A TASTE OF WHAT WE COULD HAVE HERE IN THE U.S.
Yesterday in the New York Times, Erica Rex wrote an opinion piece entitled, What a French Doctor’s Office Taught Me About Health Care. The Times' illustration is deliciously apt, showing a first aid box divided in half:
In the right hand part we see what you need for first aid in France -- band-aids, antiseptic, etc. On the left half we see what you need for first aid in America: MONEY.
Indeed it was money that caused her to move to Europe, not because she'd rather live there -- she would have much preferred to stay home in the U.S. -- but because, as she puts it, "I couldn’t afford to be a cancer patient in America." In France, as it turns out, not only does the government pay for most of her treatment by the top orthopedic surgeon she's seeing, it pays for the cab ride she had to take to get there (it was only a few days after surgery). Notice I said the government pays for "most of her treatment." Her specialist -- like many in France -- charges more than is paid for by "la Sécu" (The French Social Security System -- which also pays for healthcare). But Ms. Rex, as a tax-paying resident, does what most of the French do and pays for supplementary insurance which covers the gap.
It's a highly significant point. Most of the European Single-Payer systems I've looked at have a two-tiered system: The lower tier covers everyone and pays almost, but not quite everything. But if you can afford it, you take out supplementary insurance which covers the gap. My personal belief is that we are going to end up with something like that, here. Only a few days ago I had a conversation with a member of a very strong New York State Union. She pointed out that currently her Union has been able to provide her with a super-deluxe medical coverage which she suspects will exceed what will be offered by NYHA. She herself says that she would be willing to give up some of those deluxe extras "for the common good," though she's doubts whether many of her union colleagues would go along. As it stands now they are very uneasy about Single-Payer. But I personally believe that some sort of two-tiered approach might solve the problem, and might be what we will eventually see here.
But back to the Orthopedist's office. The financial aspects of her care are not on the top of Ms. Rex's mind. It's the feeling of relaxation, the freedom to chat with others about one's condition candidly. She writes,
"To my friends in the United States, this casual attitude seems foolish, even risky. But in France, medical privacy is irrelevant. No one will lose her job because of a lengthy convalescence. There is no possibility that pre-existing conditions will make insurance unaffordable. Unemployed people still receive treatment. Huge medical bills do not reduce ordinary citizens to a state of existential terror. The absence of unease over health care alters the texture of French experience. We get cozy in waiting rooms."
Indeed, the atmosphere of the waiting room might be described as "homey" in a declassé sort of way, with six-month-old copies of Le Monde and Paris Match on the table, and a framed print of a Monet painting on the wall. No nurse helps our author's specialist in the examining room; he changes the examining table paper himself.
The whole thing reminds me of a short movie my wife and I were shown more than fifty years ago. We were taking classes in the Lamaze method of child bearing, which enables a woman to give birth without anesthesia -- much better for the baby. The film we were shown was made in France. The delivery room was very homey, with a table bearing a vase full of flowers. The young woman used the Lamaze technique to give birth and did so with aplomb. After the umbilical cord was cut, the young mother, holding the baby, got off the table and walked out of the room. The obstetrician, smiling, cried "VOILÁ!"
Now I haven't done justice to Ms. Rex's wonderful piece; there's a lot more homey detail than I've shown here. so I encourage you to read it for yourself, and get the full picture:
Indeed it was money that caused her to move to Europe, not because she'd rather live there -- she would have much preferred to stay home in the U.S. -- but because, as she puts it, "I couldn’t afford to be a cancer patient in America." In France, as it turns out, not only does the government pay for most of her treatment by the top orthopedic surgeon she's seeing, it pays for the cab ride she had to take to get there (it was only a few days after surgery). Notice I said the government pays for "most of her treatment." Her specialist -- like many in France -- charges more than is paid for by "la Sécu" (The French Social Security System -- which also pays for healthcare). But Ms. Rex, as a tax-paying resident, does what most of the French do and pays for supplementary insurance which covers the gap.
It's a highly significant point. Most of the European Single-Payer systems I've looked at have a two-tiered system: The lower tier covers everyone and pays almost, but not quite everything. But if you can afford it, you take out supplementary insurance which covers the gap. My personal belief is that we are going to end up with something like that, here. Only a few days ago I had a conversation with a member of a very strong New York State Union. She pointed out that currently her Union has been able to provide her with a super-deluxe medical coverage which she suspects will exceed what will be offered by NYHA. She herself says that she would be willing to give up some of those deluxe extras "for the common good," though she's doubts whether many of her union colleagues would go along. As it stands now they are very uneasy about Single-Payer. But I personally believe that some sort of two-tiered approach might solve the problem, and might be what we will eventually see here.
But back to the Orthopedist's office. The financial aspects of her care are not on the top of Ms. Rex's mind. It's the feeling of relaxation, the freedom to chat with others about one's condition candidly. She writes,
"To my friends in the United States, this casual attitude seems foolish, even risky. But in France, medical privacy is irrelevant. No one will lose her job because of a lengthy convalescence. There is no possibility that pre-existing conditions will make insurance unaffordable. Unemployed people still receive treatment. Huge medical bills do not reduce ordinary citizens to a state of existential terror. The absence of unease over health care alters the texture of French experience. We get cozy in waiting rooms."
Indeed, the atmosphere of the waiting room might be described as "homey" in a declassé sort of way, with six-month-old copies of Le Monde and Paris Match on the table, and a framed print of a Monet painting on the wall. No nurse helps our author's specialist in the examining room; he changes the examining table paper himself.
The whole thing reminds me of a short movie my wife and I were shown more than fifty years ago. We were taking classes in the Lamaze method of child bearing, which enables a woman to give birth without anesthesia -- much better for the baby. The film we were shown was made in France. The delivery room was very homey, with a table bearing a vase full of flowers. The young woman used the Lamaze technique to give birth and did so with aplomb. After the umbilical cord was cut, the young mother, holding the baby, got off the table and walked out of the room. The obstetrician, smiling, cried "VOILÁ!"
Now I haven't done justice to Ms. Rex's wonderful piece; there's a lot more homey detail than I've shown here. so I encourage you to read it for yourself, and get the full picture:
After you've read it, you will smile and join me in crying "VOILÁ!"
Dio
PS: I encourage you to comment if you'd like. Just click on the number of comments area and share your thoughts in the comment box that appears.
Dio
PS: I encourage you to comment if you'd like. Just click on the number of comments area and share your thoughts in the comment box that appears.
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