Health Care reforms!

[S&S]

I was disgusted to read in this month's FPN, bottom right of page 10, comments by one Duncan Campbell, Associate Director of Siddalls, about the reforms not affecting most British residents in France.  What about those who have been paying into the CMU and are now being kicked out, is this not a change to previous practice??  Those who have been paying into CMU and have pre-existing conditions who will not be covered by Private Health Insurance companies, if indeed they can even get cover??  Do they not count? 

[8-)]

 

[cooperlola]

This is not the first person who has - how can I put it - "an interest" in not putting people off the idea of moving to France, who has been a little careless with the truth. I suppose that he is technically correct in that the majority of UK nationals here are either on E forms or are working but I agree with your sentiments, S&S, there appears to be a huge number of people who will be affected and it's misleading to suggest this.  I feel a letter to the editor coming on......

[Tony F Dordogne]

Though of course it's also in Archant's best, i.e. commercial, interests to keep the story alive about any forthcoming changes being effectively ineffective.

Like all the adverts they continue to print for people who work in France without being properly registered here.

[Deimos]

To be honest, it is difficult to know if he is

right or wrong and the extent. There are people who will be better

off under the new scheme (myself for example). How many will benefit

and how any lose and to what extent depends on the statistical nature

of those moving here.

Of course there are those with chronic conditions

and with conditions that will affect their insurance cover and those

really do need to be sorted. However, those are probably the

minority and I would suspect that the majority in the "inactif"

are probably healthy and will not have a big problem getting private

health insurance - but I have no evidence for that, just "I

suspect".

Where the numbers lie is difficult as we are

almost certainly getting a biased view here. Many not affected (or

better off) with these changes will probably not be posting. It

might just be that this guy has a better appreciation of the

situations of a larger and more "cross-sectional" sample of

those moving to France. Maybe not.

Please do not interpret my comments as suggesting

that it is not worth fighting these changes. Despite being better of

under the new regime, I am strongly against the changes. Apart from

those who lose cover for existing conditions, I think that private

insurance is not the way any society should be going. We should be

able to threat those members of our society who become ill and it

should not be a subject to private business profit considerations and

the needs of shareholder dividends.

Ian

[cooperlola]

Ian, I think your analysis is probably correct, as said above - I would imagine the majority of Britons here will hardly notice the change, and the wealthier, healthy ones will probably save a few euros.  But, yes, the problem with this is that the poor or the ill are being hit the hardest, and their futures are in the hands of profit-making bodies - morally, if for no other reason - the legislation therefore STINKS!

[rothrugby]

Having read the last two messages- how can anyone be better off paying for 100% cover than paying for a complementaire?  I've yet to see any insurance quote which is less than what we currently pay, for the same level of cover. And yes, I'm one of the unlucky ones. Came over 4.5 years ago with no problems, now got cancer.  I'm not alone!!!

[Maricopa]

Unfortunately rothrugby, there ARE wealthy people who retire to france to whom 8% represents considerably more than the cost of private medical cover.  If only we were all in that position!  The rest of us have much less choice, particularly those who are in the postion, like yourself, for whom private medical insurance will be difficult, if not impssible to obtain, and if you could, would probably NOT be able to afford it.  As I am able to work, that is my way out, though the house renovations will have to go on the back burner, but for those like yourself, FIGHT is the way ahead, and why it is imperative that EVERYONE does their bit[:@]

[cooperlola]

Yes, Maricopa, that was my point.  Those on high incomes (60,000 euros or so) are probably not going to notice a big difference between the cost of private healthcare - 8% of that sort of income, plus the cost of top-up, probably reflects the average cost of full cover for a couple in their late 50's, early 60's.  Ergo only middle and low income earners, plus more importantly, the sick, are really affected by the reforms.  What do I call that? -  discrimination against the ill and the less well off.[:@]

On the campaigning subject - I did a round robin e-mail to everybody in my address book yesterday - so far 8 people whom I know have signed the petition in less than 12 hours.  Think about it guys and gals and get e-mailing!

http://petitions.pm.gov.uk/healthinFrance/

[Tony F Dordogne]

As I said, I think in private, to somebody a couple of weeks ago, what we're talking about here is a few thousand Brits - white, middle class, early retired and comparatively well-off, especially by French rural standards - and within the few thousand, an even smaller number that have developed a maladie longue duree.

The real problem here is who's going to stick their necks out for those/us people?  Whilst everybody will sympathise with rothrugby and people in his position, the French have effectively covered their backs by including their own national inactifs in this as well so they will be treated in exactly the same way.

I think it's a battle worth fighting.  It doesn't effect me at all, I came here with an E121 because of my health so all I can do is support the campaign and make sure that people in the same position as me get everything that they're entitled to, hence my interest in the DLA stuff.

Taking apart each communication, right, wrong or mistaken, with the various CPAM offices isn't getting us anywhere.  We need to wait until CPAM central sends the definitive document out to their local offices so we have a clear target and then have one or two people who will get the information, work their way through it and post definitive statements, not the current this/that office says this/that stuff.

I'm really going to stick my neck out here.  I don't think the French government will change their mind and despite the 5 year rule (as far as I can see, that's the only way to remain here on the current system and then the Government has to agree it) the French government will, I think, stick with their policy.  Sarkosy CANNOT, from a political point of view, be seen to cave in to a load of  well off (French or other EU citizens) who can leave work early, pay 8% contributions and remain with their health cover.  If he does this to the French inactifs, he must do it to all other nationalities as well and I think that he will keep going.

We must start working with the French inactifs on this - being seen to be whinging Brits just isn't enough.  Why should the French or Brits support us, financially or politically, with our early retirement, aspirational life styles if we stay in our English communities?  If the French inactifs, trade unions, associations demonstrate in Paris, Marseilles or Lyon, we need to be seen to be with them and we need to find the other nationalities that may be effected by this and get them involved.  All we're doing at the moment is campaigning as a small, sectional, partisan and nationalistic interest group and we are in danger of re-inforcing stereotypes.

So, what's plan B?  I know people are trying to get quotes from assurance companies etc., but as a campaign we need to know what our fall back is - we must have a plan in case this doesn't get changed.

 

Edit:  Sorry, my trade union, campaigning in local and central government agitation experience has started to surface again!!!!

[cooperlola]

It is interesting this, because I'm currently composing a letter to my leftie MEPs in the area on just this theme, because they are still proving reluctant to back Mary Honeyball's declaration.  As I see it, this is all part of the same fight, because this is an attack (albeit a minor "tip of the iceberg" part of it - I still see no evidence that French inactifs are to be barred from the CMU - although the problem is that in fact a relatively small number of them uses it as they are mainly affiliated to state healthcare through employment schemes) on state healthcare, per se.  I suspect that the president would like to see all healthcare in private hands, much like the new Dutch system.

In fact, the campaign has just seen its first communication from Dutch nationals here who have received their CMU ejection letters, who have pointed out to their CPAMs that the social security website said that the reforms apply only to "Britanniques" so isn't aimed at them!

I do think we need to plug away at opposition French MPs and point out the similarities between our position and theirs, and how the two are related.  We shall see...

[Deimos]

[quote user="rothrugby"]... how can anyone be better off paying for 100% cover than paying for a complementaire?  I've yet to see any insurance quote which is less than what we currently pay, for the same level of cover.[/quote]

It depends a lot of your circumstances.  For example, in your own case you say "we" - which means your private insurance premiums will be twice what you (or your OH) would pay alone (so think of the impact for a single person).  Although my CPAM cover does not expire until Jan 2008, I got a quote to just check what I would have to pay and despite being on a relatively low income (from savings interest), by the time you take out the top-up costs I am just better off - and my income is no where near the €60000 mentioned (absolutely no where near).

Not for me but some hypothetical numbers:

Private insurance (actually what I was quoted) €2200 per year

Less €720 you would have paid in top-up gives net cost of private insurance of €1480

With CMU at 8%, then the break even point is an income of €21800 (remembering the 7000€ threshold)

Thus, anybody with an income of €21800 will be better off.

(Might be errors and variances in the above but hopefully not massive ones)

However some people will not be "a person" but two people - which shifts things.  Some people might pay more (or less) top-up (don't know as I have not yet "got round" to sorting one out - I've only lived here 4 years).  However a couple will probably have a higher income so 8% represents a higher amount as well.

Actually this "asset rich, income poor" category does not really exist.  If you have assets they generally generate income (unless you are a bit daft when it comes to financial matters).  You may chose to re-invest that income or you may have the assets "tied-up" and acquiring value.  Either way, when you take the money you will pay 8% to the CMU.  Maybe a few lean years whilst the assets gain in value but cash then in and the CMU does well that year.  Even a simplistic  sell-up for £300 000 and move to your holiday home in France gives you an income of €27000 per year in a regular bank deposit.

Thus, my theory is that quite a few individuals will be better off under the new regime.  But there are loads of issues raised by these changes that will affect a lot of people badly, even in only in indirect ways.  As Tony and others say, this is an injustice to theose with pre-existing conditions and chronic illnesses so we all need to "stick out necks out".  I personally do not want a private company whose only interest is making a profit deciding what treatments I can and cannot have - when every cent they spend on me is a cent less profit for them.

Also, this issue has raised issues relating to the French governments attitude to British residents.  The fact that they think they can ignore obligatory EU legislation (5 year thing) when it suits them needs to be "corrected".  The fact that somebody is using the issue for political gain needs to be "corrected".  Personally I think there are French politicians spreading the "why should the Brits get health care without contributing" thing.  There are too many people and MEPs thinking this way for it to be a mis-understanding.

I definately think it is a battle worth fighting and one that we should fight for moral reasons.  Society really should be able to care for those who have the misfortune to fall ill.

Ian

[sunshine 2]

Sorry Deimos but your figures don't make any sense to me. Although the small print will vary,  insurance companies in general are not going to pay 70 % towards the cost of GP visits, and the cost of  regular medications etc  The cost of some regularly prescribed medications for hight blood pressure, high colesterol etc are very high indeed - so you total bill for health care when out of CMU will be cost of private health insurance plus cost of GP visits and regular medications.

[Deimos]

[quote user="sunshine 2"]Sorry Deimos but your figures don't make any sense to me. Although the small print will vary,  insurance companies in general are not going to pay 70 % towards the cost of GP visits, and the cost of  regular medications etc  The cost of some regularly prescribed medications for hight blood pressure, high colesterol etc are very high indeed - so you total bill for health care when out of CMU will be cost of private health insurance plus cost of GP visits and regular medications.[/quote]

In my example I am in good health.  I see my GP once a year for a required medical (which is a joke) and I have never got anything back for that anyway (he has no machine so for 70% of €21 I just bin the brown form).

If you have a chronic illness that will sway the balance.  Remember I was not saying everybody will be better off, just that a number of people will be (I doubt anybody knows how many).  Many people are probably not on regular medications (remembering we are talking about the pre retirement age group).  It would not surprise me at all if people with existing conditions would be financially worse of.  I was talking about those without the pre-existing conditions (which I suspect will be a significant group).

Pretty well everybody I know in my age group would be in a similar situation (i.e. healthy, no ongoing problems, etc.) - but then they are not affected by this anyway as they are French.

The main point is not the numbers, though they illustrate the principle and are not 100 miles out, but that the "better off" group do not need to be on massive incomes as people have supposed so far.  You can be on a quite modest income and still be better off with these changes.  I think this is probably where the original Sidall's comment may have come from and maybe why there are not more people objecting to the changes.

Ian

[rothrugby]

Thanks for the explanations- we don't have anywhere near the level of income you quoted ie 21800euros and as you pointed out there are two of us. We're neither asset rich nor cash rich , just a pair of ordinary people trying to get by!

The quote you got seems very low compared to others we've seen- where did this come from? I'm sure others would be interested if this level of quote is realistic. We've seen quotes for way above this with lots of exclusions, as mentioned by Sunshine. Furthermore, we've seen small print that excludes payment for conditions that an insurer deemed were present although not diagnosed at the time the policy was taken out- hence excluded. We've also seen exclusions for illnesses if they require more than one treatment  i.e follow up cancer treatment as this will then be defined as chronic- another exclusion.

We take your point regarding costs. However, complementaires are not allowed to exclude anything- you can make  a choice to exclude doctors appointements, dental, etc. Private insurance seems to thrive on exclusions. We have made a list of what I would be covered for and so far it includes my feet, my head but nothing in between!!

 

 

 

[cooperlola]

Here is one of the few policies which I have found which covers routine treatments (but only if you develop symptoms after you've taken the policy out!)

http://www.exclusivehealthcare.com/File/client/Plan%20Platine%202007.pdf

The cost of this for the 2 of us is about 4,400 euros (one early, one late 50's) going up another 750 euros next year when my o/h reaches the magic age of 60.  But note, there is an excess of 120 euros per claim - so that knocks out most "routine" doctor and dentists visits - currently the only things we ever use ours for! Our top-up for the two of us is about 1,200 euros a year.  Ergo, we'd have had to be paying 3,200 (3,950 next year) euros to the CPAM currently for full private healthcare to be cheaper.  We have found a cheaper policy, with the kinds of premiums Deimos quotes, but they cover hospital care only.  I reckon (with my pea arithmetic brain!) that that means only those couples earning over 47k or so would be better off - and then they'd have excess to pay, and any drugs and treatments for pre-existing conditions.

The new ruling clearly states "full" private cover - so those are the sort of payments the law is obliging us to make.

[Poppy]

The problem is the problems with private health insurance. Firstly the insurers attitude and having to get clearance to be ill. I remember hours on the telephone trying to establish whether I would get reimbursed if I went to the Doctor. Secondly the French health sytems attitude. Once when I was admitted to hospital I had to wait 3hrs in reception while they checked with the Insurance Company that they would get paid. Also in an emergency situation husband collapsed and was near to death but they wouldn't put him in the ambulance until I went home for the insurance policy. Whatever you do keep your policy with you at all times.

Also we will pay private health charges but in my opinion will not receive private health treatment. Those well off enough not to worry about paying for health insurance will find it very different in reality to popping into the Nuffield in the UK.

[cooperlola]

Once again, Poppy, the reinforces the point that it's not just about money!

[Tony F Dordogne]

Sorry but I think that we're missing the point here about the French government.  The French government CAN ignore the 5 year rule, the UK ignore Euro law when it suits them as does every other government in Europe.  Spain and Greece patently do so and NOTHING has been done legally to challenge them at the highest levels in Europe.

We can try to make the moral case here and raise the subject of inequality before the law.  But to do so, it may take several years for the case to reach the European Court of Human Rights, it will cost a large amount of money to get there and the result may not be a fore gone conclusion.  And if we have the sort of money available to fight this case, we've certainly got the lesser amount of money available to pay for health care, no matter what the cost.

We seem to be getting two things muddled here.  Firstly, there is the moral high ground, the 'we demand to be treated equally under European law' argument which will be costly to get a final decision on.  Secondly, in the meantime, many of the people affected by these changes will no longer be living in France.  They will have moved on because they can't afford health care here and therefore the campaign will have a dwindling membership and in the end will fizzle out.

We need quick wins, we need to get to the politicians that matter - the French - and get working with the French affected by this.  UK MEPs really have little influence, after all, many of us chose not to live in their constituencies any more and remember we DO have a vote in French Euro elections.

[ams]

If you want to take a case against the French government, the EU will fully fund the  cost. May I suggest that you get in touch with Kathy Sinnott MEP. I talked to her a while back and she was prepared to back myself and my wife in a petition to the EU authorities. I have also been in touch with the legal representative for the EU in Paris who is also prepared to cover the full cost of a challence to the EU against France. I have not gone ahead with either avenues as I feel we may not be the most appropiate people to front such a challenge.

 

http://[email protected]

 

telephone number 00353 21 488 8793

 

ams

[Deimos]

[quote user="Tony F Dordogne"]

Sorry but I think that we're missing the point here about the French government.  The French government CAN ignore the 5 year rule ...

[/quote]

I agree.  I was raising the "asset rich, income low" point as I think it is something that does not really exist and as such should not be used in any arguments about the changes (as it can be "shot down in flames" really easily - giving people to ignore other points raised in the same letter).

I raised the issue about many people being better off, in part because when I last voted on the No. Petition thing I was disappointed to see how few signatories there were.  Given how widely the message has been spread and given that many have probably voted multiple times (though could never admit it as it would invalidate the entire petition) I think quite a few have decided not to object to something they perceive makes them better off.  I personally think that it might save this group a few €s in the short term but the longer term consequences are a lot worse and they have not thought it through.

[quote user="cooperlola"]

The cost of this for the 2 of us is about 4,400 euros...

[/quote]

A completely separate debate but, two of you will statistically require twice the treatment and thus cost twice as much (and the Private Insurance companies will make twice the profit by denying to treat twice as many conditions.

In fact there are massive inequalities and discriminatory practices/rules in the current system (where it comes to marries/co-habiting/single people).  Whilst I think they really should be sorted, now is probably not the time as at least they are not stopping ill people getting treated and not messing up peoples' residence options.

[quote user="rothrugby"]

We're neither asset rich nor cash rich , just a pair of ordinary people trying to get by!

[/quote]

I suppose I'm thinking that there are quite a few "early retires" who sold-up expensive mortgage paid properties in the south east and now live of saving/interest tiding them over until their pensions arrive (and then boosting their pensions somewhat).  Not everybody but maybe quite a few.

[quote user="rothrugby"]

The quote you got seems very low compared to others we've seen- where did this come from?

[/quote]

It was an internet site but cannot remember the full company (as I did not progress things).  They would only quote for people taking out cover within one month so I lied about when I would need cover so their quote was useless to me.

[quote user="rothrugby"]

Furthermore, we've seen small print that excludes payment for conditions that an insurer deemed were present although not diagnosed at the time the policy was taken out- hence excluded. We've also seen exclusions for illnesses if they require more than one treatment  i.e follow up cancer treatment as this will then be defined as chronic- another exclusion.

[/quote]

I have heard that US Insurance companies are refusing to pay out on conditions/illness that has a genetic link.  They are saying (on occasions) that whilst the illness was pre-existing (i.e. genetic predisposition) and was just un-diagnosed - and thus not covered.  Most I looked at seem to only cover conditions where you get ill, get treated (in the relatively short term) and get better.  Anything else (even the really expensive ones) exclude pretty well everything else.  I think this is one area where the (maybe) selfish people thinking they are "better-off" will subsequently find themselves "worse off" when they try to claim for a serious condition.

[quote user="Tony F Dordogne"]

Sorry but I think that we're missing the point here about the French government.  The French government CAN ignore the 5 year rule ...

[/quote]

And I agree - having taken the thread on a bit of a tangent.  However, where people have energy to pursue lines they consider much be productive I say "go for it".  Maybe the EU law route would be slow but maybe the questions raised by some of the organisations people have contacted will all contribute to the pressure on the French authorities.

Ian

[ams]

You are very fortunate. My GP has no machine either, however we do take the time to complete the form (brown form), usually about 32 seconds and drop it into the CPAM letter box, and hey presto the 70% refund posps into our bank account 3 or 4 days later. Mind you I have not taken full cogniscance of the cost of the envelope, usually 1c.

 

I am in excellent health. However i do reuire medication every month which costs €57. other medication for the 2 of us comes to about €160 per annum.  Then we have the other costs such as the accident with burning stuff in the garden, the medication would have cost in excess of €600. Then one must add into the mix, the cost of out patient services for my wife as she has just reached 50 years.Mind you also in excellent Health. then the visits to the GP to get the prescription renewed. Oh I forgot, the eyecheck up for the two of us and the dental check up. I am sure i have forgotten many many other costs, but the above represent the bulk of what it costs us. By the way we pay our GP €22 per visit, i guess your yearly visit must be due soon.

 

ams

[Deimos]

[quote user="ams"]

By the way we pay our GP €22 per visit, i guess your yearly visit must be due soon.

[/quote]

Early Jan.  I'm trying to work out how to renew my sailing license (not possible until after 31/Dec), get the paperwork and visit the doctor for the medical all before 5/Jan (when my cover expires).  And if I work it out I will be taking the trouble to claim this year.  Its a daft medical.  Last years was just a chat and he tried to persuade me to have an operation !!  Basically, walk into his office (mostly) unaided and you get the certificate.

Ian

[Maricopa]

There are a wide variety of people who now choose to live in France, and hopefully I can use myself as an example.

[quote user="Deimos"]However a couple will probably have a higher income so 8% represents a higher amount as well.[/quote]

We only have a small military pension to live on  When we looked at moving to France, taking all the taxes into account, this worked out as about the minimum a couple could live on without worrying about how the next bill was going to be paid.  Obviously, as a couple, we get @double the allowance before 8%, but we would still have to have contributed.[:(]

[quote user="Deimos"]Actually this "asset rich, income poor" category does not really exist.  If you have assets they generally generate income (unless you are a bit daft when it comes to financial matters)..........   Even a simplistic  sell-up for £300 000 and move to your holiday home in France gives you an income of €27000 per year in a regular bank deposit.[/quote]

They are in existence.  If we are unique, in having the above income and owning outright our house and car, I would be most surprised.  I personally think I am lucky to be debt free at 43 (and own my own home).  However, unless I rent out a room in my small house, my assets are not actually going to make me any money, which I really don't want to do.[:(]

Post edited

[Deimos]

[quote user="Maricopa"]

The only bit of sense you talked in your post.[:)]

[/quote]

And I was trying to be so nice and not be nasty to anybody as well.  Maybe I should just pick every bit of your response and miss the point and pull it to bits (which would be very very easy as you have totally missed what I said by entirely focusing on your own situation).

When you talk about generalisations you have to make generalisations !!!  You really missed the point entirely - selfish attitude.  Anyway, I cannot be bothered to point out where you are wrong (and you are).  and then to turn round and say my generalisation is too simplistic - my god.

Ian (who is pretty pissed-off with such an attitude and is questioning why bother to help - after all I'll be financially better off under the new scheme; and no, I have not given away my income either).

[Russethouse]

The trouble is that unless you are prepared to disclose personal details (ie real figures) and situations, which would possibly be unwise, it leaves other posters to assume an awful lot - assuming is always dangerous and pretty much leads to the sort of conflict you two have created.

 Maricopa, I doubt if there are too many people as young as you in your position and I suspect Ians case isn't typical either - cases are individual so perhaps its better to keep to the principal and exchangeing information rather than making it too personal ?