Laboratory refuses to do the necessary analysis

[NormanH]

One of the differences between the UK and French systems is that in the UK the service is 'free at the point of delivery'

In France if you can't pay, or don't have some form of cover, it can be refused, which seems incredible to British people used to the NHS

I have Cancer, and have a 100% cover from the Sécurité Sociale, as it is counted as an ALD.

Ir seems that some where along the line ( in June 2007) the analysis of one of my biopsy samples by the Pathologist wasn't paid for, because today, after having another sample sent to the same lab, I received a letter refusing to do the analysis of the most recent sample ( to see if I also have a cancer elsewhere) :

I quote the last paragraph:

"Nous vous rappelons l'importance des examens d'anatomie cytologie pathologiques qui ont pour but principal le dépistage du cancer.

C'est pourquoi, si vous n'envisagez pas de régulariser votre situation vis à vis de notre Cabinet, nous vous demandons de venir récupérer votre prélèvement afin de faire réaliser cet examen chez un de nos Confrères pathologiste."

My (very free) translation: We remind you of the importance of the pathological analysis of these samples, which is intended principally to detect the presence of Cancer.

This is why if you don't intend to pay what you owe us from before, we ask you to come and collect the samples from us and take them to analysed at one of our colleagues' laboratories.

Remember

that this is paid for by the Sécurité Sociale

They are sure of the payment as I am on 100%

I didn't choose this lab, the sample was sent by my Cancer specialist, and I have never and any direct contact with them so it is not as if I had contracted anything with them

I have no other outstanding Heathcare bills.

The one they are quibbling about is for  [blink] 64,06 euros

Of course I will go in and see them on Monday (give them cash if I have to) but I found the tone of the letter very misplaced; a sort of blackmail.

"The Sécu haven't paid one of our bills so we won't do your samples, even though we know you have cancer...that will make you get of your backside and sort  it out"

What I would like to do is make a lot of fuss about it. Has anyone any good ideas about who I can approach for maximum publicity?

I can write good French..

[mint]

Norman, I sympathise immensely.  Will file your story away at the back of my mind should I ever have occasion to remember it.

Good Luck with the sample!

[Chancer]

Norman.

"Si vous n'envisager pas de regulariser votre situation vis a vis nôtre cabinet" doesnt actually say "pay your outstanding bill" but if you know that there is an outstanding one then I am sure you are right.

One small question though, if you know of an outstanding bill does that mean that they have already approached you about it?, perhaps you forgot to sign or send off something? They might not be looking for you to pay the bill but perhaps to enable it to be paid.

To me the letter has no bad tone or is not threatening, probably best to concentrate on your recovery than kick up a fuss.

Good luck with your treatment. If I were in your shoes I know what country I would rather be in.

[Tony F Dordogne]

I agree with JR, I can see nothing wrong with their response, seems quite standard and not aggressive at all.  I'm also 100% Norman because of my leukaemia thing but I have to pay some element of my fees and then recclaim them through CPAM, especially where blood tests/biopsies are concerned.

Perhaps their original bill was misplaced?

I'd just pay the outstanding amount and then get on with life.

[NormanH]

Thanks everybody.

I just wanted to highlight the fact that in France such services aren't free at the point of delivery and if you can't pay you can be refused.

I am in the fortunate position that it is a small bill, but I feel for someone with a large bill and a small income.

[Sprogster]

NormanH has an extremely good point to make. Can you imagine if this happened in the UK, it would be national news and you could probably sue the lab senseless!

Contrary to the generalised perception of some posters, the French helath care system is not universally better than the NHS, as in both countries in varies considerably from region to region. As such it is just as possible to get poor or good treatment in France as in the UK.

The UK is generally accepted within the worldwide medical community as having amongst the best cancer specialists and related medical research in the world. There just needs to be more of them.

[Clair]

I am at a loss to see how an unpaid lab bill equates with poor health treatment [8-)]

[Russethouse]

Because turning down a request for analysis for something as serious as Cancer is simply not part of the NHS/British  mindset - my guess is they would do the test and get the money afterward.(if applicable) 

It's a cultural thing

[Cat]

I agree.  It's yet another example of an administrative cock-up.  Experience tells me that these kind of a-rule-is-a-rule-is-a-rule-and-no-one-has-told-me-otherwise-no-exceptions interpretations are far more likely to occur in France than the UK. 

[Iceni]

[quote user="Clair"]I am at a loss to see how an unpaid lab bill equates with poor health treatment [8-)]
[/quote]

This seems far too business-like to be France. I see nothing wrong with failing to do more work when a debt is unpaid - when you have a lever, use it.

John

[Ron Avery]

[quote user="Sprogster"]

NormanH has an extremely good point to make. Can you imagine if this happened in the UK, it would be national news and you could probably sue the lab senseless!

[/quote]

I don't think he has any point to make considering he lives in France and has been treated no differently to any other person who lives here.  To talk about suing on the basis of a letter the OP clearly hasn't understood is utter nonsense.

The first time I had an X ray despite taking CV and attestation I was asked to pay 43€ and I got that back from CPAM and mutuelle, next time I had an X ray at the same place I took the mutuelle as well and paid nothing. With my Kine I pay and get it back from CPAM, there is no hard and fast rule for this, we don't live in the UK so please stop comparing the French system to the NHS.

[Quillan]

Although I too have 100% cover for my heart I have to pay the lab bills and claim them back by sending the form. My wife also has a problem that requires regular blood tests and its the same for her.

I am under the impression that if you have 100% cover for long term illness it's different than the 100% cover you get for being poor. I say this because I know a person who gets 100% cover for this reason and they never pay 'up front' as I have witnessed more than once.

Normally the lab gives us the results but not the claim form (the form they give you to send to CPAM for your reimbursement) until we have paid, this is normally because I forget my cheque book and they don't take plastic.

[NormanH]

[quote user="Ron Avery"][quote user="Sprogster"]

NormanH has an extremely good point to make. Can you imagine if this happened in the UK, it would be national news and you could probably sue the lab senseless!

[/quote]

  To talk about suing on the basis of a letter the OP clearly hasn't understood is utter nonsense.

[/quote]

I am not sure what I haven't understood. Would you be so kind as to enlighten me?

By the way I never mentioned 'sueing'

I simply tried to bring to peoples' attention that things that are automatically free under the NHS aren't necessarily here.

[NormanH]

[quote user="Clair"]I am at a loss to see how an unpaid lab bill equates with poor health treatment [8-)]

[/quote]

I believe that you are French, so don't have the British 'gut instinct' that says when it is something like a test for cancer, money doesn't come into the equation.

For most Brits 'good health treatment'  is synonymous with it being accessible for everybody, not just about the quality of the Doctor (which incidentally I find much better in the UK than in France, if you manage to get an appointment!)

In some ways France is more American, and more commercial than the UK

[Maricopa]

[quote user="NormanH"]What I would like to do is make a lot of fuss about it. Has anyone any good ideas about who I can approach for maximum publicity?
[/quote]

[quote user="NormanH"]I am not sure what I haven't understood. Would you be so kind as to enlighten me?

I simply tried to bring to peoples' attention that things that are automatically free under the NHS aren't necessarily here.[/quote]

[8-)]

[Clair]

[quote user="NormanH"]I believe that you are French, so don't have the British 'gut instinct' that says when it is something like a test for cancer, money doesn't come into the equation.[/quote]

What a load of tosh!

Next you'll be teaching me humanity..[:-))][:D]

[Chancer]

Norman

I beleive that you have been here a reasonably long time from some of your postings and your command of the language, I also appreciate that this must be a worrying time at the moment but does it really acheive anything to be comparing completely differnt health systems?

I am sure that even people like myself who did little or no research compared to most and moved countries on gut instinct would not be naive enough to expect the health systems to be the same, so why try to warn people that "British gut instict" does not apply in France?

FWIW I think it is a reasonable assumption (and I apologise if I am wrong) that the testing clinic/laboratory is a private enterprise and therfore money does come into the equation.

[Ron Avery]

"NormanH has an extremely good point to make. Can you imagine if this happened in the UK, it would be national news and you could probably sue the lab senseless!"

Another one who does not understand how the health service works in France, and/or the variations in whether you pay up front or not,  but at least he/she does not  live here[blink].

 I believe that you can get your prescriptions made up at the chemist free of charge in France if you have a carte vitale and a mutuelle, how marvellous,[:D] In the UK you have to pay £7.10 for each item, and if you don't have the money with you they won't give them to you,  what a disgrace[:P].

[NormanH]

[quote user="Ron Avery"]

"NormanH has an extremely good point to make. Can you imagine if this happened in the UK, it would be national news and you could probably sue the lab senseless!"

Another one who does not understand how the health service works in France, and/or the variations in whether you pay up front or not,  but at least he/she does not  live here[blink].

 I believe that you can get your prescriptions made up at the chemist free of charge in France if you have a carte vitale and a mutuelle, how marvellous,[:D] In the UK you have to pay £7.10 for each item, and if you don't have the money with you they won't give them to you,  what a disgrace[:P].

[/quote]

But of course I pay for the Mutuelle, which I wouldn't have to in the UK, and I also pay 8% of my pension for the côtisations toward the Carte Vitale, which a British pensioner wouldn't pay...

And that is whether or not I am ill.

I also believe that people on a low income don't pay prescription charges in the UK.

So why is that amusing?

[Ron Avery]

Norman H said "But of course I pay for the Mutuelle, which I wouldn't have to in the UK, and I also pay 8% of my pension for the côtisations toward the Carte Vitale, which a British pensioner wouldn't pay."

 But you are not a British pensioner are you?  If you were,  you would have an E121 and would not be in the CMU would you??? 

[Quillan]

Perhaps I am being rather thick here but I don't understand what Norman is going on about.

He must be under 65 else, as Ron said, he would have an E121 and would not be paying his 8%. He gets 100% cover for his treatment and blood test  because of his illness. All that seems to have happened is that he has not paid for the last test and therefore does not have any paperwork to enable him to claim any money back, normal proccedure by the way, and now they want their money he is having a whinge. If he had paid he would have got his form, sent it off to his local CPAM office and the money would be back in his bank account within 4 weeks max. So what is the problem, it's the French system and that's how it works. To be honest he should be grateful he only has to pay 8% to stay in the French health system when many of us who work for a living pay a far higher amount.

To be honest (and I don't mean to be rude)  if Norman is comparing France to the UK and thinks the UK health system is better then I know what I would do if I were him, go back. Mind you our lab gives the results in 5 or 6 hours (blood test at 09:00, results can be collected at 14:00, every time without fail) , 100 times faster than anything I have personally experienced in the UK.

[Russethouse]

 Q, I think you may find that Norman has been in France for many years and paid into the French system, what he is highlighting is a difference in mindset, and I suspect that is valid, as rightly or wrongly many Brits would be horrified to be presented with this situation.

[mint]

I lived in the UK for nigh on 40 years and I worked in the NHS for some 22 years.  But, I had lived in other parts of the world where you die if you can't pay.

UK NHS is wonderful (not for some people who work within it, however) and you are just grateful that it is so.  However, if you choose to make your life elsewhere, why expect it to be the same as in the UK?

You pays your money and you takes your choice.  Mind you, I am not sure how long the dear old NHS can keep going the way it has done.  When the day comes when we have to lay it to rest, I shall be the first to say RIP NHS.  You were wonderful whilst you lived!

[cassis]

[quote user="Quillan"]

Perhaps I am being rather thick here but I don't understand what Norman is going on about.

If he had paid he would have got his form, sent it off to his local CPAM office and the money would be back in his bank account within 4 weeks max. So what is the problem, it's the French system and that's how it works. To be honest he should be grateful he only has to pay 8% to stay in the French health system when many of us who work for a living pay a far higher amount.

[/quote]

Whatever the reason, you missed what Norman is going on about:

[quote user=" Norman"]I didn't choose this lab, the sample was sent by my Cancer specialist,

and I have never had any direct contact with them so it is not as if I

had contracted anything with them[/quote]

Froggy administrative c o c k-u p, nothing to do with Norman prima facie.  Or are people expected to pay for bills they don't know anything about?  If I'd received that letter I'd be pretty p i s s e d off by its snotty tone.

[Sprogster]

You don't delay something as serious as a biopsy or blood test for cancer, when the costs involved are minimal but a matter a few  days can make a critical difference, due to potential degradation of the sample and patient outcome.

The danger in this type of situation is that the patient presumes everything is OK if they don't hear anything further, when in fact the test has not been processed and therefore the disease progresses beyond the curative stage, before they find out.

Even in America, the land of private medicine, this sort of delay would be unlikely because the lab would be concerned about being sued for delaying diagnosis.

If there is a lesson to be learned, it is wherever you are be it the UK or France you need to be pro-active in following up medical test results and don't assume no news is good news.