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Got to do a paper on the US healthcare


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and I want to compare it to the French system. I know the French system is said to be number 1 in the world (the US is down at 37 I believe), but I've not had a great deal of experience with it. I was wondering how those who have had experience found it and what pros and cons were discovered. I'm really talking about the system rather than expertise, as I dare say both would be on a par with one another in terms of that.

So when you get referrals to specialists, is the waiting time quick or slow (ie greater than 2 weeks would be considered slow here)?

Choice of doctor.

Price of prescriptions.

Cost.

Also, do you think it is right that people can come into France and get healthcare right away without putting anything into the system first?

Thankfully, my wife is a manager at a gynecologist clinic, and is able to tell me the cons of the US system. My paper is an argumentative paper about how the healthcare system needs to change in the US. Thankfully, I don't have to come up with a solution; that would be just too hard. 

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[quote user="You can call me Betty"][quote user="Mr Ceour de Lion II"]

Also, do you think it is right that people can come into France and get healthcare right away without putting anything into the system first?

[/quote]

Can they? [8-)]
[/quote]

It's what happens when you move to the US, you start to believe their propaganda.

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Sorry Richard but it is too huge for me to be able to answer.

Each of your questions depends on circumstances.

Cost of prescriptions, waiting time to see a specialist etc ...you cant have a standard answer.

So when you get referrals to specialists, is the waiting time quick or

slow (ie greater than 2 weeks would be considered slow here)? Can be from almost immediate to 3 months. Ophthalmologists are notoriously difficult to get an appointment with but there is always the option of going to the Urgences

Choice of doctor. You are free to choose any Doctor as your Médecin Traitant, but must be referred by that Doctor to specialists if you wish to be reimbursed. You could choose any specialist for your self however if you are prepared to pay

Price of prescriptions. These are set by a Government body and are reimbursed to different degrees according to the colour of the vignette

Cost. For the very poor it is free and for the  chronically ill there is treatment 100% reimbursed but with some 'forfaits' to pay

Most people have to take out an insurance for the 35% of the cost that they would have to find, and to give certain additional comforts such as a private room if in Hospital

Also,

do you think it is right that people can come into France and get

healthcare right away without putting anything into the system first? You have to work a minimum number of hours or be covered by an S1 form

In addition I suggest you research very seriously the validity of the out- of date survey which places France first on a very dubious set of criteria...

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[quote user="Quillan"]

[quote user="You can call me Betty"][quote user="Mr Ceour de Lion II"]

Also, do you think it is right that people can come into France and get healthcare right away without putting anything into the system first?

[/quote]

Can they? [8-)]

[/quote]

It's what happens when you move to the US, you start to believe their propaganda.

[/quote]

I moved from Australia to France and got straight into the system without putting a penny in (back  in 2005). Maybe it's changed now. We were really surprised at the time.

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I manage an NHS medical centre and would be happy to help. As mentioned earlier, it depends on the criteria but safe to say (based on World Health Organisation stats) that in terms of the relationship of $/£/€ to relevant rates of 'return on investment', the US performs poorly.

In large part, this is due to the litigious environment, so clinicians over-test; over-refer etc, to tick the boxes and play safe. It's not a judgement, rather a reflection of the circumstances.

Add to that the fact that huge amounts of pension funds are invested in healthcare insurance stocks, there's no incentive to alter the status quo.
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Thanks for the replies. I did respond yesterday, but it looks like the forum didn't save it. I was having trouble logging on, so perhaps that was it.

I thought the state covered 85% of the cost, and top up insurance 15%, so that's very interesting to learn it's 65-35. As I never used the system, I didn't look into it a great deal when I arrived. I can't even remember where I go the 15% from.

The essay is just 1000 words, so I won't be going into drastic detail with it, just need three major points to draw out for my argument (still not 100% sure what that will be yet). As for the data showing France on top, for this assignment, it will be sufficient, just to draw a contrast.

And Chris, I understand what you mean regarding the over testing, my wife has to have some tests, and they are really playing safe. They're 99% sure what the problem is, yet they're still going through all the hurdles to eliminate for sure other possibilities. Funny thing, they said they are really busy and there's a huge backlog, so they won't be able to do the testing for another 7 days lol. I was expecting them to say a couple of months at least!

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RCL I don't understand how you were just accepted into the system in France, just like that. That is not the way it usually works, if you did, well, well done you.

As NH said, it is very complicated, not a simple 85%, so many variables, plus some things aren't covered and once you get specialists then some charge over and above the amounts stated as acceptable by the government, but with the right contract the mutualists will help towards these extra charges, some or all of it.

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Probably in the States it is the same as in France and the UK (as I have learnt from others) in that the quality and speed of care varies terribly depending on where you live. I have for instance had  two scans in France, one I waited two days and the other done immediately. I can walk in off the street and get dental treatment in France but in the UK I would wait months. In the UK I can get an opticians appointment in a couple of days, here I can wait for six months or longer. Excluding weekends I can get to see a specialist in a couple of days, sometimes within 24 hours but others in different areas of France seem to have to wait longer. For me the service and quality of care is far superior to that I have received in the UK yet others will say the opposite.

Just for your info nine out of the top ten hospitals in the world are American, the seventh is French.

47% of the top 100 hospitals in the world are American, 2% are French as are UK hospitals. As a point of interest for you due to your country of birth Australia has one, The Royal Children's Hospital in Melbourne which is rated 81st.

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Interesting to note there Quillan regarding the hospitals. Where did you get that source of info?

I'm actually English by birth, but arrived in France after spending 7 years in Australia.

I have no idea how we managed to get into the system without being asked for anything, it was a while back and very much a blur. Maybe we were an awkward case, I really don't know. It surprised me anyway. However, when I emigrated to Australia, I didn't have to pay into their system either.

I'm getting a lot from posting this thread, it's not going to be as easy to prepare this assignment as I first thought.

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[quote user="Mr Ceour de Lion II"]Also, do you think it is right that people can come into France and get healthcare right away without putting anything into the system first?

[/quote]

It used to be but no longer for early retirees - causing us to change our plans and have a house in the UK and comply with the requirements of keeping our UK residency.

Paul

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Did you have dual nationality by chance. If you did then about that time (2005) you probably would have got in with no problem, it will be totally different now.

My source by the way is a database available to people working in the medical litigation business, for a price of course, it is updated several times a year and is a commercial product. Fortunatly due to Mrs 'Q' being "in the trade" I can get access to it from time to time.

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This is strictly opinion but it seems to me that in the US ( many of my friends are American) the tests start from the top, rule out the worst case scenario then work down, which is expensive for everyone and possibly means a lot of people simply cannot afford healthcare or go for a plan that doesn't really suit their needs.

On the other hand it diagnosis life threatening conditions quicker....
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[quote user="Quillan"]

Did you have dual nationality by chance. If you did then about that time (2005) you probably would have got in with no problem, it will be totally different now.

My source by the way is a database available to people working in the medical litigation business, for a price of course, it is updated several times a year and is a commercial product. Fortunatly due to Mrs 'Q' being "in the trade" I can get access to it from time to time.

[/quote]

Yep, I have British and Australian dual nationality (may have tri nationality one day if I add US citizenship too). That may explain it then. I never got my head around the health system over there, mainly as I never needed to use it.

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RCL were you working in France, if so, then your cotisations would be paying towards your health care.

I cannot ever remember anyone just walzing in and getting it and french people couldn't 'just get it' .........not that long ago.

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[quote user="Mr Ceour de Lion II"]

Yep, I have British and Australian dual nationality (may have tri nationality one day if I add US citizenship too). That may explain it then. I never got my head around the health system over there, mainly as I never needed to use it.
[/quote]

You need to read up on that one. It seems quite rare to get a US passport (which by definition means you become a US citizen) if you also have citizenship elsewhere. I am no expert on this but you really need to read up on this.

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I read up on it a couple of years ago. It's a bit weird. If you're already a US citizen, it seems you can lose your citizenship if you become one elsewhere. If you become one after already being a citizen, then although they technically don't recognize dual citizenship, it's not under their jurisdiction to remove your other citizenship. That's up to your previous country.

So basically, if I become a US citizen, under their definition, I am a US citizen only. But in reality, I would still be English too, and allowed to keep my UK citizenship. It's the other way round it becomes more of an issue.

At present, that's a long way off, and I haven't even put my application in to stay permanently yet.

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