posted February 18, 2014 11:42 AM            

PLEASE DO ME A FAVOR AND READ THIS ARTICLE BY ANNA SCHIFFRIN WHOSE FATHER WAS TREATED FOR HIS CANCER IN PARIS. IN MY NEIGHBORHOOD. BY THE GOOD PEOPLE WHO CARE FOR EACH OTHER IN FRANCE. GOD BLESS THEM EVERY ONE.

When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

I humored him — though my sister and I didn’t want him to go. We felt he should stay in New York City, in the apartment where we grew up. I could visit him daily there, bringing takeout from his favorite Chinese restaurant and helping my mother.

I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care. Not better cancer specialists. How could a public hospital in Paris possibly improve on Sloan Kettering’s cancer treatment?

After all, people come from the all over the world for treatment at Sloan Kettering. My mother and I don’t even speak French. How could we speak to nurses or doctors and help my father? How would we call a taxi or communicate with a pharmacy?

But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions.

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. Around 1 p.m. or 2 p.m. my dad would usually tell me and my mom to go get lunch. (He never seemed to be hungry.) But we were always afraid of having his name called while we were out. So we’d rush across the street, get takeout and come back to the waiting room.

We’d bring books to read. I’d use the Wi-Fi and eat the graham crackers that MSK thoughtfully left out near the coffee maker. We’d talk to each other and to the other patients and families waiting there. Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting. Total time at the Paris hospital each week: 90 minutes.

There were other nice surprises. When my dad needed to see specialists, for example, instead of trekking around the city for appointments, he would stay in one room at Cochin Hospital, a public hospital in the 14th arrondissement where he received his weekly chemo. The specialists would all come to him. The team approach meant the nutritionist, oncologist, general practitioner and pharmacist spoke to each other and coordinated his care. As my dad said, “It turns out there are solutions for the all the things we put up with in New York and accept as normal.”

One day he had to spend a few hours at Cochin. They gave him, free of charge, breakfast and then a hot lunch that included salad and chicken. They also paid for his taxi to and from the hospital each week.

“Can’t you think of anything bad about the French healthcare system?” I asked during one of our daily phone calls. My mom told me about a recent uproar in the hospital: It seems a brusque nurse rushed into the room and forgot to say good morning. “Did you see that?” another nurse said to my mom. “She forgot to say bonjour!”

When the gemcitabine stopped working, the French oncologist said he would put my dad on another drug — one my dad’s U.S. insurance plan had refused to approve in New York.

By this time, I had become a French healthcare bore. Regaling my New York friends with stories of my dad’s superb care in Paris, I found people assumed he was getting VIP treatment or had a fancy private plan. Not at all. He had the plain vanilla French government healthcare.

I had read many articles about the French healthcare system during the long public debate over Obamacare. But I still I hadn’t understood fully, until I read this interview in the New York Times, that the French system is basically like an expanded Medicaid. Pretty much everyone has insurance, it explained, and the French get better primary care and more choice of doctors than we do. It also turns out, as has been much commented on, that despite all this great treatment, theFrench spend far less on healthcare than Americans.

In 2011, France’s expenditure on health per capita was $4,086, compared to $8,608 in the United States, according to the World Health Organization. Spending as a percentage of gross domestic product was 11.6 percent in France while in the United States it was a far higher 17.9 percent.

Last fall, my mother asked me to come and see their general practitioner in Paris so we could plan ahead for my father. My mom got an appointment for the next morning and we walked to the office, five minutes from my parents’ apartment. We waited for a half-hour on a comfortable couch, chuckling over the very French selection of magazines on the coffee table (Elle and Vogue) andadmiring the lush garden view. The waiting room was quiet. I realized what was missing: There was no billing department.

We spoke with the doctor for about 45 minutes. My mom wanted to know what would happen when my dad was no longer able to walk. “Oh,” said the doctor, speaking in English. “I prescribe a wheelchair and it’s delivered to your house. Shall I do it now?”

When I asked the price, she looked surprised. No charge. She asked if we wanted someone to come to the house every day and it was my turn to look surprised. What would they do? For example, someone could come and give my dad a massage to alleviate his neck pain. Again, no charge.

At the end of the appointment, my mom pulled out her French insurance card. Total cost of the visit? 18 euros.

When my dad began to get worse, the home visits started. Nurses came three times a day to give him insulin and check his blood. The doctor made house calls several times a week until my father died on December 1.

The final days were harrowing. The grief was overwhelming. Not speaking French did make everything more difficult. But one good thing was that French healthcare was not just first rate — it was humane. We didn’t have to worry about navigating a complicated maze of insurance and co-payments and doing battle with billing departments.

Every time I sit on hold now with the billing department of my New York doctors and insurance company, I think back to all the things French healthcare got right. The simplicity of that system meant that all our energy could be spent on one thing: caring for my father.

That time was priceless.

Staff note: The French health system treats health care as a public good rather than a profit. It is a stark contrast to the US health care system that treats health care as a commodity so that patients only get the health care they can afford rather than what they need. It is up to us to change this because we have everything we need in the US to change to a health system that is about health and healing except the movement to demand it.

THIS ARTICLE MADE ME CRY. AN AMERICAN WOMAN LIVED THIS EXPERIENCE AND WAS ABLE TO SEE FOR HERSELF HOW IN FRANCE DOCTORS AND NURSES CARE FOR US. THEY DON'T WANT OUR MONEY. THEY WANT US TO GET BETTER. I CANNOT EVEN REMEMBER NOW HOW MANY TIMES THOSE GOOD PEOPLE HAVE SAVED MY LIFE.

PLEASE SHARE. EVERYONE EVERYWHERE IN THE USA SHOULD KNOW AND BEGIN TO FIGHT FOR THE RIGHT TO SINGLE PAYER HEALTH INSURANCE. AMERICANS ARE SLAVES TO THE INSURANCE COMPANIES AND THE PHARMACEUTICAL FIRMS.

posted February 18, 2014 08:23 PM            

quote:

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HEALTH INSURANCE IN FRANCE DOES NOT COME OUT OF OUR TAXES.

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posted February 19, 2014 08:10 PM            

Amyway, if you prefer to shrug it off as a scam that's your prerogative, and one more reason we have the expensive cockamamie system that reigns here. As someone who knows the good and bad of the English system, I believe what the letter and Suzanne both say...the hospitals may not feel like hotels but it's a lot easier to stay healthy when the system employees are not thinking about whether you can pay or not.

posted February 19, 2014 10:47 PM            

As i mentioned, this was shared on FB by someone( who happens to be a writer) because she thought it was well written and direct-experience. Your insistence that it is a "chain letter" ie bogus, does not show an open mind. It doesn't even indicate that you read the original post.

I understand a trusted friend's account can carry more weight than a stranger's but the need to dismiss it because it's well written and Suzanne used caps for emphasis and to differentiate between her own posted words and the Article she was passing on(not much font choice available on FB) ...is no indication that you gave it a fair shake. Foreigners often find foreign places distressingly unlike what they expected and you have given no hint of what she found"less than wonderful" so...no discussion available really.

But keep your made up mind if you want. Just be aware that you are allowing it to misclassify something as junkmail which was sincerely shared. And that seems to have shut down any possibility that you would hear what was said.

posted February 20, 2014 01:56 AM            

And if it was completely voluntary so that anyone could take it or find a different insurer then that would be the free market at work, even if the vast majority were to choose the same insurance company.

It may be a FB post but it's written in the manipulative, melodramatic and overly emotional style of chain letters and says, in quotes, "Please Share." Call a turd fertilizer if you want, but it doesn't mean it's not a turd anymore. In any case once it starts passing as emails because it's shared then it's just another chain letter just like the garbage my relatives get on why Obama is evil which are written in the same exact style as that chain letter, including in painting people as good or evil, greedy or caring in it as she does (such chain letters also like using the words as "slaves" as well, another melodramatic word meant to provoke an emotional response over a rational one). You may think that's well written (perhaps only because it agrees with your politics, I bet if the politics were different you'd see the same flaws in it that I do) but I see it as being too melodramatic to not be taken with a grain of salt, and once she twists the truth with spin phrases like calling a "tax" a "premium" (which is what you call it when you buy from a private insurance company rather than having it taken from your income) then her credibility is further dwindled even if she sincerely believes what she posted.

It was too many years ago when I heard of my friend's trip there but IIRC she was treated, it was okay but not as wonderful as painted here (or by Michael Moore) and they'd forwarded bills to her insurance in America, IIRC. Plenty of countries are careful about allowing foreigners use their healthcare system, that's why Americans who try to get any meds or healthcare from Canada try to get a Canadian to get it for them (though it's still generally cheaper for Americans to buy Canadian health services & meds than in America even when paid for honestly). And it makes sense...those who don't pay taxes into their system should be expected to pay more for it because the people who treat them aren't a charity, they have to be paid, and if they're not paid by the government (who pays with taxes) then they have to be paid in another way.

posted February 20, 2014 11:16 AM            

No, you did.

Did i tell you where to "stick it" and call you a moron? No, but some people would.

This has less to do with my politics than it does universal healthcare, which serves people of all political colours. I told you three times it isn't a chain letter and obviously my experience and theirs is different from yours (hearsay) but you can dismiss it if you like. I am objecting to your objections because it doesn't seem to me you were listening. That is not ad hominem or belittling.

When I lived in England my anglophile mother visited me there. She did not find the place she had imagined and couldn't see it either. Everything except the historical places struck her as inferior to her preconceptions. Even the teaspoons "why are they so small?"...

So forgive me for pointing out that you misread the text and dismissed knowledge in favour of a single out-of-context experience relayed by someone from outside the system.

Having payment waived and using loopholes to dodge taxes are two different things. The public school system comes out of taxes, whether you use the system or go private. Sure, people will always find loopholes but this is set up to allow choice, so not a tax, basically. The fact your friend was billed for her treatment because she doesn't pay into it is pretty reasonable to me, but I doubt it cost as much as it would have in her localER. We'll probly never know that...

It was to Americans who think universal healthcare is a con that she was hoping to show an example of how it is not. The woman who told the story mentions the same disbelief among her NewYork friends when she told them her experience. If we can't take on any new info without calling it impossible, we will always stay where we are...not my idea of thinking for oneself, which can't be done without admitting the unfamiliar to be possible.

posted February 20, 2014 12:06 PM            

I read the article on another sight awhile back, and tried to find it again....didn't find the original link, but found others with the spelling Anya- not Anna.

I find it a shame that the focus is on the
postings format---not the gist of what it is about.

I for one think that making healthcare profit oriented, and allowing the insurance/pharma camps control has been more than just the teachable moment....will the U.S. healthcare [and I use that term loosely] system ever recover?

posted February 20, 2014 10:22 PM            

quote:

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Originally posted by Catalina:
[B]PJ, re read please...did I come here and dismiss a friend's FB offering on a subject she is passionate about as moronic "chain mail" and discount her lifetime experience because a friend of mine found reality less than MM's hyperbole?

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No, you made claims about me rather than my valid concerns on the manipulative language that, at best, shows a grain of salt is needed (even if belief is sincere) or how it says to spread it like a chain letter in the same melodramatic & sensationalistic style, and like so many chain letters people forward (as it tells them to do) it's made to garner outrage and make some people look like saints (doctors don't want money?) and others look like greedy villains while giving very little information that can be verified which is itself also meant to motivate through manipulative and questionable means rather than facilitate an informed decision. Furthermore, she lied about it not coming from taxes (no matter how she wants to spin it, and btw, it's a tax for reasons stated in the dictionary) and that throws the credibility of everything else she says into question (especially when someone I know didn't describe her experiences with it in such glowing terms). You don't deal with what I say but rather take the easier path of dismissing me as cynical who can't comprehend what I'm reading which is your casting doubt on me rather than my actual points or concerns.

posted February 20, 2014 10:25 PM            

"I don't know what you mean by 'glory'," Alice said.

Humpty Dumpty smiled contemptuously. "Of course you don't- till I tell you. I meant 'there's a nice knock-down argument for you!'"

"But 'glory' doesn't mean 'a nice knock-down argument'," Alice objected.

"When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean — neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master— that's all."

posted February 21, 2014 03:39 PM            

This is less "hyperbolic" in its enthusiasm in fact fairly wry. It also explains one American's take on why Americans might feel disappointed in the treatment they receive in France. Since PJ's friend's story is a vague memory it is possible it was her conditioning by the American way of medicine that gave her that feeling...or perhaps she thought it was going to be free. Maybe the docs seemed offhand to her, maybe they set her arm crooked...I can't know that.

If you go to England and say you are "p1ssed " they will think you are saying you are drunk. Not all differences of meaning/terminology are down to spin, but often plain perception differences.

I don't expect anyone to go vote for universal healthcare on the basis of any anecdotes. However the American fatal allergies to the words TAX and UNIVERSAL HEALTHCARE are largely based on hyperbole so I don't consider this to be particularly offensive. Hyperbole/enthusiasm/caring ... all slightly different and all perfectly useable in this context.