Sunday, March 22, 2015

French health system as experienced by me ...

In a way, I was lucky (if you could ever call getting sick Lucky) that I fell sick in Paris or in France. The health system here is nothing like the US pre Obama, where when you did not have private insurance, well just rather tough luck. The French system probably is closer to the more ‘social’ systems of Canada and Australia. In my case, the national insurance took care of all my médical expenses. This is due to the nature of my illness, considered to be long term illness (there is a gouvernment list indicating what illnesses are considered long term or ALD = Affection Longue Durée in French), which gave me the right to a 100 percent coverage by French social security. Not as automatic as it sounds though, because your MD or the MD taking care of you in the hospital has to send documents (This is French, everything takes a lot of paper work to do) to the Social security asking for the 100 percent coverage. And then, which is logical, the coverage includes only treatments for and related to the specific illness. They also have to be renewed every number of years (at least for some maladies that can be totally treated). But this is a load of the mind of many patients (I shivered thinking how much my hospitalisation and care would have cost me in the US !). Several ALD illnesses that I know of are cancer/tumor, diabetes, tuberculosis (I thought it does not exist anymore in France, but apparently there are close to 5000 declared cases in 2012 in France !) and HIV (for those séropositive or/and taking treatments). For HIV, the price of antirétroviral médications can be upwards 1000 euros per month! The 100 percent coverage also covers expenses at tarifs as deteremined by Social Security. When you do see a doctor, for instance, the tarifs praticed by the doctors may vary as a function of whether they follow the tarif guidelines of the social security (the cheapest) or they decide freely their tarif (more expensive). For the latter, social security reimburses the sum équivalent to their standard tarif and the rest is out of your pocket or if you have complementary private coverage they will probably reimburse the différence. You also have to, except in rare cases, see your own general practitioner designated as 'medecin traitant' (does not apply to specialists though)
Everyone in France has a health card or Carte Vitale, with an electronic chip like you now find in most crédit and débit cards. This card contains all information about you (DOB, address as well as the médications you’re currently taking or have taken in the past etc.) which means that you probably have to protect it as you would your crédit cards. The advantage of having a 100 percent coverage when I go see my doctor is I just give him my Carte Vitale and the payment would be done directly from the social security to his account (my doctor is a he). Ditto with the médications that I pick up at the pharmacy. The déduction for each use of service is 1 euro.

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