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French health care


woolybanana
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I agree with every word of that Betty. Interestingly our doctor was saying the other day how it is daft that he had to train for ten years to diagnose a cold and how much better it would be to have triage at the surgery and nurses to do some of the work that doesn't need a doctor. Well it is like that in England said I - and there are specialist clinics for diabetes, hypertension etc all within a practice (I dare say there are practices where that doesn't happen, but can only go on what my friends and family tell me).

I read the article in today's Observer about private healthcare providers setting up in tax havens ready for the break-up of the NHS and thought - why are people complaining about the NHS, why aren't they out there fighting to save it...

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And I hate the Nurse Practioner option in the UK. If I thought I needed to see a nurse, I'd ask. I know what is banal and when I need to see a Dr and unfortunately some of my current problems require a Dr. Once they are sorted, maybe I will just need to see a nurse about them, but not now.

And all that medication, well sadly at the moment I need a bag full, much to my horror and quite unavoidable, but if all goes to plan in a years time I'll be back to hardly any.

 

French pay slips are initially quite shocking, me being a wages clerk at one time. But it is a good way to see how things are viewed in France, how each social body is treat separately. Necessary, well, I don't think so, but it is the french way and they understand it.

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[quote user="idun"]

French pay slips are initially quite shocking, me being a wages clerk at one time. But it is a good way to see how things are viewed in France, how each social body is treat separately. Necessary, well, I don't think so, but it is the french way and they understand it.

[/quote]

Scary....really scary....DADSU, PERCO, CSG, CRDS, AED, N4DS, DIF,

STC, AGS, ARRCO,AGIRC,GMP,AGFF,APEC,CIPS,CIPC R, DUE,CIX, TA,

TB,CCNSA,CE,DP,IJSS…….
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You are so right Betty about confusing quality with quantity. Your doctor doesn't ask you to pop back at the end of your 5 day course of antibiotics because he cares, but because you are going to pay him 23€ so he can say you are OK now!

The system is very difficult for doctors in rural areas particularly - hence the shortage of doctors in many places. For the same reason many doctors (illegally) refuse the CMU cards as the government takes longer and longer to reimburse them. They have overheads and lives to run but unless enough people come through the door brandishing 23€ they'll find that difficult. Very tempting indeed to have lots of elderly 'worried well' who are happy to fork out knowing the hard pressed system and their mutuells will repay them. Much easier than having actually unwell people who have no money.
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How that'll work in the future I don't know as some of these come under HUMANIS now. And if that is an acronym, then I dread to think what the full name of it is.

We have several of these pensions, but I know that CIPS came under Malakof Mederic when we applied for the pensions, and that is now under ARRCO or AGIRC which is now HUMANIS, what with the statement coming yesterday.[:D]

No wonder pay slips were almost two pages long[Www]

 

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Yes sad but true. Many of the 'private' clinics also refuse the cards. I read somewhere that as many as a third of doctors in some areas of Paris refuse CMU patients. Of course they are not supposed to but they do.

I have had the personal and very very shocking experience of taking someone to hospital for a cancer diagnosis in my capacity as member of localCCAS. We live in a rural area and hospital transport is only available to those who are already diagnosed. A doctor announced to this poor lady that she had stage 3 cancer and when - very shocked - she went to the reception she handed over her CMU card and it was thrown back at her and she was told she had to pay 46 euros. She had no money and was weeping - I was also nearly in tears (she was not someone I knew) and got out my cheque book and paid because I could not stand a fellow human being treated like that. When I went to complain (and believe me I complained) I was received with a shrug and told that it was the way life in France was now! The poor woman re-paid me when the money was reimbursed but I was left with a profound distaste for the system of the country I live in - even more so as very few people seemed surprised or disturbed by this tale.
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Emily, you would be shocked as to the percentage of fifty somethings diagnosed with serious medical conditions, such as diabetes, cancer and heart disease. Apparently, if you get to your sixties in good health you are likely to live to a good old age, as your fifties are a perilous decade for health issues according to Dr's.
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Cérise raises a point that most Brits don't realise: as the CMU was intended for the poorest, and as those on the CMU_C are indeed often refused for care because of the delays and problems, the French consider the CMU as almost a dirty word, as they don't make  a distinction between those who pay to be in the CMU and those who don't....

I am glad to see her back posting as I have been ploughing a bit of a lone furrow in my view of the system, and as I have recently benefitted so much from it I feel awkward making criticisms.

But the financial side with gross overcharging by some specialists , and poor  people unable to get care is something documented, as is the way private cliniques milk the system.

The 'nit-picking' of some Mutuelles is also something of which to be beware as I posted last year, when despite being at 100% and having a Mutuelle my total 'extras' for my stays were well over 3000€

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Cerise, this has been going on more or less since the CMU started, difficulties were always there for the poorest, but it was still better than it was. And my feeling is still that the CMU was really started for poor french people, but look how it ended up.

I remember nearly blowing a fuse on here, me and Miki when an early retiree said that they were in the CMU. We couldn't believe it. I was flabbergasted. 

 Frankly I never ever cared what happened to early retirees who chose to move to France and when it boils down to it, I still don't really care. I have been too many years emotionally tied to how the french were affected by their 'lack' of health cover and the real anguish I felt for them. The difference between french poor and early retirees is that the french poor are poor and needed help.

The new rules ofcourse didn't help early retirees and  should have been amended. I understand that.

 

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Norman - I don't think the fact that we have received good care makes it any less important to criticise the problems. Good care should be for everyone not just those fortunate enough to be able to afford it.

I actually felt I had to come back and post as I was so incensed by the righteous indignation over the state of the NHS and the seeming lack of interest by the same folk in the parlous state of the French health system. Because I am involved locally in all that goes on, good and bad, I find it hard to osit on the sidelines saying all is well.

Like idun I am naturally curious and interested in the place I live , be that UK or France.
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Which all comes back to what I was saying. The problem is not with the CMU and who it is or isn't intended to be for, the problem is with the daft system of having different caisses for different occupations instead of one integrated system. That is why the founding principle of the NHS is so wonderful and why people should fight for it.
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Apart from the who should be covered (foreigners etc) . . . . . . .  there are those that are too 'rich' to be covered by the CMU (or to recieve any other help) yet poor enough to be classed as poor.  The idea that one might be too scared  to call for a doctor or an ambulance because of the bills is still an idea that horrifies me.

When in England I only changed doctor \ dentist what ever if there was a reason to, a move, a retirement or similar. I moved back to London in the early nineties and for ten years had the same doctor (at least stayed with same surgery) and stayed with the dentist there for similar amount of time.

In France I am on my fourth dentist here now, have found one who is not French and who did not train in France (who so far is excellent). Based on previous experiences (not good so far) would not be too keen to chance it with another 'French dentist' (last one I refer to as Marathon Man. Am on my third doctor. Have very mixed feelings, experiences. Sufficient enough perhaps for me to ask myself if I really want to stay in France (though there are other contributory factors in this).

 

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[quote user="EmilyA"]Which all comes back to what I was saying. The problem is not with the CMU and who it is or isn't intended to be for, the problem is with the daft system of having different caisses for different occupations instead of one integrated system. That is why the founding principle of the NHS is so wonderful and why people should fight for it.[/quote]

But the problem could be if they got rid of the CMU. Because it really did target a group of people and it was very easy to slip between the cracks in France before it came in.

The trouble with all systems that are not universal is that one ends up being in no man's land and in this case, not quite poor enough and not quite well off enough.

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''In France I am on my fourth dentist here now, have found one who is not French and who did not train in France (who so far is excellent)''.......and yet.........for some years, in Sharjah (UAE) I had a Lebanese dentist who WAS French trained and was utterly superb. I don't think it's necessarily the training but rather the individual.
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[quote user="Sprogster"]Emily, you would be shocked as to the percentage of fifty somethings diagnosed with serious medical conditions, such as diabetes, cancer and heart disease. Apparently, if you get to your sixties in good health you are likely to live to a good old age, as your fifties are a perilous decade for health issues according to Dr's.[/quote]

 

Six people I know of now,including my OH who have died in their 50's just in the past couple of years. Two of them worked for us when we had the business in the UK and one was a year younger and one two years older than OH. People I was at school with too, when speaking to siblings on phone who tell me. Seems it is a very perilous period of life now and if you make it to 60,you can live to a good age.

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[quote user="powerdesal"]I don't think it's necessarily the training but rather the individual.[/quote]

Or my bad luck  . . . . . . three individuals in the same jobs like that . . . . . that is bad luck for me.

[quote user="Val_2"]Seems it is a very perilous period of life now and if you make it to 60,you can live to a good age.[/quote]

Panic ye not. When I worked in the NHS I saw people of all ages die. More old people than of any other age group though (if that's any consolation?).

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 Coops - As far as I know dentists don't get any more for treating pensioners, although there maybe certain exemtions regarding their payments depending on other factors: http://www.nhs.uk/chq/Pages/1786.aspx?CategoryID=74&SubCategoryID=742

Balham - you only sign on with your dentist for a course of treatment, once you are dentally fit you are free to go anywhere....as long as they will have you of course

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[quote user="Russethouse"]

Balham - you only sign on with your dentist for a course of treatment, once you are dentally fit you are free to go anywhere....as long as they will have you of course

[/quote]

That I know, hence getting through three of them!

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I think that some people get confused by talk of CMU, when what they mean is CMU-C.

CMU-B is, of course paid for at 8% of income above a threshold, although whether there should be a minimum (or a maximum?) payment is another question.

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[quote user="NormanH"]... but as so few French people have CMU-B most have never heard of it, and automatically assume CMU-C.

[/quote]

Which is why my new Dentist said not to tick the box for CMU on the welcome form I was filling in ... when I explained we have CMU-B. The team thought all CMU was CMU-C.

Sue

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