I lived in the States for 18 years, I live in Europe now. I reside in Madrid but today I had a medical emergency while visiting Paris. It was so well taken care of that I would like to write an unusual post in favor of the French Health System. This is clearly a case and not a statistic but I will try to draw some general conclusions comparing the US and French health care experience.I will limit myself to three key elements of the medical experience, the quality of the medical care, the paperwork and the cost.
The case: I had a 3 cm cut on my chest that urgently required stitches. I was rushed to Hopital St Antoine which is not far from Place des Vosges where we have an apartment (my wife is French and we come frequently to Paris). I was successfully treated and sent home in less than 90 minutes.
During the years I lived in the States I had many occasions to go to hospitals mostly for two reasons: one is that I do a lot of sports and tend to get into silly accidents, the other because of my four kids three were born in the States. When you enter a hospital in America, you are greeted by a mountain of paperwork. The first surprise in France is that there´s no paper needed anywhere, no forms, no signatures. The French have developed what I would call the USERNAME system of medicine. Just like many web sites who just want you as a user and don´t really care about your real identity, the French Emergency Health care system is the same. They would like to know who you are but they do not need to know who you are when you are in a medical emergency. They only need to know that “whoever you are”, you are in danger and they treat you in a rush. As I had to go to the hospital without preparations, I did not have any documentation on me. As I walked in, I worried about this. The first good news was that there were no security guards at St Antoine, no ID was required. Secondly there´s absolutely no paperwork. I had never seen anything like that. You tell them your name, they believe you, you tell them your address, they believe you. They don´t ask you for medical insurance nor for any kind of payment and the whole admission takes at most 45 seconds. Compare this to the situation in America where while you are bleeding you have to hear about insurance, malpractice, payments, you have to fill out forms about allergies and medical history. Again I am one case and not a statistic, but this was indeed my experience after being hit by my opponent with a squash racket in the face and rushing to being admitted at Columbia Presbyterian in NYC (I told you I have silly sports accidents…). Here in Paris they did not care if I lived in France or not, nor that I did not have any documentation on me. They treated my injury with great professionalism and sent me home in less than 90 minutes. They were courteous, they did ask me of course if I had allergies or other usual medical questions but this was all done by the doctor before treating me. It was done as a medical procedure not as a legal requirement. From what I could see the legal system is mainly absent from French medicine. When it was all done it was shocking for me to leave the hospital without having to sign any release forms. The surgeon herself notified the administrative staff that I was done and she released me simply saying that I could go home without seeing anybody. But since I don´t pay taxes in France and everything had gone so well so quickly and free of charge, I felt like thanking everyone at the hospital and I did. They just smiled back probably thinking that I was some weird foreigner. The French see free medicine for all as a right and don´t make a habit of thanking medical care workers, something I feel is wrong as they earn half of what their American counterparts make and their work is mostly vocational.
Now this is my conclusion: America probably has the best doctors in the world, the best medical research in the world and the best hospitals in the world. Once an American medical professional gets to treat you the medical care is great. It is not the treatment itself that is better in France, indeed I am sure that on many occasions it could be worse. But what´s wrong with the American health experience is that it is invaded by a lot of elements that are foreign to medicine. The result is a cost so onerous that the percentage of GDP Americans spend on medicine is much higher than in France but the results are very disappointing. Americans spend the most in the world on medicine but live much shorter lives than most in the developed world. They rank 48th in the world in life expectancy. France is 16th. I am not recommending to any American politician to share my story as praising France seems to be the kiss of death in American politics. Still quietly emulating some of the practices here would make a lot of sense.
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