months, with all the appropriate exams (usually including a MRI), and we’ve never had to wait for the appointments. Again, no cost for us, no funds to be fronted.When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that’s where the best hope was, the costs of that would have been covered too by French social security.…So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.

A specific case illustrates the US’s failure in health care

(I assume that Michael Moore’s indictment of US healthcare, Sicko, couldn’t cover many of the ways people are deprived of adquate care, and I think the case below illustrates one of  them.  But even if he did include it, the specific case again usefully makes the point.)

I received the following emessage today.  “UTMB” is the University of Texas Medical Branch in Galveston, TX.  It is well-know for treating indigent people; their emergency room does not ask for proof of ability to pay before one receives treatment.  But there are horrendous gaps nonetheless.

Galveston is about 45 miles from Houston, which contains what is, by some measurements, the largest medical center in the world.  Methodist Hospital, with its teak furniture, piano and fountains in the  foyer, provides treatment for some of the world’s richest people.  And yet, in its shadows…well, you’ve read Dickens…

All of you know Dave Diggins and most also know his wife, Susan. I am sorry to let you know that Susan has been diagnosed with breast cancer – she has two areas in her right breast. At this time, the physicians are talking about chemotherapy treatment in order to shrink them before they consider surgery. The radiology department at UTMB has referred Susan to oncology.

Unfortunately, Dave and Susan do not have health insurance and they would have to qualify for indigent care before they would be allowed to see oncology. Since they do not qualify, they have, at this time, been turned away. It is really hard for the mid-income people who are self-employed to make enough to afford health care and Dave just happens to fit into that group.

They have been put in contact with Sr. Joan James, who works with the Susan Cronin Breast Cancer Foundation that administers grants to people that find themselves in Dave and Susan’s position. However, as you know, obtaining grants can sometimes take longer than anticipated.  [All names of persons changed.]

Perhaps, like me, you weren’t aware that indigence is means-tested in the case of life saving health care.