Wednesday, September 14, 2011
French Healthcare - the User Experience
No system, be it national, private or charitable, is perfect. Kant once wrote, "Out of the crooked timber of humanity, no straight thing was ever made." My purpose here is not go into a comparison of different healthcare systems found around the world which all, in their own unique ways, generally do work more or less for the people who use them (unless, of course, you happen to be the citizen of a failed state in which case all bets are off). What I thought I would do this morning while sipping my coffee is to describe what happened this morning when I took my daughter to the doctor. You can then take that information, add it to your general store of knowledge and decide for yourself if this system "works" or not.
My younger Frenchling has been having some problems with her knee and since she has to walk up a very steep flight of stairs to get to school, we thought it would be a good idea to have someone look at it. We have a family doctor within walking distance of our house and so we called and made an appointment for 8:00 this morning. Under the French system we can choose any doctor we want and all we have to do is declare to Social Security that a doctor is our "Primary Care Physician."
I love our doctor - he is young, very competent and he is almost always on time (something that warms my little Anglo-Saxon heart). He also attended the same high school as the younger Frenchling so they always have much to talk about. Today he is indeed on time - at 8:00 the door opens and he ushers us into his office. We answer questions, he looks at my daughter's knee and says it will probably go away by itself but he's going to write a note that she be excused from sports for the next two weeks.
Still chatting I hand over my daughter's Carte Vitale. This is a little green card that has my daughter's photo on it and a chip. The doctors puts the card in his reader - this sends information to the social security office that we saw the doctor that day so they can directly reimburse the expenses to our bank account.
I then hand my Visa card to the doctor and tap my code. In the French system you are reimbursed (usually within a week) but you still must pay the doctor at the end of the visit. The fee is 23 Euros (34 U.S. Dollars - the Euro is really high against the Dollar right now). We chat some more with the doctor (he asks about the elder Frenchling in Canada), we shake his hand and leave.
This visit took about 30 minutes. Less than 5 of those minutes had to do with administrative stuff (forms, payment and so on). The rest was the doctor doing what doctors do best - care for their patients. You also might notice that our doctor (like many here) does not have and does not need staff. He does share a receptionist with about ten other doctors in the clinic but that's really all he needs. With the card system, there is almost no paper - in our case just the handwritten note for my daughter's school.
As a long-time user of this system I would rate my satisfaction as Very High. It is not only efficient but I feel that I and my family have received very good care. It's a real relief not to have to fill out forms and go through three different people (only one of whom is actually the doctor) for something as simple as checking out an aching knee (something we experienced on a regular basis in Seattle).
In my experience where the system tends to break down is when the private companies get into the act. Many companies offer private supplemental insurance (called Mutuelles) to their employees for extras like slightly more expensive glasses or a private room in a hospital. We are currently battling with our two private insurance companies over fees for care received late last year. Social Security has paid its share and now these two insurance companies are fighting it out over who should pay the rest with both saying that the other is responsible. Kafkaesque.
Look, we can have an argument about the cost, about how it is funded, about its efficiency and even whether or not this sort of system is adaptable to other places and other peoples. Those are legitimate topics but, speaking as a user of this system, I personally am a very happy and satisfied customer. The national healthcare system in France is, in my humble opinion, something that the French should be genuinely proud of.