Saturday, July 11, 2009

French health care

Like its high speed trains and extensive motorway network, France's health care system is admired throughout the world for its efficiency - and it is available to you when you settle in France. Under a reciprocal agreement with the British government, you can acquire the all-important 'Carte Vitale' which is your personal health card. When visiting your local doctor, specialists and other services such as X-ray departments, your electronic card is swiped automatically, and the charges ransferred to your health care provider. You 'pay as you go' but 70% is reimbursed by the French health care system, and you can take out additional insurance for the 30% balance. Note that some long-term, serious conditions - such as heart problems and cancer - are covered fully by the state.

The service takes a bit of getting used to, as it is semi-privatised, and dispersed among a range of specialist services. For example, after a typical routine visit to your doctor, he may send you for an X-ray, usually available at a clinic in the same town, with the results discussed with you by a specialist almost while you are getting dressed, and a written report prepared for you and your doctor, which you take away with you as you leave. The same with blood and urine tests, undertaken the same day at a special 'labo' and the results discussed and given to you when you return a few hours later, and automatically emailed to your doctor, who probably receives them before you.

Note that, in line with the principle that it is you who are the 'customer', you have access to your own records, which you retain and take with you to your next appointment, avoding delays or possible loss in transit. Although you now have to have an appointed 'generalist' doctor, who co-ordinates your treatment and directs you to the various services (which are reimbursd by the Sécu as it is known), you can approach a specialist directly and indeed decide on your own to have a blood test or an X-ray, visit a sports clinic or an eye specialist (prior to buying spectacles, for example), all privately if you wish.

What is particularly impressive is the system's speed and efficiency. I will give you just three examples that have amazed British friengs recently moved to France:

1) A 70 year old neighbour suffering from a knee injury visited his local doctor on a Monday, and was referred to a specialist, the following day, Tuesday in our nearest large town (Perpignan). The specialist saw him at his clinic that afternon, and advised that an operation was necessary. Opening his appointment book, he sighed and said 'Sorry I can't fit you in tomorrow, will Friday be okay?'. My by then astonished friend was duly operated upon three days later, spent a pleasant few days in a private room, before returning home. He had a visiting nurse to change his dressings, followed by several weeks of physiotherapy - at a clinic a couple of streets from his home.

2) In another case a friend found himself suffering from 'flashes and floaters' in one eye and advised it might be due to a detached retina, visited his local doctor that afternoon. The doctor referred him immediately to an eye specialist in the same village, who saw him within an hour (allowing time for some eye drops to take effect). The specialist carried out a full examination and said my friend needed laser treatment, and 'could he be at his clinic in Perpignan at 10.00 o'clock tomorrow?' The next day, treatment was carried out within minutes and my friend returned home by taxi (he was advised not to drive as one eye was bandaged). Total cost was 84 euros!

3) Part of the routine of starting a new job is that you have to visit the 'médecin de travail' (work doctor) who visits every local town once or twice a week, and deals with perhaps 10 or a dozen people. A friend joined a group of youngsters starting seasonal jobs and was seen within about half an hour. Being in his sixties, the doctor advised going for some routine tests at the occupational health centre, 'next time he was in Perpignan, just phone and make an appointment the day before'. My friend duly followed this advice and arrived at 3.45 for his appointment and was seen right away. Within half an hour, he had an X-ray, cardiogram, breathing and hearing examination - tests he told the astonished medical staff he never once had been offered in the UK.......

Vive la différence!