What a French Doctor’s Office Taught Me About Health Care

Jan 02, 2019 · 673 comments
EWood (Atlanta)
Recently, I’ve had to make several appointments with specialists for my daughter for a relatively minor condition that won’t go away. Each time I call to make an appointment with a new provider, the first thing I’m asked — even before my and my daughter’s names — is what insurance do we have and all the group and ID information. Only the can we discuss appointments and why we will be there. I’ve had our insurance company reject numerous claims for services that are covered under our plan. I have to fight that battle to get reimbursement. Our health insurance system needs to be burned to the ground and rebuilt, correctly this time, as befits an advanced, industrialized country.
Paul (San Diego)
Mystery solved as to how Ms Rex obtained health services in the UK: https://www.npr.org/templates/story/story.php?storyId=123210644 Marrying a Brit to be able to avail yourself of the NHS, not having a full time job for 6 years, but then going for 'another' degree to improve your employment chances, strikes me as being a bit of a 'taker' Having paid into the NHS service myself for 40 years, then moving to the US and paying insurance premiums/deductibles/copays and now paying Medicare costs, Ms Rex's story makes me more than mad.......
B Scrivener (NYC)
Corporate medicine is killing America. Corporate medicine is killing America. Corporate medicine is killing America.
Frank Walker (18977)
Bloomberg recently ranked our US Lobbyocracy 54th out of 56 countries for healthcare efficiency and mediocre results. It's a wonder that our sick haven't rolled out the guillotines.
Hector (Bellflower)
We give free treatment to anybody here in LA County at hospitals like Harbor UCLA Medical Center--after a wait of six or eight hours. No ID needed. Illegals and indigents get it free, all of it, but you have to pay A LOT if you are working. I was ill in Venezuela once and the hospital ER treated me for free, did not even ask my last name.
Martha (Northfield, MA)
Tell it to the Yellow Vests.
george (Kalispell, MT)
The Frenchman was right: our values ARE screwed up. We spend hundreds of billions of dollars a year on the military/industrial/congressional complex, which hasn't won a war since 1945, yet "can't afford" national health care for all our citizens. And if the GOP had their way, they would destroy the social safety net we do have, passed by the Democrats---FDR, LBJ, Obama--- over fierce Republican opposition.
beebs (kona )
You are leeching off the taxes paid by French and British workers for their health care. Bad karma.
Jacqui (Taiwan)
The same can be said about Taiwan... Lol American healthcare system is so backwards!!!
Beyond Repair (Germany)
Medical refugees from the US are a burden on European tax payers. Someone should compile a statistics of the number of American HIV patients who have moved to Berlin in the past 15 years. And that is just one example. The European systems were designed to take care of their own. They cannot take care of all the sick and ailing from the Third World and the US. Those people should be sent back to where they came from. ESPECIALLY people coming from a wealthy country. Go and figure it out for yourself. You clearly have the resources. If your society and the parties you vote into power decide that low taxes for the rich are more important than health care for all then face the consequence. Dig your grave, if you have to. But don't be a burden on us tax payers here in Europe. We are already paying for the consequences of your disastrous foreign interventions in the Middle-East and beyond.
Steve (Seattle, WA)
For the most part, we have the AMA (doctors' union) and the ADA (dentists' union) to thank for our laughingstock of a healthcare system.
faivel1 (NY)
The very praised book on the subject... American Overdose: The Opioid Tragedy in Three Acts... Review "American Overdose confirms Chris McGreal's stature as one of the truly essential reporters of our times. It is - in its investigative depth and documentary breadth - a riveting and urgent reckoning of colossal corruption that has taken such a staggering toll on twenty-first century American life." ―Philip Gourevitch, author of We Wish To Inform You That Tomorrow We Will Be Killed With Our Families "In this gripping account, McGreal exposes the avarice and corruption that caused one of the most shocking crises in American history. A searing expose full of extraordinary characters - heroes, villains and victims."―Katty Kay, contributor MSNBC Morning Joe, presenter BBC World News America "McGreal shows how the overdose crisis was driven by the pursuit of profits, not just drugs-both of which combine our instinctive craving for pleasure with our evolving capacity for denial and deceit. Fascinating, disturbing, impressively researched and elegantly written."―Marc Lewis, author of The Biology of Desire: Why Addiction is Not a Disease
David Michael (Eugene, OR)
I recently stated that the American health system is broken at all levels. Indeed, if you read the comments with this article, even the doctors agree. In my case, I have a daughter and step son who are successful physicians. Only this past summer, my daughter, who works for Kaiser, was ready to pitch the whole thing because the work hours were horrendous. What we don't see are the hours after the regular day that require hours and hours of computer time for most physicians. Start the day at eight in the morning and arrive at home by ten pm. With two young daughters in school, she finally made a change to half time. Now she can work and put in seven hours a day and get paid for four hours. On all levels, this American system is broken...from Health Care to the United States Congress and Senate. If you decide to vote another Republican to office, you deserve what you get, but the rest of us don't. The military sucks up our money for useless wars, the Congress has become corrupted by money from billionaires, and the people languish in our so-called democracy as the homeless population multiplies with each year. We need drastic changes in this country or there will be anarchy in the streets, thanks to the idiocy of people like Trump and McConnell.
Josh Bing (Iowa)
Twenty somethings best move would be to move to Canada and become a citizen while studying something. You can always vacation in Florida or Arizona and you would not have the anxiety of the 'American Health Care Non-System' sword dangling over your head for the rest of your life.
mjb (toronto, canada)
Americans deserve universal health care and they deserve to be taxed appropriately to pay for it. We supplement our universal health care in Canada with private plans (for those of us working) to take care of things that aren't covered such as eye care, prescription drugs, etc. It's worth it. And it doesn't bother most of us one bit if our tax money is also supporting the healthcare of our fellow citizens. Look at it as a privilege to be helping children, elderly and infirm vs. a burden.
Stephanie (Southern California)
Every time I read one of these articles about the excellent, inexpensive, relatively stress-free healthcare in other countries, I get so upset. Why can't we have such a system here? I know the answer, but it only infuriates me more. I can't afford the healthcare I will need if I keep reading these articles!
Renee Holt (Seattle)
As long as we allow large donations in our politics, the system will not change, because powerful corporations or wealthy libertarians can force their view on us all by buying politicians. Think of how much more creative and kind we could be as a nation if we had REAL social services and health care coverage!
Grevillea (Antipodes)
So happy for writer that she has been able to unload her health needs onto French and British citizens. They call that "systeme D" in France and she seems to be great at working it. As other writers have pointed out, her story is not consistent with British or French law, and one wonders whether her claim of paying taxes is equally plausible. Getting more from the state than one pays in is always a heady sensation, and I hope France doesn't disappoint her as it faces a deadline of 2024 to pay a E 120 BILLION "social debts" bill coming due.
Ivan (Jersey City)
I was working as a postwar relief worker in Banja Luka, Bosnia, in 1999 while the U.S. was bombing neighboring Serbia. Banja Luka is a predominantly Serb town, and public opinion at the time was highly anti-American. So when I sprained my ankle pretty seriously, I was a little worried about going to the hospital to get treated: what would be their reaction not just to any foreigner, but to an American seeking help at the same time one could literally hear U.S. warplanes flying overhead? The answer, it turns out, is with complete professionalism and kindness. I was x-rayed, diagnosed, and put in a cast and crutches in less than an hour, and for the grand total of $15. This article is a reminder of how broken our values and health care system are. It’s shameful to think of how we treat foreigners in our midst today (not to mention our fellow Americans).
Mike (Milwaukee)
For 10 years I cared for my wife who had a debilitating and costly illness. I could not work and we lost everything. We spent 10 years relying on family and public assistance which was mostly just ok health care. And I was grateful for the ACA b/c without we we were dead. Now she is no longer here and I am trying to put back the pieces of my life while being emotionally, psychologically and physically broken. My income went from zero to about 30k. A whole 30k and all I can get from the marketplace is an average premium of $600/mo and $7000 deductible. Basically all my income goes to rent and healthcare, while trying to pay off our debts. Shame on Trump, shame on Republicans, shame on anyone who thinks this is ok in the most wealthy and "advanced" nation in the history of forever.
ANUBIS (los angeles)
You've chosen the best health plan in the developed world. However, France is subjected to many warts. It's a matter of trade offs.
NewYorkLady (New York, NY)
The author's accurate assessment of these healthcare landscapes notwithstanding, any American who manages to pop over to live in Britain and/or France is a person of great privilege and/or luck. For someone who went to Brown and then Columbia to imply that this is an option for but a precious few of us is incredibly irritating.
rich (hutchinson isl. fl)
A letter in my local paper described an elderly American's experience in Britain when he suffered stroke symptoms then received expert care that required a three day hospital stay and was charged only $2000 dollars. (It would have been free if he were British). This is part of what he wrote: “There I remained for three days and two nights undergoing many tests, including an MRI. When I rang the help bell, an attendant was there within five minutes. The printouts of my tests, a dossier about one inch thick, were presented to a team of doctors headed by a world-renowned authority on strokes. The whole team came to my bedside and explained the results. It was atrial fibrillation, not a stroke. I was not discharged until I had been examined by three therapists speech, occupational and cognitive”. As an American healthcare investor I find this incident very disturbing. To maintain the profit margins,that make me rich, my investments in hospital, insurance and drug company stocks, require that $2000 dollars cover the in hospital cost of about 4 Tylenol tablets and that the care he received, cost him or the taxpayer, about $160,000 dollars. If America were to provide health care without obscene profit how could we pay hundred million dollar health care company CEOs salaries, and how could those health care companies and CEOs pump millions into our elections and political system? All that expert health care at such a low cost seems very un-American.
Brian (Montreal, Quebec)
As an American who has enjoyed Canadian public health care for the past 14 years, I find it incredible that some Americans still believe universal health care is an infringement on their liberties and not a right that they deserve. Greed has broken the current system, and it should be tossed out along with those who have profited all these many years from the sick and dying.
Jean (Cleary)
Medicare for All is the answer, regardless of what the Politicians say. With the amount of taxes that the citizens pay in these United States starting with Federal taxes, FICA, State Income tax, State sales tax (except for a few States} city sales tax and Real Estate taxes, there is no way that we should not have access to the best health care in the world. It is not as if Medicare for All is a freebie. Medicare is paid for through FICA and once you are on it there is a monthly premium, but no where near what a premium costs for other health insurance. No pre-existing conditions, you can keep your doctor, you do not need referrals for specialists, it is portable if you move, if you get sick in another State you are covered. if you are laid off you will have coverage, if you retire you have coverage. We need to stop putting our heads in the sand and force the elected politicians into taking their heads out of the sand and give Americans what they need. They have to stop lying to us as to why this is not doable. It is a problem with a simple solution. The system is already in place. Oh, but I forgot, we are not Insurance Lobbyists who can give big donations to their campaigns. Stupid me.
Truthseeker (Great Lakes)
Unfortunately, red America, most in need of universal healthcare, will never read a story like this. Since these types of stories never appear on Fox news, they won't vote for the politicians who would legislate such policies. This ignorance is to the detriment of all Americans. As mentioned in the article: " Doctors here often ask how I landed in Europe. When I tell them, they shake their heads. AMERICAN VALUES ARE DEREANGED, they say."
Panthiest (U.S.)
How do European taxpayers feel about Americans coming there for free health care? I'm curious.
Paul (San Diego)
@Panthiest They get as mad as heck .........
Paula Gaubert (France)
Amen Amen Amen Amen. I did not move to France for health care, I moved because I fell in love and married my French love. However four years after we were married, I got breast cancer, and two years after it was treated and removed, it came back again and is now metastatic and incurable. I would certainly be dead if I had not left the United States, in California I was self-employed and had only very bad catastrophic insurance, I would not have even been able to pay the mammogram to find out there was a problem. I am covered with wonderful concern and care and great follow through. I feel in wonderful hands and am not worried, even though my prospects are not great. I wish for nothing more than the citizens of my home country to have the same peace of mind for themselves, for their mothers, grandmothers, sisters, and daughters in particular because breast cancer is a huge scourge. May our new congress make some progress on this score please !
Tears_Of_Niobe (Melbourne, Australia )
I wish you all the best, Paula.
SR (paris)
I hope NYT readers in the States can relate this article to the excessive recent coverage of a very small minority of indignant French people wearing yellow vests. The health and retirement systems are very generous, as this article points out, and to many foreigners passing by, immigrants and refugees as well. Being chatty and comfortable awaiting health care is nice but someone else is paying for it for half of the people in the waiting room who pay nothing. Shame on the NYT for focusing on French deadweights instead of current efforts to renew the economy. Obviously it would be better, for France as well, if the author could get treatment at a reasonable cost in her home environment in the States and I certainly hope you all vote for someone who will make that a priority.
DukeSenior (Portland, OR)
We have socialized medicine in the US, but not for you -- not unless you're a veteran, and even then only for some veterans. It's also the best healthcare system in the US. Don't take my word for it, look up the statistics. (Full disclosure: the VA just saved my life.) And the VA's success is why it's in danger. Those horror stories you've heard are exaggerated accounts of a few incidents, planted in the media by the VA's enemies. Republicans hate the VA because (a) it proves the government can do the job, and do it well, and (b) they want to get their greedy jowls into that great big budget. Medicare For All would be greater, but VA For All would be lots greater.
Har (NYC)
So, why not vote for a 77-yr old man in 2020 who spent all his life advocating for a federal "single-payer" healthcare plan that has become mainstream in 2018 (but not in 2015-16, when we were told "US is not Denmark")?
c smith (Pittsburgh)
Helps be better understand why French productivity is so notoriously bad. Thanks!
franko (Houston)
And yet, whenever anyone here tries to improve our insane health care system, conservatives cry socialism and ruin, and nothing changes. Of course, they said that about Medicare, too. Try telling your parents and grandparents they can't have that, because it destroys their freedom. I blame "American exceptionalism". We're Americans, so naturally we have the best of everything, even when we obviously don't, and can't learn from anyone.
John Xavier III (Manhattan)
It's touching to see how many readers here actually believe that French healthcare (or Austrian, or German, or Australian or whatever example people use, some from experience) is low cost or no cost. Rest assured, somebody is paying for it ... just not you. Either taxes are paying, and that's transfer of wealth, or they print money ... or they borrow money from private sources ... so the Euro is now $1.14 ... There is no other way. There is never a free lunch, but everyone seems to believe quaintly that there is. But there isn't. Nothing of value is free (Ayn Rand). Doesn't make it false just because it was she who said it. Socialism that you so love is a forced transfer from providers to users, from creators of wealth to consumers of wealth. Works until the creators have had enough. It always amazes me how many fantastic new drugs and medical advances France produces ... Or Sweden. Or Germany. --- 5:00 PM
Barbara (SC)
If only the United States would handle healthcare so logically and reasonably. We would all be better off.
DiavolissimaNelCielo (Disneyland)
The cheapest individual bronze plan in New York state is (sic!) $415 …monthly i.e. $5K annually which I find absolutely ludicrous. Not to mention $4-7,5 K out of pocket responsibility until this bronze plan kicks in with…a 50% co-pay for *everything* but annual checkup. As a person with a heart on my left side I cannot comprehend how the current system is still called “affordable” when in reality it goes to private insurance companies and we do not have a *public* health care in our beloved US. America became my home with a capital H a long time ago but I had a chance grow up in a country with a universal public health care system which I am an absolute proponent of …but European Union is a completely different system. Universal health care works if there is a public health care system/provider. Otherwise it is like growing strawberries on the Moon. Is it possible? For sure but what about its cost?
RochD (Little Rock, AR)
A French citizen, I used to live in the US and experienced healthcare in Arkansas. Coming back to France, it felt as if healthcare here was "cheap" as nothing more than the strict minimum was spent to render a minimal service. In some cases, it felt like the doctor had been alone in its practice with no contact with colleagues and no refresher for years. Many public hospitals look underfunded. In contrast, most practices in the US had many doctors and nurses and high cost was also an incentive for increasing efficiency. Standard procedures are evolving more rapidly in the US where cutting edge technology is rushed into the operating rooms faster, and maybe some of this R&D cost is not supported in all countries equally. Inversely, our Sécu is in effect subsidizing many drugs that are actually sold by american pharmaceutical companies. US GDP per capita is higher than France and that shows for health as for many things. But not unlike education, France is following the American exemple and more practices are being run by health corporation in search for efficiency and more doctors are employees rather than self employed, nowadays. "Who shall live?", France used to be a small country, now that it's part of a bigger Europe, it seems that it's becoming more and more difficult to continue to promote "Liberté, Egalité, Fraternité".
Costanza03 (Milan,Italy)
This article, along with many others in the last few years shows the difference between US health care and other systems which many Americans label as "socialized" medicine. As most comments mentioned, in Europe, the national health care systems provide emergency and regular health care to residents. In my own experience, the quality of health care, especially for critical care - husband's heart attack, father's cancer ect.ect . is excellent. There can be long waiting for "minor" illness, but overall the feeling of security when a major event occurs is priceless. A parallel system, funded privately through voluntary insurance plans (sometimes job related) allows the more affluent to acess private practice, which is costly but will not lead to bankruptcy (specialist visit range from 150-300€). Many public hospitals also offer "private" treatment, for those who want private hospital rooms, surgeries, shorter waiting times - allowing employed doctors and staff a quota on the income. Doctors are also allowed to practice privately after working hours, with part of the fees going to the hospital, in exchange for general expenses. I find this system a good compromise between public and private, since many of the public hospitals are also the primary research centers, therefore allowing the most up to date treatment.
E (here and now)
Imagine what the working class - of which I am a proud member, in company with the majority of Americans - might accomplish in the way of productivity and imagination on the job, if we did not have to worry about losing healthcare if we lost our jobs.
Dave (Nc)
This debate is in many ways no different than the discussions over climate change and unions; the moneyed interests, their bought politicians, the various and sundry sycophants, culture warriors and zealots, usually religious, combine to persuade enough Americans that to change the statistically inferior system is an assault on our very way of life, un-american even, and will lead to Armageddon in the form of death panels, economic ruin (aggressive climate regulation) and less jobs and/or "rights" to work (unions). It's complete and total insanity, is literally bankrupting our country and doing absolutely nothing to improve the health and welfare of our citizens. As someone who is paying over $1200/month for healthcare, on top of a $15k/year deductible, I'd take literally any change as a positive.
Tom McAllister (Toronto)
I was in Costa Rica on business a few years ago. While not without its issues, it is a beautiful country and many of the local people I spoke with were proud of the success of their country relative to the profound challenges of some of its neighbours. One person explained to me how every citizen had deductions from their paycheck for taxes (of course), and also for pension and universal healthcare. Yes, little Costa Rica with a GDP per capita just one sixth of that of the US has universal healthcare. It all boils down to a society's priorities. As a certain president might say - 'sad'.
pb (Norway)
I'm an American living for the last 5 years in Norway. I feel so much freer here than I did in the States. It's because I have to worry about so much less. I pay high taxes, but I don't worry a bit about losing my job, house, car if I get sick. No worry about medical bills. No concerns about losing my job as I have a tight work contract. Retirement pension is big enough and guaranteed by the gov't with no additional savings from me. All that ( more) is regulated to benefit the average person here, not the medical or financial industries. My primary care physician can see me for a routine visit with 1-2 week wait. She even asked to share my family history and test results with her brother, who happens to be one of Norway's top cardiologists - this, after she ordered some specialized blood work for me. Cost me about $10 for everything. My one medicine I have to take all the time used to cost me $87 a month by mail in the States (with my Cadillac corporate health prescription insurance that I paid almost $200 a month for as a 35 year old single woman), and costs me just over $3 for a 90-day supply here in Norway. No insurance premiums to pay as my taxes cover it. Yay for high taxes and worry-free stability! I can spend my time thinking about nicer things than finances and medical costs.
Mary (Paris, France)
My husband and I are in our late 50s, native Californians, and we also moved to France in large part because of the health care system (we arrived just 2 years ago). While we love France, we, too, would have preferred to have the option to stay in our home country. Neither of us has a major health condition right now, but we made the move as a safeguard. The hardest part for me is realizing that I have reache this age and STILL, the US has no universal coverage. Why not just expand Medicare to cover everyone? It would be a simple way to start.
Paul (San Diego)
As one who is well versed with the immigration policies in the UK and Europe, there is no way that Ms Rex could have been sponsored by an 'acquaintance' - that route just did not, and does not exist. One needs to be sponsored by a spouse - there is not even a relative visa one could apply for, unless a dependent parent. She could have, of course, been sponsored by a company for a work visa but not by an acquaintance. Additionally, one only obtains indefinite leave to remain when one has lived in the UK, continuously, for 5 years. So, either Ms Rex is merely making up this whole story or she, somehow, got her visa using fraud? Either way I am sure most Brits would not be pleased to learn their hard earned tax pounds, used to fund the National Health Service, were being used to treat an American who had paid nothing into the service. While they might have sympathy for US citizens who do not have health cover, they are not sympathetic to those who fly into the UK and throw themselves onto the NHS. She appear to have also conned the French too, although she now says she is paying French taxes - hope her new book sells so she can continue to contribute.
Ellen (Seattle)
@Paul I am American and lived in the UK for 8 years, married to a UK citizen. I did in fact encounter Brits who thought I had no right to use the NHS (unfortunately, one of them was my doctor). I worked there, and paid taxes. I also paid into their national pension system, which I will be unable to recover when I retire here, despite the "reciprocal" agreement with our Social Security. No, you can't just up and move to Europe when you get sick.
Paul (San Diego)
@Ellen If you were a bona fide legal resident of the UK, then you were fully eligible to use the NHS - the visa in your passport would have proved so. Your doctor must have not been conversant with UK immigration rules, nor NHS ones. I hoped you proved him wrong. With regard you paying into National Insurance contributions and not being able to recover them when returning to the US this is the same for those moving to the US. Many folks, especially those on work visas, pay into US SS and Medicare and when returning to their home countries do NOT get a refund. There is no reciprocal agreement to cover this situation.
Tim Mitchell (New Zealand)
Here in New Zealand healthcare for most major illnesses is essentially free. A visit to the doctor will cost around US$50 or about $12 if you are unemployed, retired or disabled. Children under 14 are free. There are waiting lists for many surgeries but when your life is in imminent danger the system responds quickly. I went to my doctor complaining about chest pain and as soon as he found out there was some history of heart disease in my family had me checked in to the local hospital immediately. They ran a barrage of tests at no cost to me. Pharmaceuticals are controlled through a government agency which negotiates the lowest possible price and uses generics where appropriate. For most consumers pharmaceuticals are a minor add on cost. Chronic sufferers receive discounted treatments. Inevitably some rare conditions are not covered. We also have a "no fault" accident compensation scheme. Any injury caused by accident is covered. If necessary the scheme will cover you for life. The trade off is that you can't sue someone else if another party is involved. That helps keep medical costs down as doctors don't have to worry about malpractice suits. Our top personal tax rate is 33%. There is a small levy for the accident compensation scheme (just over 1% for an employee). We also have a 15% value added tax on all goods and services (but no other sales tax). Government debt is about 20% of GDP (vs close to 100% in US) and the government expects to run a surplus this year.
Detalumis (Canada)
@Tim Mitchell Sure pharmaceuticals are so controlled that some are just plain unavailable even if you want to pay for them, the drug companies don't even bother to sell them. So yes, you are sacrificing some for the good of the majority. We do similar things here in Canada, it's called "I'm all right, Jack." "I have had okay treatment so my experience must be yours." My neighbour was diagnosed with breast cancer, had a perfectly clean mammogram and six months later found a lump. Went to the doctor and was told she was stage 4, nothing we can do for you, go home and die. She then went to Europe, paid for a chemo drug not available here, went into remission and is not dead 2.5 years later. Americans wouldn't stand a system where you have no choice at all.
Federalist (California)
French healthcare can also be rather poor, as my daughter discovered when the French clinic she was seen at while in France on an exchange program almost killed her with malpractice. She came home deathly ill and was immediately put into the local ICU. She was out of the ICU in a week and out of the hospital a few days later, after being seen by a competent specialist, properly tested and put on the correct medication. Had she stayed in France she would be dead.
Zee (Toronto)
From the gaurdian: The United States is simultaneously the most expensive place to give birth and the highest risk. I can’t believe people are charged 51k for a c section, with out of pocket costs in many thousands of dollars. It seems that access to healthcare is considered a perk and not a right. https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america
Ned Netterville (Lone Oak, TN)
I'll take American health care and freedom--relatively speaking--to the French version. France appears to be leading Europe in economic decline. Eventually, its gratuitous health-care system will prove untenable. Then what?
Deirdre Oliver (Australia)
Sounds pretty much like Australia, and according to my Canadian daughter in law, like Canada, too. I hear Germany, Sweden, Denmark, Holland, Italy, Japan and quite a few others also manage to help their citizens feeling safe in their health care needs. Of course none of these programs are perfect, and you'll hear complaints and griping from all over the places. `The waits are so long', `the doctors don't care', `the hospitals are run down' and from the politicians, `it's so expensive', but everyone, that's EVERYONE, knows they won't go bankrupt if they need a hip replacement, or they can't afford the pills they've been prescribed or they have MS or asthma, or a congenital condition that prices them out of health care, that no one will help them. Only Americans live with this fear. Like my other daughter in law, in the USA. Her chronic health issues keep her family poor and chronically anxious, even though my son has relatively good health insurance through his job. Could it be time to ditch the ideological stand that says too much government interference is an impingement on people's rights and think, maybe government might assume that the right to health is NOT interference but its responsibility. Citizens might think that government is not there to be the benefactor of the private insurance companies, whose baseline is PROFIT, but be the PEOPLE'S benefactor instead.. Of course the DONORS might stop paying but he people might start voting.
sm (new york)
Ms. Rex is fortunate to have had help from friends living abroad ; not all of us are so fortunate to "score a social security card"in Europe . Our medical care , medicines , are geared towards profit , certainly they are not in the health business for our health . It will not change unless people see it for what it is and are willing to pay higher taxes as they do in France or England for medical care that will not bankrupt them.
Paul (San Diego)
@sm She did not have help from friends - she conveniently married a Brit.
kim murray (toronto canada)
As an American ex-pat living in Canada, I can totally relate to what Erica says about France's health care system. The same is true here; patients are a caring community and they are generally good natured and polite about waiting their turn. We're all in this together, rich and poor. I have lived in Canada since 1970. I have had 2 knee replacement surgeries, a tubal ligation, and am due for two other surgeries later this year. I have seen top specialists in at least 7 disciplines. I have never waited longer than 2 months to see a specialist or book a surgery. One specialist called me at 9pm on a Friday night to give me the results of a test I had taken that same day. Every year I receive reminders in the mail to be screened for breast, colon and cervical cancer. I get a flu shot every year. All of this has cost me nothing. Of course we pay taxes that offset these expenses. But, as Erica points out, the absence of anxiety over health costs, plus preventive medicine programs, make life a lot more predictable. Our health care system makes us feel safe and protected, because we are. There is absolutely no justification for Americans not feeling the same way. As Trump likes to say, "It's a disgrace."
Detalumis (Canada)
@kim murray "I'm all right, Jack." My husband injured his knee in February 2 years ago. It swelled up to a huge size. The appointment, just for a diagnosis was October, so eight months later. We had to go to Buffalo to find out what was wrong. But you had your knees replaced so all is right with the world. We had an 18 year old girl die in my area waiting for a bone marrow transplant. She went out of remission because the hospital didn't tell her parents the reason why they didn't do the procedure was lack of beds. So 18 year old is dead, but you get a flu shot every year. "I'm all right, Jack."
George (Florida)
A doctor, MD, PhD from a healthcare advisory group, was invited to address our hospital executives on the pending impact of the recently passed Affordable Care Act back on hospital operations. Basically, she said that the day to day business would go on as usual but funding construction of new facilities would fall more to hospitals than from government financing. My interpretation, and I'm sure I missed some other important points. But this is what I found fascinating. After the meeting I went up to her to asked my questions which were; was the ACA a step towards universal healthcare? She said, "not really, maybe a baby step". I then said, but why can't we have universal healthcare? She looked at me and said " universal healthcare works in 19 other countries and we don't have it because too many people in the healthcare system are making too much money and no one is willing to give any of that up!".
John Xavier III (Manhattan)
@George I will tell you from personal experience that you failed to ask the key question: is she willing to cut her pay in half? You should have asked that question because the answer would have enlightened you. But in any case, we know the answer: NO!
Upstate Dave (Albany, NY)
My father was a Republican's Republican with the exception of his attitude towards health care. He said it should be a source of national embarrassment to claim that the United States of America can't provide guaranteed access to medical care to everyone who needs it, if the French, who can't do much of anything right or on their own, can manage to do so.
hen3ry (Westchester, NY)
It's been 35 years since my father had a brain abscess. Very little has changed regarding health care in America since then. It was 1984. My father was unconscious in bed. We called the police who called the ambulance. The first thing we thought of wasn't if he would be able to recover. It was if we could afford the care he was going to need. If it happened to him now the same thoughts would be running through our minds. We've known for decades that our health care system doesn't work. But we keep on chasing our tails. Isn't it time we fixed it so it works for all of us rather than some of us?
Scott2335 (Naples)
Give Trump his wall in exchange for Medicare for all. At least start lowering the age for Medicare by 5 years each year for the next 13 years. That way all the employees in the health services industry that currently process "insurance" could transition to other employment.
Steve Snow (Cumming, Georgia)
If we had a system similar to the one in France or Canada, how would Insurance and Pharmaceutical companies continue to rip us off and milk us for every penny we have? What would those poor people do if they weren't able to hold us all hostage?
John Xavier III (Manhattan)
@Steve Snow They would produce no new drugs.
Amy ODowd (Ithaca)
I have lived in both Canada and Britain, as an American, and received good medical care there. Not fancy, but decent. I don't think that most Americans have the stomach for what medical care for all would cost. A friend in Canada recently received a $10K a year raise. Her take home pay each payday went up only $23. I think it would be fine for us to move to a different system, but people need to be honest about what the cost looks like.
Carolyn (Canada)
@Amy ODowd Poppycock! The highest marginal tax rate in Canada is in Nova Scotia and is 54% on income earned over $210,000. Either you are lying or your friend is lying to you.
cdearman (Santa Fe, NM)
No question health care in France is quite inexpensive and US citizens can take advantage of it. It's not free for US citizens but it's cheaper. Except for Medicare and Medicaid, regular US health insurances will pay for the care minus your deductible. Oh, yes, medication is way cheaper in France than the US. Health care in Netherlands for US citizens is somewhat higher than France but available.
Doug (Ottawa, Canada)
About 10 years ago my wife & I were in the small village of Saignon, in the Vaucluse region of France. We met a young woman who had moved to France from the United States for what she thought was a temporary visit of perhaps a couple of years. However, she developed a cancer and was faced with the prospect of never being able to return home. An involuntary exile because of the health care market in her beloved country.
Tim (Upstate New York)
Sorry to say but most physicians I've met in my 35+ years as a Registered Nurse believe they are deserving of the social and economic status this country provides them. They won't say it but they like the system just the way it is.
John Xavier III (Manhattan)
@Tim Yes, that is the truth and are they wrong? Most people don't have the brains or will power and discipline to become doctors, and are not willing to spend 10+ years becoming one. All doctors I know single payer would be a disaster.
Mark (Illinois)
It's the underlying fear or lack of safety as the author stated that takes an emotional toll on Americans. Having lived in Canada for a number of years I found Canadians in a different place mentally and emotionally. Knowing a safety net existed and that they would never have to worry about health care, or education for that matter, made for a different and better society. It's the difference between we are all in this together, let's look after each other vs. every man for himself. We have lots to learn here in America.
Thank you for this column. I an French born premanent resident in the US where I pay over $700 monthly health insurance. I recently had to do a series of medical tests and did them in France while I visited simply because the costs were very low, even without Social Security coverage. I paid the full price of visits: $25 Euros for doctors visits (both to a generalist and a specialist in a top ranked Paris private clinic), 24 Euros for blood tests and 66 Euros for an echography. Each time the receptionist was very sorry to hear that I did not have Carte vitale of Social Security and I explained it was ok without explaining that these amounts were less than my co-pay in the US and certainly not explaining that the cost of healthcare in the US is out of control.
amir burstein (san luis obispo, ca)
thank you vewry much, erica rex , for this most enlightening article. it should be read not only by most/ all americans, but mostly by those republicans in DC. alas, MOST AMERICANS need to keep pressuring their reps in DC so medicare - for -all health care model will hopefully become a reality and we can finally make "america great again" for real. healthy new year.
Robert Haar (New York)
The medical care in US although imperfect is still the envy of the entire world. When some international patient require surgery or specialized treatment they mostly come to the US. Most Americans are happy with Employer based insurance and access to care as are Medicare patients. As America is still a center right country politically the electorate has rejected the social democracy policies of the Obama years. The single payer mantra of the hard left is a pipe dream. America is not wired to adopt European style socialized Medicine. Nor should it be.
Beyond Repair (Germany)
The outcome for most diagnoses in the US is way worse than in civilized countries. Your cancer centers are great with their marketing (in civilized countries advertising is banned doctors and clinics, saving the system costs) but their long term survival rates are average at best. However, they do manage to financially ruin the family of the patient.
Peter Bugden (Australia)
I’m sure plenty of Americans envy the American health care system as well. I’m sure they’d all. Dry much like to access it.
BBH (South Florida)
I have to agree here. We do not qualify to be included in a discussion of “civilized “ countries. Certainly when talking about medical care for average citizens. A disgrace.
Nick R. (Chatham, NY)
As a former consultant to the insurance industry, I can tell you that the health care system in the US is designed to deny patients service. Health care in the US is a for-profit business. Large insurance companies work with conservative politicians everywhere to weaken and derail national health programs. When Americans talk about how bad "national health" programs are in France or Britain, they are talking about private corporations acting through political entities that have slowly eaten away at the original mandate for those services. Obamacare, aka the ACA, was a handout to insurance companies, which has ultimately helped them make their propaganda point--public health is confusing and doesn't really work. A Republican congress and senate, wholly owned by conservative activists has reinforced this erosion and bad messaging. The only solution is national health/100% single payer. All doctors must take the national plan or give up their license to practice. Why all Americans don't understand this is a complete mystery. I run a business that offers health insurance. It costs me a fortune, isn't great, and premiums are going to go up again next year. Are nurses and doctors suddenly getting paid that much more? No. And the cost of medical care will drop with a national plan. it always does. Would you rather pay $30k/year to an insurance company or $2k extra each year in federal taxes?
[email protected] (Joshua Tree)
short answer: most Americans would rather die (and very many do) than pay anything at all in taxes, ever, under any circumstances. and the framing of paying MORE in taxes is a nonstarter. the only thing worse: the concept that the extra taxes for healthcare might benefit somebody else, especially the feckless poor. we have been sold this bill of goods for so long it may be impossible to regain rationality. moral: don't stand too close to anybody i. an ekevator because yoi can never tell what untreated disease you might catch. and that goes for goldplated escalators, too.
Eric (NYC)
As a Frenchman now American citizen, married to an American with kids born and raised in NYC, I decided long ago that my kids were American more than French, that the US were their country. A while ago, as I was reflecting on the difficulties of the company I work for to provide an affordable health plan to its employees, the thought came to me that I wished that my kids would leave the US after college and go start their lives elsewhere. I was shocked to hear myself thinking like that, as if we were living in a 3rd-World country with the prospect of emigrating as our only hope for a decent life. But this is where we are indeed. Health care and guns - two very good reasons to go live elsewhere...
Rosie (NYC)
You are not alone. I came to the U.S. over 30 years ago and it breaks my heart but between out of control gun fanaticism, greed over people and fear of losing healthcare if I can't afford the 1500 a month I am currently paying, for my own sanity and emotional well-being, not only I am encouraging my daughter to attend a foreign university but I am seriously planning on leaving, at least for a few years until the United States is sane again.
NH (California)
It's simple. We just need to agree to pay higher taxes for health care for everyone. And to pay for the education of physicians, as other countries do, so that people are not graduating from medical school with an average debt approaching $200,000 (before the interest begins accruing during several years of internship and residency). And stop asking for what's new to treat Alzheimer's/Parkinson's/cancer, etc., because the new stuff is expensive. And stop expecting a brain MRI for headaches that make one worry a brain tumor is present when the exam indicates it is not, or a referral to a specialist for each organ system, or multiple opinions from several specialists for the same problem. When we do these things we can have universal healthcare.
Beyond Repair (Germany)
U also need to outlaw malpractice compensation. If a doctor is found guilty they will lose their license. But u as their patient won't leave the court being a millionaire. Doctors paying 200k a year for health insurance is a waste. Their salary shouldn't even be 200k.
Larry (Long Island NY)
As I age, I realize the importance of healthcare. Until I reached the age of fifty, I had never seen the inside of an emergency room. Doctor visits were on an as needed basis. All that has changed. In the last dozen years I have spent more time in hospitals than I care to admit. I have had an Aortic valve replacement and two cardio ablations. I have had numerous issues pop up that required stays of three days or more. A year ago I was diagnosed with Chronic Lymphatic Leukemia. Of all the cancers to get, this is the least worrisome. At least for now. I have watched four of my five siblings die from cancer. They struggled to fight the disease and they struggled to keep up financially. Medical debt is the leading cause of bankruptcy. Healthcare in this country is a disgrace. Insurance companies are a disgrace. I resent my body being a profit center for greedy corporations. Our politicians are a disgrace. They have the best healthcare supplied by the government that employs them. They work for the people, yet they would deny us the right to decent and affordable healthcare because it would mean less profit for their insurance company donors and perhaps higher taxes. The system needs to change. We can start with extending medicare to everyone. Health is not a privilege and our government needs to stop treating it as such. Force the politicians in Washington to deal with the same insurance issues that the average American deals with and see how fast it changes.
David (Victoria, Australia)
It is fascinating to read the ongoing healthcare debate in the US. From someone who enjoys ( and yes pays into) a universal healthcare system, I wouldnt have it any other way. I dont see it as any different from car or house insurance. Surely the concept is the same? Maybe other countries are just less dog-eat-dog?
FFFF (Munich, Germany)
Note that if one has access to the health system of an EU country, then this person has access to the health system of every other EU country - on holiday or simply by choice. Thus, the author of this article could go to Germany where the health system has some advantages over the French health system (but also some disadvantages). In the EU, resourceless people (including refugees) get health care. Many people illegally residing in the EU also get health care: The trick is that many staff at public hospitals care for them without doing the paper work and justify their doing by their Hippocratic oath. Most people in the EU are proud to pay the taxes making all this possible.
Ellen (Seattle)
The one, albeit strange, advantage of being the last developed country to have national health care is that we get to learn from everyone else's mistakes. I was a patient in the British NHS for 8 years. The NHS had its shortcomings to be sure (a 13-week wait for pap test results? Seriously?) but no one was ever bankrupted by illness. If we could combine European and Canadian social responsibility with American ingenuity and customer service, we really would be the envy of the world!
Karin Byars (NW Georgia)
Read it and weep. I remember when Mrs. Clinton was working on Health care in 1993 a "Quarter of a Century ago" I was invited to many of those meetings and my head would spin after all the options proposed. I finally stopped going and suggested they just copy the Northern European Model as I was leaving. I am German and I have lived with that for many years, it works and it cost less than half of the GDP percentage that we pay and the care is better. We don't deserve better health care, after Trump the focus will need to be on Mental Health anyway.
Michael (UK)
I am Irish - I have lived and worked all over the world, but having arrived in the UK in the late 70's I took free healthcare for granted. I have had a son born in the USA and been lucky enough at the the time to have had a 'gold plated medical plan' sponsored by my employer. In the 1990's $20k was a lot of money for a baby. I have recently had a hip replacement on the NHS - under 60, I was not a priority but as I pointed out to my consultant - my weight was ballooning and the pain killers would eventually cause organ damage. I got to chose a date (they did the procedure within 7 days of my chosen date) and was successfully operated on and now have a new hip. No pain, and my weight is slowly decreasing. Overall cost to me was under $1,000 - which was mostly spent on private physio-therapy. Health care is a human right - everything else is just politics and greed...
BBH (South Florida)
Politics and greed are the manna to the rightwing in this country.
willw (CT)
Great article! I think it would make an interesting theater film or even a documentary. But France's economy, of course, is slightly different than ours, to say nothing of their form of government. Because she is a talented writer, she can "make it" anywhere she can find appropriate public health care. I don't think France is her only option, but they are certainly few. The United States is going to have more affordable and better progressive health care for everybody sooner than later. It is going to be demanded by more than seventy-five percent of the population, if it isn't already.And who can we thank for this? Speaker Nancy Pelosi.
faivel1 (NY)
When we first came to US with my two daughter7 and 8yrs old we took a trip to Canada where my daughter had a slight injury. We went to the doctor's office, she was helped instantly and when it was time to pay they told us that her treatment was free. We felt so relieved, since we already experienced how devastating it was to have any medical treatment and buy medication in US. Really shameful system, even in USSR we had a doctor visit at home, without paying anything.
Geraldine Conrad (Chicago)
I'm surprised the writer could gain residency in both Britain and France with ease. Decades ago I inquired about finding work in Europe with two MAs and experience and was told I'd never get a permit to work. Perhaps it's changed.
sk (CT)
It is not smart for a doctor to be changing linens and table cover in office. That is a very expensive way to do these things. That doctor could probably see one or two more patients in the time he is spending changing linens Health care is a precious expensive resource - even in France. Only way to manage this is to manage supply and demand. Americans have far more obesity than French. Use of health care resources specially orthopaedic services rises rapidly with obesity. The costs will always go up when demand for a item starts climbing. That is one of the many reasons for expensive american health care. If obesity rates went down to 10% from current 40%, orthopaedic surgeons will be in over supply because demand for surgeries will go down. This will bring down fees for every thing. US health care does not incentivize people to manage their health better. That is one of the big flaws.
Larry (Long Island NY)
@sk You are missing the point. When doctors don't have to grovel to insurance companies they can take their time with patients. It is not about volume but about quality of care. You clearly have not been to France. The only obese people you will see walking the streets are American tourists.
Jack (Florida)
nice moral values you are showing. Rip off their system, first the Brits and then the French, and then glory in it. O you citizen of the world. That's why Trump is in favour of immigration controls. I'm sure those who you have ripped off along the way treasure having paid for you; that includes me, as a UK resident and taxpayer.
BBH (South Florida)
There was nothing in this article that remotely suggested she was ripping off those countries. She merely availed herself of the “normal” medical services there.
Larry (Long Island NY)
@Jack You are right. The author should have stayed in the US and died from lack of healthcare. It is always about the money. Disgusting.
nils mellquist (Brooklyn)
And that is why my family all have Irish passports. Need plan B the way this country is going.
nerdrage (SF)
"Too many Americans do not realize how much better off they would be if they felt safer about access to medical care." I think they know, especially when their health fails. Kind of hard to ignore it then. What they don't seem to know is that they've bought a lot of stupid lies regarding health care and many other topics. Such as a stupid wall being worth building while millions of Americans' fragile health care is at risk, assuming they ever got it, even with Obamacare. Why anyone votes for Trump who isn't independently wealthy is beyond me. He is deliberately attempting to sabotage Obamacare among many other attacks on anyone below plutocracy level.
Inveterate (Bedford, TX)
Americans pay far lower taxes than Europeans, but they must essentially pay for their own medical care. Most US citizens vote and prefer this option. Independence, for better or for worse, is what America is about. Immigrants want to come anyway. Of course medical care in the US is in the hands of large companies that charge 10 times the prices of Europe. But the private sector gives jobs to Americans, so private ownership is good and public is bad. Obviously many patients get bankrupted by the medical system. This is part of the risks of living in this very great country. They should put more money into health savings accounts rather than waste it in frothy coffee and suc stuff.
Peter Bugden (Australia)
A country that cannot provide good health care to all its citizens is not a “very great county”.
Driven (Ohio)
@Inveterate Agreed.
BBH (South Florida)
You have totally drank the kool-aid. Polls show an overwhelming bias towards “Medicaid for all”. We realize taxes will have to pay for it, but will be offset by not funding pharmaceutical and insurance companies that deliver no medical advantage.
Herr Fischer (Brooklyn)
Thank you!! When will Americans understand that the "USA has the best health care" is a myth, ridiculous propaganda regularly spewed about by politicians who have no clue how much better, and cheaper if not free, health care is in Europe, or even Canada?! American healthcare is a disgrace!
Henry Martinez (Atwater, CA)
Thank you Ms. Rex for the well written personal account of your medical experience that serves to illustrate why we need a single payer medical insurance system here in the U.S. In your short form article you clearly and convincingly make the same point as T. R. Reid in his excellent book "The Healing of America", that a single payer medical insurance system is the only way to provide healthcare for everyone. Please accept my best wishes for your recovering and continued health.
David Michael (Eugene, OR)
Thank you for such an outstanding article about health care and the reality of living in France. I have been fortunate to have been treated in several European countries and Canada in the past thirty years as I worked and traveled around the world. I have always experienced excellent health care at a fraction of American prices. In Turkey and Jordan, I always paid the bills out of pocket cash (never more than $50), rather then mess around with filling out insurance forms. American health care is broken at every level. And, I suppose one could say the entire government, under Trump, has blown up as well. It's like putting a first grader in as principal of an elementary school. No sense, no boundaries, no reality. When will the American people wake up, especially those in the south and midwest? Maybe, it's just easier for the West and Northeast to secede and join Canada. What a collossal mess!
Ralph Durhan (Germany)
I moved to Germany with my wife over 3 years ago. She had a job and I was covered in a family plan for her insurance. I started getting Social security and now I pay my own way based on my income. I still have the same insurance. Any doctor or specialist I want to see when needed. No cost at the point of service. So much nicer land less cost and hassle than my previous insurance.
Pat (Toronto Canada)
It's not only European health coverage that gives real security. Here in Canada I never worry about medical expenses, even as I age. And I have no coverage beyond what our health care system provides. In Canada, we can see whatever doctor we want (though we access specialists through our GP.) I have never had to wait an undue amount of time to see a doctor. If I have a sudden emergent situation, I call in the morning for a same-day booking in my clinic. Some soul searching is needed in the US, a softening of hearts. The fear that someone "undeserving" might access health care is just mean-mindedness, a mistrust of neighbour. And yet this seems to underlie the US aversion to universal coverage. No one goes to a doctor for their own pleasure, just for their needs. What an appalling health care system it is, when people must decide between financial and health care needs. When they must stay in a job for fear of losing coverage. When they have a sick child and cannot afford treatment. When older people choose to die rather than bankrupt their families. When families must hide illness from their insurance companies. The USA can and should be better than this.
Jackson (Virginia)
@Pat Can you explain why Canadians come here for specialists?
Pat (Toronto Canada)
@Jackson You'd have to ask them - I've absolutely no idea. I've never wanted to, and it's not something I've ever heard discussed. I'd be interested in learning what percentage do so.
Larry (Long Island NY)
@Jackson Let's see the data on that. I don't buy it. Especially with the dollar exchange rate, US healthcare would be a fortune for a Canadian. And there is nothing wrong with healthcare in Canada as Pat says. This I know for a fact. I think you are perpetuating a common myth.
Assay (New York)
My wife fractured two foot bones last summer. No dislocation. One and half hour in Emergency Care of State University Hospital, an X-ray for above prognosis and hard slipper with flimsy velcro billed over $2,500. Of the bills, I am liable to pay half. Over half of billed amount was for use of Emergency Care facility; which amounted to sitting in wheelchair in typical waiting area in any medical facility. The same in local Urgent Care facility would have been a fourth of what hospital charged. It gets better. Real care with well known specialist, plaster cast, a much superior boot after the cast was removed, and four follow up visits cost less than hospital bill. Now what is wrong with this picture? Everything. In the US, an average patient is victim of five powerful lobbies; insurance companies, pharma, hospitals, doctors and lawyers. Good luck winning over them.
Earthling (Earth)
@Assay Here in the US I have taken to going to a CVS Minute Clinic for flu shots, for the occasional bad sore throat (once very other year or so) and minor ailments. About $80, covered by insurance, a neat and modern exam room, and from the minute I enter the store it's less than 30 minutes before my exam is over and Rx in hand -- which I can fill right there and do sundries shopping besides. Why would I go to a "regular" physicians' office to pay more, wait in a boring, germy lobby and get less time with the health care provider?
VVV03 (NY, NY)
Twelve years ago, I was in Cologne, Germany for a wedding. I was seven months pregnant and thought my water had broken. My husband and I were directed to a wonderful little hospital where we hardly waited ten minutes before being seen by an OB who spoke English, did an ultrasound and assured me that my water hadn't broken and I wouldn't be going into labor anytime soon. I seem to remember leaving my insurance and billing information, but I never received a bill, nor did my insurance. The hospital was small and not state of the art, but clean and uncrowded. The staff was lovely. What is our country doing wrong? Any way you do the math, our healthcare system is incredibly broken. PS -- Thanks, Germany!
atb (Chicago)
This is SO important. Perhaps THE most important issue we are facing in the U.S. and I know we have many problems. But it is simply unconscionable that we allow this horrific system to continue. We treat our health like a business. It's not. Or it shouldn't be. The fact that we allow our fellow citizens to go bankrupt or even die when faced with medical challenges is just wrong. Employed people with insurance in this country STILL need crowd funding to help pay for their chemotherapy, rehab, and when they become disabled. Most illnesses and injuries are not anyone's fault. Yet the message our government sends us is that we are not worth helping if we cannot afford the inflated costs of health care and oh, by the way, it's probably your fault if you're unwell and too bad if it isn't. Employers shouldn't be responsible for our health! We live in a society and we need to start acting like it in this country. This "every man for himself" attitude is crushing us- it's killing our dreams and our democracy.
Barbara (SC)
@atb Sadly, the attitudes of American libertarians and other far-right wingers is that we must each take care of ourselves. They believe that signing up for government healthcare shows a lack of freedom, though when asked they can't explain how that is different from signing up for health insurance in general. Their smug viewpoints are part of the reason the U.S. doesn't have better health coverage.
Jeanie LoVetri (New York)
@atb The Koch Brothers, who finance almost all the GOP candidates (many of whom are elected), do not believe in any social system for any reason. Libertarians think we should all be on our own resources, as do the Rand Paul types. Survival of the fittest, period. If you are "smart" enough to "make it big" you deserve whatever you can get. If not, too bad for you. It is the opposite of "I am my brother's keeper." How the "evangelicals" go along with this is through blind ignorance and belief in a bunch of ideas made up by white males who like power...using "the bible" for justification. Absolute brainwashing. We like to make fun of Sweden, but visiting that country lets you know what it means to create a society in which everyone thinks that others matter, that the planet matters. Way smarter than us. Yes, the USA system is crazy and lots of people like it that way. The Trumpites suffer the most and can't make that connection at all as to why. They blame others for their own ignorance. Their reliance upon FOX for "news" is like being a real fox relying on Mother Nature to supply you with chickens. Until and unless we have a Progressive government (in all branches) forget "health care", social security, medicare, medicaid, and assistance of any kind, We will get less and they will continue to say "let them eat cake." Corporate greed, corruption, malfeasance, selfishness, suffering, and in the end, the demise of us and the planet. Hail, King Trump forever! (Yikes.)
ak bronisas (west indies)
@atb. .......Unfortunately for Americans its not medical or health professionals but the "health industry" corporate lobbyists and their "investors" on Wall street through,campaign finance "funded" and "owned" politicians..........that decide how health care is provided for the country........because its REQUIRES a GROWTH INDUSTRY.....while the Trump Environmental Pollution Agencies policy of allowing increased toxin tolerance....in air, water,and food assures.....such GROWTH.........The increasing heath problems of the American population as a source of growing corporate profit..........is directly engineered through the INSTITUTIONALIZED corruption of the political system.......Americans need to WAKE UP and PROACTIVELY FIGHT for expansion of the existing and well functioning MEDICARE SYSTEM FOR ALL ..........or remain corporate fodder and victims of profit !
Fato (Pittsburgh)
ok, I am a physician. I have had two sisters become ill in Europe, one in Italy and the other in France. The healthcare was no way near the American standard. In fact, I had to have both of their studies done there sent to me urgently to have them interpreted by specialists here, one of my sisters had her life saved by flying back home deathly ill. Care here is outrageously expensive and I believe and support socialized medicine. But I will tell you having traveled as a physician, that the care in some parts of Europe is not as good as it is here, and no one will convince me otherwise.
SoWhat (XK)
@Fato No one doubts your assertion. Socialized medicine is definitely not perfect. But neither is outrageously expensive care that is denied if one can't pay for it, or leaves one indebted for life. And then - to add salt to one's wound (pun intended) - assisted suicide is still largely illegal in this country.
Rosie (NYC)
I will take an imperfect system anyday as I am not part of the top 1%, the only ones for whom The United States offers the "perfect" health care system. In the United States, your value as a human being is based on how wealthy you are.
Richard (Krochmal)
My significant other was ill for many years. As her physical condition deteriorated, she took to the bottle. A subdural hematoma occurred when she fell down a flight of stairs. After several months of seeing blurred images her health improved. Several months later, she fell again and broke her hip. She required a long recuperation and therapy. Her physical well being was also coming into question as she was coughing more than usual and was diagnosed with lung cancer. I couldn't take care of my own health during her illnesses as I had to be available 24/7 to prepare her medication and make certain she eat the food necessary for her to maintain her strength. I woke up one morning in Dec of '09 and had lost the eyesight in my right eye. To shorten this story, over the next five years I had six eye surgeries. Between our Blue Cross / Blue Shield monthly premiums, approx. $1900 a month, her medical treatments, my medical treatments and the fact that I couldn't work for several years we went through our stock portfolio and sold a 2nd home we had in Florida. Soon after her death the bank foreclosed on our main residence. Thank god we paid cash for the condo in which I now reside. If not, I'd be living in a rental room or small apartment. I'm on Medicare now. We spent over $1 million combined medical treatments and lost our home. Our government will spend $2 trillion on a needless Afghani War but won't provide affordable healthcare for its citizens. What's wrong with this picture?
jc (Brooklyn)
Many years ago I worked for a health insurance company with a unionized workforce. At the time Edward Kennedy was trying to get a universal healthcare bill drafted. My union opposed Kennedy because universal coverage could mean the end of insurance companies and their bloated administrative staffs. In the process union membership would diminish. I was young so I was shocked to learn that personal interest trumped the common good. I’ve grown up since then. Americans have rarely been willing to act for the common good. In any case, there’s too much money at stake. The drug companies and the medical industrial complex won’t give that up. Get to Europe, if you can, before the Europeans are convinced that universal healthcare has to go in the rush to privatize for efficiency’s sake.
Jackson (Virginia)
@jc If the government takes it over, of course it will be unionized. Can you name something the government does well?
Bridget (Wisconsin)
Many seem to imply that there are no wait times for care in the United States. This is simply not true. Often the waits for specialists can drag out for months in the United States as well. My grandmother recently had her knees replaced. The wait just for the initial appointment was four months and the surgery wasn't scheduled until months after that. I recently had a suspicious lump. That took months to be seen as well (I have good insurance). Waiting to see the doctor is not a uniquely European problem.
Norman Dupuis (CALGARY, AB)
"Deranged" indeed. It seems, from the outside, that the ability to pay for outrageously high individual health care premiums in America is another means to winnow the winners from the losers in society. And the rest of the world looks on in disbelief.
Dr Remulack (Fl)
I will be waiting for Trump's " beautiful, affordable healthcare" to begin. I will be also still waiting for Gadot.
David Eike (Virginia)
Since Medicare for All appears to be a non-starter, and likely just another bureaucratic quagmire, how about making the cost of health insurance deductible from your owed taxes? Not a deduction from your gross income, but a one-for-one deduction from the money you owe the government. This would make it a no-brainer for young, healthy people to buy a policy, thereby underwriting older, less healthy folks, and might even incentivize the government to try to manage costs. Too naive or just too dumb?
BBH (South Florida)
That is called a “tax credit”. Not a bad idea, but probably naive.
Catherine (New Jersey)
You elected not to buy health insurance. You chose not to contribute toward any of the plans that provide coverage for your fellow US citizens, as was your right prior to the ACA. Post ACA, with subsidies and prohibitions on excluding for pre-existing conditions, you again choose not to pay into the system over here. I have three close relatives who chose that route. Even after the ACA was passed, they elected not to enroll for as long as possible. All three developed cancer. Melanoma, throat and cervical cancer respectively. The 61 year old managed to get through almost his entire adult life never buying health insurance. At 60, his income is now low enough that he qualifies for Medicaid, and now has fabulous coverage. All of his care is free to him, nothing out of pocket. The 55 year old managed about 15 years without health insurance. Over the same timeframe, I paid monthly premiums of about $1300, for a difference of over $230,000. I feel a little bit foolish when I note the difference in homes we were able to afford, the trips he took that I could not, his restaurant meals and nicer shoes. Alas. My 35 year old loved one had her cervical cancer treated at Planned Parenthood. It cost very little. The irony in her choosing not to get insurance is that she is a nurse. We can blame politicians, insurance companies, drug companies and doctors -- but the reality is that none of us want to pay.
Bob H (seattle)
Many countries have healthcare industries. Most of them are health-based. Not here in the USA. Perhaps we could advance the dialog if we referred to the American system of healthcare by it's full name: System for profiting off the fact that people get sick and injured. Like any industry, increasing profits is all that matters and it therefore becomes their full-time job to increase earnings while diluting the product as much as possible.
Edward Goldstein (Paris)
I have lived in Paris on & off for 30 years. Near retirement, I cannot even contemplate returning to live in America. I know that if I fall ill, I won't lose everything. The healthcare is a right here, as it should be in the USA. Is there a link between the absence of paid political advertising & good healthcare?
UARollnGuy (Tucson)
Republicans will never stop threatening access to necessary health care, because they take orders from just a few billionaires like the Koch brothers, whose extreme right-wing ideology mandates tiny government providing tiny benefits so THEY (born into staggering wealth like 2 year old millionaire Donald Trump) won't have to pay TAXES. It's really that simple. IMPEACHMENT NOW. Democratic Senate and White House in 2020!
rapatoul (Geneva)
As a Frenchman, I call upon Emmanuel MACRON, President of France to immediately erect a wall to protect us from the hordes of uninsured or poorly insured Americans: ''they’re not sending their best. They’re not sending you. They’re not sending you. They’re sending people that have lots of problems, and they’re bringing those problems with us. They’re bringing drugs. They’re bringing crime. They’re rapists. And some, I assume, are good people.” On a more serious note, Americans generally believe that their market based health care system is the best in the world. Yet, America is the only country suffering from an opiods crisis. The universal payer systems which exist in all other OECD countries prevented big pharma from pushing their dangerous opiods based pain medicines. The concept of needing to obtain approval before seeking treatment is foreign to the French. You can consult any doctor you wish, get any procedure your doctor or surgeon prescribes. Everyone is covered from cradle to grave, and for roughly 60% of the cost of the American system. What explains the difference: health care professional incomes are lower, administrative costs are massively lower thanks to the single payer system, and hospital and big pharma profits are significantly lower. La sécu is nothing more than a Medicare for all which sets and negotiates prices for care, drugs and hospital procedures. Truman proposed Medicare for ALL after all after WWII. The southern states voted against.
Juultje (Delco)
Holland is in the throes of an opioid crisis.
Rosie (NYC)
If only we could turn back time and let the Confederate states go, as they are nothing more than third world societies dragging us all down their self-destructive paths.
Jeff (Chicago, IL)
Vive socialized medicine! No one health care system in any country is 100% perfect but the American one is perhaps the most shamefully abysmal and unfair in the industrialized world. Access to good and affordable health care over one's lifetime should be a guaranteed right for everyone, not a privilege for only those with deep pockets.
Alexander (Charlotte, NC)
As much as I hate our healthcare system, and wish we would move to a single-payer system, it does have a few advantages-- for one thing, you would never hear of a European moving here and freeloading off of lifelong taxpayers because they couldn't afford coverage in their home country, like the author.
SoWhat (XK)
@Alexander You are forgetting Medicaid which get used by the recently arrived just as soon as they can. Why is it that the middle aged people are the only ones without socialized medicine as an option or a catastrophic catch all? The young have CHIP and the old have Medicare after all.
Earthling (Earth)
@Alexander In the US, lifelong stay-home spouses can totally freeload off lifelong taxpayers by claiming Social Security monthly payments AND Medicare via their wife or husband's account. Do you think that loophole should be eradicated?
Alexander (Charlotte, NC)
@SoWhat Yes I did forget about Medicaid and Medicare, and you raise an excellent point-- If we are going to make a welfare state work, then we either need to ensure that people have been paying taxes into the system for a reasonable amount of time, or impose capital requirements upon new immigrants to compensate for the fact that they haven't been paying-- and the requirements should go up with advancing age, as their payback period shortens, or is nonexistent.
NFC (Cambridge MA)
"Americans can always be counted on to do the right thing…after they have exhausted all other possibilities." - Winston Churchill (or somebody else) I feel like America is going to run out of time before we run out of "other possibilities" on healthcare, energy policy, penal systems, voting rights, women's reproductive health, white supremacy...
Brian Will (Encinitas, CA)
I am afraid to say that most US citizen just do not understand that we do not have "the best healthcare system in the world" if you compare it to other European countries. Many European countries are way ahead of us. Having said that, no every healthcare system in Europe is as stellar as the article made it out to be. But, even poor public healthcare that is generally available is better than decent healthcare that is available to just part of the population. Somehow Americans don't get that.
SoWhat (XK)
@Brian Will Precisely. Most people will prefer the option of the certainty of getting care affordably - even if delayed or without frills. They would definitely prefer this to not being able to afford care at all or going bankrupt getting it. Why Americans chose to not get this ...who knows.
BBH (South Florida)
We aren’t choosing the current situation, but the elected representatives of the country are absolutely in the pockets of big Pharma and the insurance companies. Polls show we, the majority, want single payer, but our representatives don’t deliver. Vote out the GOP !!
Meg Conway (Asheville NC)
I hope that young people read this article and move to another country before they become ill. While the US remains focused on, as Harry Reid recently put it, an "amoral" rump, and his fellow gops in congress who support his amorality, those suffering and dying from lack of affordable healthcare, are overlooked. The inhumanity of healthcare insurance companies, and in some instances medical institutions themselves, continue on, because they can. Journalists who would investigate are overwhelmed with the daily chaos and crisis of rump, from his treatment of immigrants, to shutting down our government. The US needs a Mueller to investigate health insurance companies and the medical institutions who find ways to deny care to people who cannot afford it. President Obama tried, but now we need universal healthcare coverage.
Lucy M (Minneapolis)
I've worked in healthcare finance for over 20 years; my husband is a physician. I've known the fear a "pre-existing condition" and no health insurance; I've had the comfort and luxury of full coverage ever since. I describe my feelings because I felt (sorry) this author hit on something money can't buy: patients who live with the security of knowing they or a loved one don't have to worry about health care, pre-existing conditions or medication are happier. Happier patients = better outcomes. Better outcomes = lower healthcare spending. All of the above = less provider burnout. The white elephant in the room here is our "fee for service" system. Third party insurance providers delay and deny payment - while collecting insurance premiums which if unpaid 30 days will be terminated - as a business model, leaving providers to spend more money on business office operations in order to recoup payment for services rendered as much as a year earlier! In my experience, government payers (Medicare, TRICARE) process and pay claims efficiently. "We all do better when we all do better" - Paul Wellstone
laura (SF)
I realize. I think many, many Americans realize how much better off they would be to live under a single payer health care system. BOLIVIA just instituted universal health care, for goodness sake. For older generations, I wonder if their optimism for better has been jaded (and silenced) after so much propaganda that the US insurance can NEVER be changed. I hope the younger generations unite their voices to demand better. I believe that they will. Demand that and the companion issue, response to climate change.
Stefan (Germany)
... a friend of mine says .. maybe the whole money based health care industry and education industry is just a way to keep the rich part of the nation healthy and well educated while the poorer part of the nation is never really able to change their status when deciding between paying for studying or helping out the grandma with money for her cancer treatment. My nephew is currenty studying "computer science" and he is paying the minimum fee for complete, premium, platin coverage which makes up about 150$ a month plus 140$ for the university fee (this is a quarter-fee including bus ticket). The media should bring more reports about the so called "socialism". Yes, we pay higher taxes to cover free education and we also don't earn as much as Americans but look at the numbers above and tell me what the same would cost in the US
Katherine Smith (Virginia)
I lived in France for 10 years and worked at a language school. It wasn't always an easy life.I became pregnant as a single mother, and my baby was born at 28 weeks. After 3 months in the neonatology ward and a staff of incredible nurses and doctors at Robert Debre, my daughter went home. The bill was nothing--0. She had a pediatrician who lived downstairs from us and who made house calls. My France wasn't the tourist brochure either, and I had some difficult times. But I will always love France dearly for the humanity with which it treated my child. When we came back to the US, hen she was 4, it was a shock--she was uninsured for two years. Praying took the place of healthcare.
LeeMD (Switzerland)
As a fellow American living in France, I can confirm what you say. It is worth noting however, that the French healthcare system is under strain - as the government tries to manage costs. In some parts of France, there are longer waiting times, doctor's visits are quick - with very little time for either the doctor or support staff to listen. HOWEVER, access to care and medicines is always guaranteed. Switzerland takes a different approach - there is a universal mandate to purchase at least a minimum level of coverage, and this is effectively enforced. And even the minimum level of coverage has a yearly cap of 2500 CHF of out of pocket costs. Your story confirms a major reason to continue to live in Europe. Thanks for sharing your experience.
JR (Nebraska)
It seems that the US isn't really a country anymore. It's a business, and corporations are people, my friend.
Newport Iggy (Los Ángeles)
@JRI have news for you. Corporations are people. They are people who banded together to form a legal entity to reduce their individual liability.
BBH (South Florida)
We have morphed into the United Corporations of America. Everything here is based on profit. Capitalism run a-mock.
Kate K (Nevada, MO)
Our country is good at many things, but health care is not one of them. Patients can't get in to doctors, doctors are overwhelmed with paperwork and insurance companies telling them how to practice medicine, and many people have to file bankruptcy because they got seriously ill. I've reported fraud to my insurance company, but they didn't care and told me that they were powerless. The system needs a total overhaul. Excellent care -- not extra tests -- should be rewarded.
Jorge (San Diego)
A simple anecdote: I was at a festival in Spain and rescued an Irish tourist-- he couldn't speak Spanish and the locals thought he was drunk-- hailed an ambulance and took him to the hospital where I did some simple translations for admittance and diagnosis (ulcer and food poisoning). No paperwork, no money, they simply saved his life. Indigent Spaniards receive no welfare checks, but they get free housing, utilities, and healthcare-- and free college if they pass the exams.
atb (Chicago)
@Jorge As it should be!!!
SteveRR (CA)
@Jorge That would be the Spain with a structural unemployment rate of about 18% and one of the largest underground economies in the world to evade the crushing taxes that no one really wants to pay? I am glad your acquaintance got 'free' health care... except we all know that it was not really free - right?
Jan Mueller (Bremen, Germany)
You might want to cover the problem from a different angle to get the attention of republicans. Maybe something like: Good American Dollars went into the pockets of foreign doctors in foreign countries who pay foreign taxes and buy foreign stuff with the money payed, for treating illnesses that occurred on American soil. It's like outsourcing Doctors and nurses.
Michael Lueke (San Diego)
Yeah it all sounds great, but you're forgetting about all that freedom you are sacrificing to get secure access to quality health care.
rich (hutchinson isl. fl)
@Michael Lueke Trumpcare is all about "freedom" 1. The "freedom" to go bankrupt and lose one's home because of a serious illness or accident in your family. 2. The "freedom" of the insurance vultures to deny you insurance, or cancel your policy when you get sick. 3. The "freedom" for taxpayers to pay the $2000 when the uninsured go to emergency rooms instead of $100 for a doctor visit. 4. The "freedom" of the nation to spend 17% of GNP on healthcare, with poorer results than every other industrialized nation who are paying only 10% 5. The "freedom" to keep uninsured children from receiving the early care that might prevent us from having the taxpayers support them for the rest of their lives. 6. The "freedom" to keep working in the same dead end job because your very sick wife, husband or child will not be covered by a new employer's healthcare policy.
Michael Lueke (San Diego)
@rich You may have caught it but the post was intended as sarcasm.
Ralph Möllers (Munich)
Exactly what freedom do you mean?
Scrumper (Savannah)
My Dad is 88 and his Urologist prescribed some Prostate tablets when his PSA began to climb. The cost? THIRTY THREE THOUSAND DOLLARS for a three month supply! The Doctor looked surprised when I told him my Father cannot afford such drugs. Healthcare in this country is totally out of touch and has nothing to do with "health" or "care" it's all about ripping people off and making billions of dollars. Trump should ask his friends in big Pharma for five billion they have plenty of throwaway money.
Tumiwisi (Privatize gravity NOW)
We have the best healthcare system money can buy. The best justice system money can buy. Best tax laws money can buy. Best ...
Newport Iggy (Los Ángeles)
Have you seen how France taxes the middle class to death or how its unemployment rate has been hovering around 10 percent for years? We don't want this in the US.
Earthling (Earth)
@Newport Iggy I'm a middle-class American and my marginal tax rate is more than 25 percent (federal) 4.5 percent state income tax, 17 percent FICA. So on my marginal income I pay more than 40 percent taxes -- and get what? Pothole-ridden roads, no healthcare, a sub-standard education system that churns out illiterate and innumerates by the millions and millions each year, a do-nothing Congress, a damaged environment, zero public transportation, old airports, second-rate electrical and internet grid, subsidies to environment-poisoning big agriculture -- the list of banana-republic services and systems in the US goes on. I'd rather have a 50-percent tax rate in Europe and get their level of health care, education, public transport, cleanliness and modernity.
Rocky Mtn girl (CO)
Insurance companies exist to DENY you healthcare. My brother, a healthcare lawyer, who knows the system well, says that Kaiser is the best, if you can get it. It is repulsive to me that Agent Orange and his Republications consider Medicare and Medicaid programs to be cut to fund his wall, while their 3 trillion dollar deficit billionaire tax cut is just dandy.
Postette (New York)
The system here is cruel, and the poster child for that cruelty is Trump. Hopefully our current system will go the way of smoking on planes, and be replaced by something saner, and more realistic.
Jack (Austin, TX)
All the hand wringing about healthcare... Author either have never had any insurance in the US or less than candid about it... Almost any employer based insurance cover lion share of costs... including the storied super expensive prescriptions... Those who are poor have Medicaid and seniors have Medicare... additional costs are bearable and exist everywhere even in France... And spare me Canadian system that so many here mentioned... there's a reason why extensive network of private clinics just across their southern border is thriving and for cash only... the waiting the availability etc... Many latest medicine not even available in Europe... not because they're not approved but just their "single payer" did not agree to cost and depriving their patients of the latest care e.g latest genome based cancer cares are very expensive and aren't fully or at all available even in Europe... Our system isn't perfect or fair... needs adjustment but not the socialist takeover as being advocated...
Carolyn (Washington )
@Jack Employer plans depend on the employer and the ability to subsidize at least some of the cost. This is exceptionally difficult for small businesses, that form the backbone of the US economy. And in fact small businesses with fewer than 50 employees have not been required to purchase coverage. And if the employee does have coverage, they're still looking at monthly premiums, copays, deductibles, and prescriptions. Fee for service plans are run by insurance companie must approve tests and procedures, anything beyond the basic. A person can wait for a long time for surgery approval, even when the doctor has fought on that person's behalf. Add in bars on preexisting conditions and lifetime coverage limits, and people die. Medicaid is limited, and not all doctors accept it. Medicare pays most of hospitalization and most of a doctor's appointment, but the patient is expected to pick up the rest. Or buy a supplemental insurance plan. On a fixed income. Not good. In the US, people file for bankruptcy because of medical bills. People pay on medical bills for decades. A family member was born prematurely many years ago, and it took her parents nearly 20 years to pay their portion! I had a c-section (medically required to save both our lives) and spent several days in the hospital. Our cost? Under $10. Thank you Kaiser! People die every day in this country from lack of access to affordable, timely health care. I'll take nasty socialized medicine any day.
Rosie (NYC)
Sure, after 15K a year of deductibles and co-insurance payments, that on top of the 1500 a month I pay for it!!!!!
Rosalind Gnatt (Germany)
Universal Medicare is the answer. I'm living in Germany, where my insurance is partly covered by my employer. I pay around $200 a month for excellent health care - no frills, but excellent care. I'm 66 years old and would like to someday be with my kids again. Will I ever be able to move back to the US? Not unless Medicare is extended to all Americans.
George Warren Steele (Austin, TX)
Thank you for telling your story. Would that there was a way to insure that every American would read it, plus all the comments that it has generated. Finally, I wish that every American could find and attend a production of a play called "The Great American Mercy Tour." (Check out the short YouTube video.)
GNol (Chicago)
Here’s an interesting model for you – Australia. Universal healthcare provided to all, with supplemental private health insurance well within reach of an average middle class family (if they so desire). No guns, so the metropolitan hospitals’ ERs are focus on real emergencies, not preventable ones like bullet wounds in children’s heads day after day. Affordable world-class universities, with a government loan scheme that is not required to be paid back until the student earns above a threshold (of about $50k, at a super low interest rate) and doesn’t financially drown young doctors just as they’re getting started in life. A minimum wage that you can actually live on. Sure, the cost of living is a bit higher (still cheaper than NYC/SF/Seattle/LA/Chicago/Boston), and the 1% don’t earn the same amount of billions that their US peers do, but that’s a small price to pay for a population that doesn't become homeless because of an emergency surgery. (BTW, i realize this is incredibly rose-tinted, and Aus has a lot of social problems i.e ingrained racism, but that's for another conversation).
Ellis Krauss (San diego , Ca)
The comment from someone in Denmark preferring the U.S. system may represent that particular country's health care system. Other democratic countries do not offer those obstacles. I have been fortunate to have had few major health problems most of my life, to have very good health insurance through my former employer (and still do) and when I have had some problems had them in France, and Japan, both advanced democratic countries with good national health care systems. In one case in France, I ran out of some anti-inflammatory medication and went to a French doctor. He examined me, said "oh sure, we use that medication here too," and wrote me a prescription. I took it to the nearest pharmacy and got a month's supply--enough to last me until I left France. Total cost for both doctor's visit and medications: $60 because I did not have French insurance. Imagine what I would have paid had it been in the U.S. without insurance. In Japan, a country ruled for most of the past half century by a conservative party by the way, I developed a leg issue. Went to a primary care physician 3 times and a vein specialist twice who ordered a 14 panel blood test and an imaging of both legs. Turned out it was a muscle issue not veins and I walked out paying $165 for EVERYTHING because I had Japanese national health insurance that time. In both cases, I had I picked my own doctor and hospital. What is wrong with Americans that they all don't support a national health care system?
brian lindberg (creston, ca)
to medical care, you can add nursing home care for the aged...
josieX (London)
I am really sorry you had cancer. I am a huge fan of national health systems. My family and I owe our NHS more than we could ever pay back. The service only works though because people pay into it. I hope you stayed in the UK some time to contribute back into the system. I hope you are better now.
Freedom Found (Spain)
Last year in the States, I had a minor outpatient procedure. I had private insurance. The cost of the procedure which lasted about five minutes put me back $21,000. My insurance paid about half of it. I’m still struggling to pay it off. Then they had the gall to tell me I might not have actually needed the procedure. I up and moved moved to Spain last February. Since then I managed to get in their system and have FULL coverage. Just like that, and my taxes here unlike what you are all told, are the same as they were in the US. The relief I feel for if that issue reoccurs or anything else catastrophic, is indescribable. My medication cost went from WITH insurance in the States $300 a month to... oh, $20? Plus Spain is a much more fun place to live. The food is better and healthier and Spain has recently become the country with the highest life expectancy in the world. And yet they stay out late, drink a lot of wine and a large number still smoke. It’s probably because they’re not so stressed out by life as many Americans are despite lower incomes on average. Unlike the author, I’m glad I left.
GUANNA (New England)
Let's start the reform be realizing doctors are not the rare gems they pretend they are. The system keeps the number of new doctors as low as possible and spreads the nonsense that a special genius is needed to study medicine. These these students our our special elite. Somehow that special genius is not needed to study physics, Chemistry or any other subject at a graduate level.
Earthling (Earth)
@GUANNA Exactly. The medical school at my alma mater admits about 150 would-be MDs a year. Why not 300 or 450? They have the space and most of the studying is done self-paced and online anyway. God knows there is no shortage of patients needed more care on clinical rounds, etc. -- so why not train triple the number each year? Or, change the laws to allow nurse practitioners and PAs more scope of practice. Maybe then people wouldn't get the evil eye if they want to spend more than 7 minutes a year with a health care professional. But those docs wouldn't be earning 5-20x the average American, either, would they?
lm (boston)
I lived and worked in France for 6 years (with both national health care and private supplemental insurance) - and I often recall my experience with French medical care with nostalgia; doctors, who, as stated in this article, do not have assistants or fancy hospitals costing a fortune to build. A simple form to fill out, no need to figure out which doctors accept which insurance, and, of course, only one bureaucracy to deal with, not all the staff at both doctors and insurance companies, lowering the overall cost of medical care. I've always been promptly reimbursed for office visits (with very low fees compared to the US), and never even seen the bill for hospital stays. I've even purchased OTC medications, out of pocket, on my frequent trips to France since having left because they are less expensive or available without a prescription. French friends with life-threatening illnesses (some with minimal savings) were all successfully treated without going into bankruptcy. Most of all, though, is the personal care I received. Maybe I was fortunate, but my personal doctor cared and didn't assume that I was a bad person in some way just because I am ill, the way it increasingly appears to be here. I don't know whether this is still the case, but you could even ask for house calls if you were too sick to go to the doctor. I decided to return to the US for various reasons, but wonder if I made the right decision for my long-term health.
luisromo1973 (Avilés, Spain)
I had the opposite experience as a European who was living in the US for just a year. I deeply admire the American sense of freedom but I dont understand why Americans accept the dictatorship of health insurance companies instead of giving up a little bit of that freedom in the hands of the State. Universal healthcare is not an act of charity, it is actually a profitable investment.
Rosie (NYC)
Because we are The United States of Greed.
Jeffrey Stern (Chicago)
Recommend reading The Healing of America by T.R. Reid. It lays it all out. Hard to believe that there are people who believe that proper health care is a privilege, not a right that belongs to everyone just because they're alive. Anyone who thinks that some people should not have proper health care because that's "just the way it is" needs to re-think their position.
maya (detroit,mi)
I live just across the Detroit River from Windsor, Canada. Every summer I visit Stratford, Ontario to attend the Festival Theater. We often have conversations at cafes and frequently the subject is the Canadian healthcare system versus our system. The reaction of Canadians is always the same. How can Americans tolerate such an outrageously expensive, ineffective system? I have never met a Canadian who is unhappy with their healthcare despite its flaws. We need Medicare for all including prescription, dental, hearing and vision coverage. Also mental health care. We need to stop the Republican Party in league with Big Medicine and Big Pharma from blocking our access to better coverage.
John (Toronto)
I've had 2 experiences with health care while travelling. One was in the US in 2002. I had a condition where I passed out on public transit. I was immediately taken to the hospital and had several tests done and released about 24 hours later. The cost? Just under $24,000. This was a combination of tests, doctors, mediaction and the hospital stay. 2 years later I was grazed by a passing vehicle while in the UK and suffred a fracture. I went to the hospital, had my arm set and sent off. The cost? £75. In both cases I was reimbursed because I carry travellers health insurance (currently $400 per year which covers me for 180 days of travel outside of the country). The difference I believe is the US provides health care in a system that is based on profit and many, I dare say most, other countries provide health care as a service. Here in my country, I pay health care through sales taxes and some through income tax. At the end of the day I still have disposable income, I'm not worried about any catastrophic illness and I'll never go bankrupt from being sick. Are my drugs covered? No. I have to pay for them or buy insurance to have it covered. It may be time for Americans to look at Health Care as an essential service.
CEl (New York City)
This is the nightmare that keeps me awake at night. The decades of work my husband and I have done may be for nothing. We could lose everything and be left homeless and penniless with a single diagnosis. We don't have kids and live within our means. In our late 30s we own a home and are debt free. But it could all be for nothing. I had a recent medical incident and told almost no one of it. Yes, I am fearful of the wrong person an employer, an insurer, a banker finding out and putting me on a blacklist. The US is a disgrace.
Tom (NYC)
I am very confused. We were told in 2010 that Obamacare would fix our health system once and for all. What a liar he turned out to be.
GARY nyc (New York)
@Tom It would have had it not been repeatedly attacked and systematically gutted by the Republican know-nothings.
SParker (Brooklyn)
Don't worry; Trump will take care of all of us.
Earthling (Earth)
@Tom What liars the people who are brainwashing you are. If the individual mandate had been enforced, and if all states had adopted Medicare expansion, the ACA would be in full swing and our health care landscape would be undergoing beneficial transformation. As usual, obstructionists in the GOP have ruined it for everyone. I bet if you get a cancer diagnosis or something equally as dire, you will hotfoot it to the nearest hospital or university health system hoping for the best treatment. Do you not understand that the only thing that will make it affordable for you is being in a large insurance pool?
theresa (new york)
The schizophrenic NYT runs this article while simultaneously supporting corporate Dems in bed with pharmaceutical companies and running hit pieces on Bernie, the only candidate with sense enough to support Medicare for All in 2016. Hypocrites.
Blew beard (Fort Worth Texas.)
In each of the modern countries on earth that have had a taste of freedom.. ( That excludes those that are Communistic) there are good ways and bad ways to distribute health care. The same applies to the ways government works. In England there is still a Monarchy which Americans did not want to bow down to. There seems to be more of a ruling class system there also. France has good food I'm told but they would be saluting Hitler if they had not been bailed out by Great Britain and this country. Germany would not have had its economic rebirth had it not been for the Marshall Plan. The US is blessed with many natural advantages and freedom to reinvent itself every 20 years or so. Despite all of its warts I'm glad to be here. I'm certainly not a MAGA Trump supporter but I do think we have some things that work and if our elected politicians can learn to work together things would go better. If not we are a doomed society that aliens from other planets will wonder what happened.
Bob (Smithtown)
Shortsighted article. Glad France was your answer but you offer nothing of value from a policy standpoint.
rich (hutchinson isl. fl)
While some who call themselves "conservatives" might prefer that sick and disabled citizens who can't fully pay their way just vanish to pay for the tax cut of the Republican Party financiers, that is not what will happen. Without good health insurance, ill and injured working Americans often become poor and unemployed Americans. They stop paying taxes, families lose breadwinners and society picks up the cost of both healthcare and welfare for them and their dependents. . There is no doubt that giving all Americans good healthcare, would extend their ability to work; make them more productive; Keep families together; Avoid bankruptcies, and actually do more to make America great than slogans on hats. The ACA, (Obamacare), should have been named the keep Americans Working Act, because that is exactly what it accomplishes in the long run.
Danielle (New York)
Interesting take of an American moving to Europe to take advantage of free healthcare. Also interesting is the tone of the comments, which are far less hostile than those made when the article "International Patients, Seeking Cures in the States" was published a few weeks ago. Every American can empathize when an American has to go "take advantage of healthcare" in another country to avoid being bankrupted. However when people who come to America to seek treatment the reaction is far more hostile and less empathetic. What does it say about the heart and values of this country? No wonder we're in the mess we're in.
ConA (Philly,PA)
I live fearful every day even though my insurance company motto is to "live fearless," which every time I see it on TV or hear it on the radio it is like a slap in the face. Many people in my shoes have only the choice of a bronze plan-$542 per month, $6800 deductible and still $50 copay to see a GP. I feel for the people who need medications. I am wondering why it has taken so long for self-employed people age 50 to 65 paying for their own insurance to be heard by Congress. I am sure employers could protest more, too. Congress needs to share our pain before they see our pain because they have not been listening.
Mystic Spiral (Somewhere over the rainbow)
The problems here start even before the medical system... people here mention how much doctors make here compared to Europe - well.... remember that here a medical student will graduate school with $200,000, maybe even $300,000 in debts before they even start making any money, and their career is delayed compared to many others as their schooling is extended - it can be up to 16 years of post high school before the person actually starts really earning... Good grief... why put yourself through that. My husband and I with out plain old little 4 year BA's were able to be debt free (including our home) before those folks were even out of school... If you want physicians to be satisfied with earning less, we, like Europe, need to start way earlier and make the education more accessible too.
GUANNA (New England)
@Mystic SpiraL Easily fixed, Eliminate the Guild stranglehold on doctors. More Medical schools and more 6 year programs. Only in Medicine is the system unresponsive to demand. Medicine and Dentistry are archaic guild systems. The GOP screeches Free Enterprise but happily supports the medical guild system. The population has almost doubled but the number of trained doctors graduated from US schools has only crept up. We steal doctors from poor countries to provide our medical service. A disservice to these countries and the many well educated Americans denied spots in our overly competitive and restrictive system.
NH (California)
@GUANNA Yep, easily fixed. Just find the money to expand class size and establish more medical schools. And the federal government pays for residency positions, so we just need to cough up a bit more in taxes to have more residency spots to train more doctors.
Ron Brey (Montana)
I have a seasonal place in Canada and have watched my Canadian friends use their health care system for all sorts of issues including some very serious problems. One aspect of universal health care that is rarely discussed is the fact that folks can concentrate solely on their recovery afterwards rather than focussing on the financial ruin they would confront in the U.S. This has a significant effect on outcomes.
Demolino (New Mexico)
I am an ER doc . Our system will cover an MRI for a demented nursing home patient who is feeling “dizzy,” at a cost of thousands of dollars (tens of thousands if you add a short hospital stay and a neurologist consult). With zero change in outcome. But it won’t pay for a home-health aide for someone who just needs some extra help—at a fraction of the cost. The MRI generates a profit for the hospital. That’s why. Great system, huh? BTW I see this almost every shift I work.
kris (California)
I have been lucky, very lucky: I worked in higher education in California that provided complete paid health insurance with a big HMO (Kaiser). When I retired I immediately went into Medicare with a Kaiser supplement. It's socialized medicine at its best and I'm very lucky. My doctor and I work together to preserve my health through preventative measures, and there is no out of pocket extra expense.
cindy (Maine)
There are so many good stories in these comments about how people, poor or better off, in the healthcare profession or not, are affected by the state of healthcare in this country. I wish that these stories could be compiled into a book or blog or FB post or something that would go viral so everyone would see, not just NYTimes readers. We need a movement that is so large that lawmakers can't ignore it.
cindy (Maine)
To add to that, we are perhaps the wealthiest and most powerful country in the world and we cannot provide even basic health care to all our citizens. We should all be angry and disturbed by this. A large percentage of the population wants to use every means possible to make sure unborn babies are not aborted but once they are born, they and their families can fend for themselves. This is beyond hypocritical. This country needs to emerge from the dark ages.
LT73 (USA)
Healthcare is very much a part of the difficulty selling US products abroad. We are the only developed nation where the price of goods has to include the cost of healthcare for the company's employees aren't we? If we had national healthcare like every other developed nation the playing field would be less to our disadvantage wouldn't it? Perhaps I'm wrong. At least partially because there are two or three systems also built on private practice using private insurers but even there price controls amount to the healthcare costs being a fraction of what unlimited profits require in the US.
Pundit (Paris)
I have been in a few medical waiting rooms in Paris. No one has EVER chatted about their medical complaints. It would be considered a rude invasion of privacy. Those provincials down in Tours sound pretty weird to me. But having lived in the US, with very good insurance, and now in France for over a decade, let me tell you, the French system IS wonderful. And, dear libertarians, doctors here are mostly in private practice and charge what they please. But, for reasons to long to go into, the market here functions, and they charge, AND EARN, a fraction of what they do in the US. BUT, the system is not a panacea, because although it costs a good deal less than the US for comparable or slightly better results, health care costs here are rising annually at a similar % as in the US. In the long run, the only way to keep medicine affordable will be by robotizing a considerable portion of it.
David Currier (Pahoa, HI)
American's have so (too) much to learn about that monster, "socialized medicine." Last summer, in the city of Apt, France (near Avignon), my husband woke up one morning with a painful rash. A French friend recommended that we bypass his own doctor and proceed directly to the local hospital emergency room. My husband was efficiently registered as a patient, an RN took him into an evaluation room, and a doctor quickly appeared. The two of them diagnosed the condition as "zona", shingles. Prescriptions were written which were filled at a nearby pharmacy; the hospital and pharmacy all took about an hour. The emergency room visit and medications cost under $175 out of pocket. Because the amount was so low, each of the services required cash payment, but they willingly provided the documents necessary for us to file our insurance claim. Back in the states, our travel insurance company called us to verify that the cost was really that low. They willingly paid the remarkably low amount - with no deductions! Ah! The way healthcare should be delivered! Medicare for all!
Walter (Toronto)
Every critique of the US health system brings out the naysayers who will complain about high taxes, waiting times for procedures, the high quality of the best US procedures, and so on. Whatever the merits of these arguments, here is the clincher that condemns the US system. Reuters reported in March 2018: "(Reuters Health) - The U.S. spends about twice what other high-income nations do on health care but has the lowest life expectancy and the highest infant mortality rates, a new study suggests." And that in the richest country on earth.
James Murrow (Philadelphia )
I am an American. My family and I lived in France, and the quality of healthcare was superb. I was hospitalized for a 2-week period there, my son underwent complicated inpatient orthopedic surgery, my wife received outpatient surgery, and all of us had regular checkups. I know if I write that the system there is superior to the US’s in many ways - and that it includes every socioeconomic stratum of society, doesn’t bankrupt the government, and doesn’t allow insurance and Big Pharma companies to be the ridiculously greedy profiteers they are in the US - someone will think, or even reply, “Why don’t you just go back to France.” I’m fine with that. It’s because of the closed minds of such people, who elect the politicians whose campaigns are paid for by insurance and Big Pharma companies, that our healthcare is second-rate, it’s almost nonexistent for poor people, we have the worst infant mortality rate among so-called ‘developed nations’, etc., etc., and nowhere in the world comes anywhere close to charging patients what US doctors charge...
Susan L. (New York, NY)
@James Murrow Re: your last comment: Nowhere in the world do doctors have to pay *hundreds of thousands of dollars* for medical school!
Susan L. (New York, NY)
@James Murrow I left out something: Nowhere ELSE in the world (outside of the U.S.) do doctors have to pay *hundreds of thousands of dollars* for medical school!
Kno Yeh ('merica)
America began as a plutocracy congratulating itself as a democracy. We still are. A true democracy would take care of all it's citizens equally, not allow the wealthy to grow wealthier at the expense of the sick. I watched a TED talk where the speaker, Jon Jandai, explained the four basic necessities are food, clothing, shelter and medicine. These should be considered to be the basic rights of every citizen of the United States instead of as vulnerabilities to be exploited by the rich.
Stefan (Germany)
I am Typ 1 diabetic since I am 8 years old. When I finished school when I was 18 I went to an insurance company and became a member. Since then I am paying 15% of my income on the insurance (7.5 by myself and 7.5 directly through my boss). I got full coverage in all aspects since then. I never had to deal with the insurance company in any other way than just sending in applications. I kept full coverage even when i could not work anymore, they even paid 18 months 65% of my normal wage when I was sick until my retirement due to illness was accepted. Many Americans don't understand that this is no socialism it's just a way to provide full health insurance to everyone. Yes, people starting their career pay in only a small amount while they are studying or in apprenticeship and they earn more someday and pay in more and when they are old they pay in less again. The working class is sponsoring the old and the young and that's totally okay with everybody in Germany because everybody was young someday and gets old someday.
Wolf Kirchmeir (Blind River, Ontario)
Many years ago, on a cross-Canada trip by train, we met some US citizens enjoying the same ride. My son had obvious health issues, and we answered some questions. When we made it clear that his lengthy hospital stays and meds had not cost us a penny (apart from hotel costs for us worried parents), one of those US citizens refused to believe it. He in effect accused us of lying. Rush Limbaugh had said that Canada's health care system was a socialist fraud, or some such, and that we poor Canadians were dying in droves because our health care was inadequate. (My son would have died without the care). After he left the dome car, a couple of his compatriots apologised for his rudeness. But it illustrates how quasi-religious ideologies prevent the USA from having the cheap, effective kind of health care system that serves the citizens of the other G7 countries so well. Not that any country has a perfect system, but they are all pretty good compared to the USA, even with Obamacare, which from here looks like a scheme to guarantee profits to the insurance industry.
Earthling (Earth)
@Wolf Kirchmeir I have friends (perhaps straining the meaning of that term) who still routinely trot out the Fox- and Limbaugh-fueled fallacies about Canadian health care. It makes me want to beat my head against the wall. These friends have retiree health care based on employment with a local municipality; one of them retired on a "30 & out" deal at age 48 from a blue-collar job there and will get pension and retiree health benefits -- including full Rx coverage -- for the rest of his life, courtesy of that town's taxpayers getting up and going to work every day to fund his lifestyle. But that kind of "socialism" is OK with them! Just not the kind that would provide health care to people not lucky enough to fall into, or marry into, one of the scarce jobs that provides that sort of security.
Susan L. (New York, NY)
@Wolf Kirchmeir I have a friend in Canada who waited a YEAR to have an MRI. Much as I agree that our medical system has many disastrous aspects, there are aspects of the Canadian (and European) healthcare systems that are far from ideal.
Wolf Kirchmeir (Blind River, Ontario)
@Susan L. Well, I didn't say the system was perfect. Diagnostic procedures aren't on-demand. As with all procedures, more urgent cases take precedence over less urgent ones. When and where was this? In the early years of MRI and CAT scans, there weren't enough techs to do the work, nor specialists to read the results. Some of those machines, bought at great expense with fund-raised money, were at first idle 80% to 90% of the time because of lack of staff. (Many people don't realise that every medical device requires staff. A "hospital bed" is not a physical object, it's nurses and support staff. Ditto for MRI and CAT scanners.) Here, the longest wait I've heard of in the last three or four years was two weeks.
Kate Shrewsbury (Minnesota)
YES YES YES. Just moved to Mexico for most of the year. A visiting relative was curious about the cost of his insulin, which is skyrocketing for no good reason in the US. His copay in the US is $200. Total cost of his prescription in Mexico: $13. He bought four months’ worth. This is helping him stretch his "flex spending" plan, which is a joke in that it can’t possibly cover everything he needs. There is private "health insurance" here but anyone in need, which means everyone, can be on the federal health plan. I am still getting used to the feeling of "my health care won’t change because now it’s January". It wasn’t always this way. When everything got privatized, the costs went UP, not down. When your local town or city owned the hospitals, things were humane. Then "managed care" came into existence and suddenly faceless insurance types were making decisions about how many visits you could have with your doctor. In the end, having something like Medicare for all will SAVE us the costs of people going to the emergency room for every little thing. Come on, US, get real. Make American humane again! #bluesenatenext
Michael Croudson (Toronto, Canada)
I won't discuss universal health care with Americans. They simply don't get it.
gmgwat (North)
We thank the powers that be every day to be living in Canada. My husband has had cancer twice, and I am a stage 4 breast cancer patient. We have had the security and peace of mind to know that our treatments and tests are paid for, we can choose our physicians, and some of the best oncologists in Canada available for our care. If we lived in the US, we would probably be dead by now, if not from cancer, then certainly from the stress of dealing with the US medical system. If anyone tries to tell you that Canadians don't like their medical system, it's utter rubbish.
Bob Laughlin (Denver)
But... but... aren't we Americans so exceptional? A misquote from John Steinbeck says something like.... Americans all seem to think they are just temporarily inconvenienced millionaires. We all seem to think we are going to join the ranks of the oligarchs and live lives of ease and luxury. When in reality we are all in danger of being one paycheck away from living under a bridge. We are all in danger of one more whim from the so called president, or any so called president for that matter, of being unemployed with no health insurance and no safety net. Because we buy into the nonsense that we can all pull ourselves up by the bootstraps and achieve the kind of wealth that people like t rump and the koch bothers had handed to them at birth. Exceptional... Ha!
RobertSF (San Francisco)
There have been many studies that corroborate this. When you look at any public good or public benefit that we don't have, the reason is racism. In other words, we don't have universal health care because that would mean black people would get it too. That goes for all the other nice things people in places like Denmark have. We can't have nice things because we don't want to see black people having nice things. It's truly a cut-your-nose thing, and it's truly real.
H (New Jersey, USA)
In the US, the high health spending does not lead to healthy citizens ... or does the treatment make us sick? Average health spending per capita (in USD; data from 2017): - Rank 1: USA: $10,209 - Rank 2: Switzerland: $8,009 - Rank 3: Luxembourg: $6,475 - Rank 4: Norway: $6,351 - Rank 5: Germany: $5,728 - Rank 6: Sweden: $5,511 - Rank 7: Ireland: $5,449 - Rank 8: Austria: $5,440 - Rank 9: Netherlands: $5,386 - Rank 10: Denmark: $5,183 - Rank 11: France: $4,902 ... Source: https://data.oecd.org/healthres/health-spending.htm Average life expectancy (in years; data from 2016): - Rank 1: Japan: 83.7 - Rank 2: Switzerland: 83.3 - Rank 3: Spain: 83.1 - Rank 4: Australia: 82.9 - Rank 4: France: 82.9 - Rank 4: Singapore: 82.9 - Rank 7: Canada: 82.8 - Rank 7: Italy: 82.8 - Rank 9: Republic of Korea: 82.7 - Rank 10: Norway: 82.5 - Rank 11: Island: 82.4 ... - Rank 33: Cuba: 79 - Rank 34: USA: 78.5 ... Source: http://apps.who.int/gho/data/view.main.SDG2016LEXv?lang=en
Sheila Ray (Suburban DC)
Reader anecdotes should be front-page broadcast material. U.S. citizens need to hear that there can be a better way. Then again, those who need to hear it probably don’t read the NYT...maybe the National Enquirer could take up the mantle?
dave (california)
"It has taken me nine years to grow accustomed to the idea that my health care won’t suddenly evaporate at the whim of a new government. Doctors here often ask how I landed in Europe. When I tell them, they shake their heads. American values are deranged, they say." Derangement for sure! They elected a dangerous imbecile as their president.
A doctor in the Americas (Chicago)
I am a physician who works in a public hospital and I have excellent training. I incurred the costs of that training in middle age.....as did my husband, as a second career. We put off saving for retirement, having children and buying a house. Many of my colleagues in this public hospital undertook a second round of training in middle age when they arrived on these shores from their countries of origin as immigrants. I am committed to my work because I see an unending sea of patients who need care (and I'm not in primary care!) Everyone in this country needs excellent medical care.....we could do it if we got rid of the layers in this system that suck up the resources. There is something so peaceful and civilized in reading this essay....it is calming. Do we want to see so many people ending up on dialysis because they didn't have diabetes or hypertension care? This costs the entire society. The controlling entities in this system are not the physicians or the nurses...we are surrounded by layers of rules makers who are sucking up the health care $. And yes, when I go to the doctor, I dispose of the examining table paper in the trash and try to leave the area tidy. I cannot imagine being the endocrinologist who commented that she works until 11pm many evenings on paperwork......soon, the best and the brightest will veer away from medicine and get an MBA, an engineering degree or become entrepreneurs. Who will take care of us then?
MCD (Northern CA)
And don't forget that lovely gift of the GOP & President Bush - the "donut-hole." My mother was perscribed Eliquis recently. It has no generic equivalent. It is pricy. She hit the donut-hole this year and has to pay out-of-pocket several hundreds for drugs for several months because she takes Eliquis. (Actually we, her kids, pay this as she cannot.) All her cardiologist could do to help was hand her 30 days of pills he had from a pharma rep. And those friendly programs drug companies talk about to help those who can't afford their meds are only for those who have "private" insurance.
Robert (Out West)
I’d just point out that an awful lot of the Americans who’re thrilled about their care in France or wherever are fairly privileged: retirees who have the money and ability to pick up and move, people with good jobs, people who just plain have money, and so on. I’d also point out that I happen to have superb insurance through my work (where, let me add, I do rather a lot of union work to keep it that way), and have generally paid less for care than described in some of these gee-whiz stories. Go, Team Kaiser! Part of our prob, here in the States, is that we’re in lousier shape than, say, Australians. And definitely less willing to accept an HMO; some nonsense about individual choice, I believe, even though very very few are capable of understanding their own care and options. Not to mention our propensity for every new drug or fancy! Shiny! Treatment that comes down the pike. I’m all for universal coverage; long live the PPACA, a vital first step. But let’s not pretend that French health care would be a panacea.
Ted (Portland)
@Robert Sounds like you have Kaiser, you’re fortunate, it’s the closest thing to European healthcare we have, but you’re wrong the French as well as the German and Scandanvian systems are much superior to ours, but congratulations keep your Kaiser I had it for thirty years, if only they were everywhere, I would gladly drive five hours to see them but out of area is strictly enforced. They have some of the best physicians I have ever met, including if I may Dr. Holsclaw and Dr. Schpall, in Redwood City, without a doubt the best Opthomologist and Dermatologist anywhere.
JJ (California)
@Robert I 100% support universal healthcare. Not insurance because insurance is a product and healthcare should be a right along with basic food and a dry place to sleep. I also have a healthy fear of HMOs. I have rare, complex birth defect. A combination of the ongoing effects of that and damage from botched surgeries I had as a kid leaves me with ongoing issues. For a time I was stuck with a medicaid HMO. None of the doctors had a clue how to treat me and decided everything I had was psychosomatic. Despite the MRIs showing my metal implants and spinal cord damage, the obvious severe curve in my spine, the clearly visible foot deformities that cause me to need a cane and wheelchair. They did not know how to spell my conditions let alone what was involved with them and they knew I had no other options for doctors so they did not take the time to learn. I am fortunate now to have a doctor who is very young and willing to learn. He trusts that I know more about my condition than he does and we work as a team to address my problems and improve my quality of life so I can reach my goals. He seems me despite my inability to pay his fees becaude he knows that the only other option for doctors locally would either not treat me (many have refused due to the complexity of my case) or would treat me poorly. When we have truly universal care I would like to see a system with some choice and more importantly good doctors who are willing to learn and trust their patients.
Mark (Cheboygan)
@Robert In 2013, the percentage of workers belonging to a union was 11.3%, compared to 20.1% in 1983. That is one of the reason that healthcare coverage in the USA is so lousy
Earthling (Earth)
I was just on one of those European river cruises. As you can imagine, the demographic of the American travelers is pretty old; I was younger than the norm by a good 15 years. I overheard a smug couple from Topeka, Kansas say to tablemates: "We voted for Trump because we didn't like the ACA. We don't care to be paying for people who just want to sit around and nothing." Need I add that these retirees, one of whom occasionally used a wheelchair (i.e. chronic condition requiring medical treatment) were both on Social Security and Medicare, and one of the couple was a military retiree (from a non-combat, non-dangerous stateside job, and not a lifelong one at that) collecting his pension from the taxpayer-funded trough. These deplorables sure didn't mind "socialism" when it funded their cushy overseas travel. But god forbid anyone else should benefit.
wanda (Kentucky )
One of the scare tactics used by those opposed to universal health care is the long wait for doctors. While I do not expect universal health care to be perfect--nothing is--I always wonder what planet they live on where doctors are always available. My brother, who is 53, has diabetes. He passed out after having stitches taken out after knee surgery. He was sent to an emergency room and was told his condition was normal and he passed out because of the sight of blood. His sugar count went up dramatically. Now the whole left side of his body is completely numb and he has difficulty performing daily functions. He has a job to which he must return in February and insurance through his employer. Different explanations have been offered for his problem. Only a GP has read his MRI and saw nothing, though he believes he might have had a stroke (not checked in the emergency room). It will be a SIX WEEKS wait to get into the see a neurologist, which he is told is the next step. Will he be strong enough to go back to work? Health care is extremely expensive in this country, but I struggle to see how it works better, and, of course, he is lucky. He has insurance (at least if he can keep his job). For some people it does not work at all.
Anne (Washington, DC)
Imitation is the sincerest form of flattery, as the saying goes. Many countries have imitated us in outlawing discrimination and in providing public access for disabled people. Our music and movies are hugely popular and also imitated worldwide. Our universities are the envy of the world. (Indeed, the global elite often send their children to universities in USA, thereby crowding out our own kids, but that is another subject.) Our medical care system? No where imitated. Often described as awful and beneath the enviable standards the USA has set in other areas.
Asher Taite (Vancouver)
So glad I married a Canadian and moved to Canada. My husband and I pay about US$80 per month for the both of us for our health insurance (true, it doesn't cover dental, but care is cheaper than in the US).
MED (Mexico)
I have lived in Mexico for decades. I know not much after a sour three years with one of the governments public health care programs, IMSS. If one is a member of the half of Mexican society who live "in poverty", you never see a doctor and instead use herbal medicine. Thing are slowly getting better. However, for me who can pay cash, I find one person working in the doctor's office, the doctor, be it a specialist or generalist. A specialist costs about $35 USD per appointment which one can easily get a day ahead. Something like an echocardiogram is about $90 USD. The same type of specialist I see in the US has seven people in his office which helps explain the cost of an appointment. Not all is wonderful with Mexican medicine however. One often needs to know the language, customs, and expectations in order to get reliable care. It can be a tricky business to navigate.
smtexas (san antonio)
I've been hospitalized in Paris and Barcelona, and my fiancee was recently hospitalized in London. All three hospitalizations were unplanned, but owing to our respective underlying conditions. In Paris, an overnight visit which included the ER, xray, labs, etc cost me about $100 if I recall correctly. This was back in 2010. Six weeks later, I was hospitalized in Barcelona for two weeks after showing up to the ER with an spo2 reading of 81. My course of treatment essentially mirrored what I have done back here in the states, so needless to say the day of my discharge I wasn't scared of my prognosis, but the bill. After tallying everything up (private room, meals, central line access) the total came out to 1300 euros. I didn't believe her and asked to see a receipt. I almost cried tears of joy as I paid thinking I was in the hole for at least $50k. In London although my fiancee did have to pay an exorbitant amount, this was due to us choosing a private NHS service in Chelsea to facilitate her treatment given her condition. The service in all three locales met or exceeded anything we have here in the US and not a day goes by where we don't contemplate living overseas, where the travails of the health care system don't conspire with our medical conditions and monopolize time better spent on living life and getting better.
Larry (NY)
Health Care in the US is a BUSINESS, plain and simple. In most of the rest of the world it is a public trust. No meaningful reform will take place in the US until someone has the guts to call a spade a spade and begin the process of de-monetizing medical care.
Larry (Long Island NY)
@Larry Exactly! And I resent my body being a profit center.
Rob F (California)
The healthcare industry provides a tremendous amount of money to politicians (mainly Republicans) to keep the average American in forced bondage to maintain their profits. For the cost of my Bronze HDHP insurance for a family of three ($20,000) and the deductible ($6,500 per person), I can easily live in Costa Rica or Panama with health insurance. I may have to move out of the United States also.
RichardHead (Mill Valley ca)
Our government is to protect businesses. Medical care is considered a business. Even drug addiction is considered a business. Thats why we allow al of these folks to charge what they will. Until our government accepts that our country democracy is not to protect business interests but to deliver care and safety and comfort to the citizens we will have this problem. French citizens may seem difficult to govern but they demand that they are put first.
mytwocents (Ventura CA)
I'm a vet who served 8 years in the military in my 20's. The VA, for the most part, has provided my medical care until I turned 65 several years ago. Now it's Medicare and my supplemental insurance that handle my medical issues. I feel far less stressed and concerned by any potential medical crisis that may (and probably will) arise in the future. I still work full-time and still cover the health insurance for my wife. I'm a big fan of Medicare for all.
Koen Thomeer (Belgium)
I'm a M.D. (Family Medicine) in Antwerp (Belgium): I get €25 for a consultation (=10-15 minutes) from the patient and he gets €21 back by the national health insurance. (€37,5 for a home visit.) What I want to say: the medical cost is much lower then the US, what also explain the differences between the 2 health systems. I earn +/- the double of a normal worker, so I don't complain.
Jud Hendelman (Switzerland)
The US offers world class health care – but only affordable by those who are fortunate enough to have the means to pay. In Europe healthcare is very good, and it is available to all. I had the best of both worlds when I fell ill in the US. My Swiss insurance covered a sizable bill. When I arrived at the hospital there was more discussion about my insurance coverage than my condition. I was basically told that if I wasn’t covered (it took them 3 days to find out that I was), I was going to die. Of course, the folks in Congress who vote on healthcare issues have coverage that is unavailable for ordinary citizens.
JTBence (Las Vegas, NV)
At the age of 51, I gave myself a junior year abroad in France, Tours to be specific. I was advised at the language school to only purchase hospitalization insurance because medical care was inexpensive. During my second month, I came down with pneumonia. The concierge at my residence immediately got me into a doctor. There was no receptionist or nurse in his office. He examined me, diagnosed me, gave me three prescriptions, and handed me the bill. I paid 20 euros. The three prescriptions were 26 euros. A chest x-ray several weeks later was 38 euros. During the debate about the Affordable Care Act, the Wall Street Journal featured an op-ed piece written by a doctor who pointed out why the French system was the best medical system in the world. He also showed why it can't happen here. In France, medical school is free, so doctors don't owe hundreds of thousands of dollars in loans when they start their practices. French doctors also don't expect to millionaires. The price of pharmaceuticals is negotiated by the state. Finally, the French aren't litigious like Americans, so malpractice insurance isn't extremely expensive. If there is a God, I will be able to retire to France to enjoy the wonderful food and wine, the beautiful countryside, the charming people, and the affordable and efficient French medical system.
karen (bay area)
Great column, great comments. However, may I pose a politically incorrect issue? In the USA we have an epidemic of obesity, morbid obesity, and merely overweight people. They require scooters in grocery stores, are first in line at Disneyland, and incur grave medical costs due to associated health problems. Other countries do not suffer with this obesity, all you have to do is look at photos of Americans traveling in Europe versus European tourists here as evidence. How will this be addressed with universal coverage? Will the costs of obesity increase or decrease? I think this is a fair question, and no-- I am not being snarky.
Cantaloupe (NC)
@karen Until we are willing to talk honestly about issues like obesity, smoking, poor nutrition, and sedentary lifestyles and how they impact health, we aren't going to get ahead of our medical issues. My doctor told me that more than 60% of the issues he treats would be completely eliminated if his patients were of normal weight, ate healthy food, exercised some, and didn't smoke.
Robert (Washington State)
Your concerns are real as there is a diabetes mellitus “crisis” that closely follows the increase in obesity. Unfortunately I think that this is affecting all western and even some non western countries and I don’t think we fully know the cause or causes of this problem. More work needs to be done which I think would be helped by a more comprehensive healthcare system with a more comprehensive data base. One problem that I foresee arising out of the concern you raised is vastly increased medical costs here in the US widening the disparity in insurance coverage and complicating the debate over a nationalized insurance scheme.
Former expat (Nola)
@karen Actually you are being snarky, but that is your right. However, you need to know that a great majority of French chain smoke which helps them to stay thin. The problem is that they don’t believe in second or third hand smoke that has been proven to harm those around them.
Janet (Here And Now)
Beautiful. I am thankful France welcomes Americans without the trouble French people have coming to live in the USA. And treat them as equal citizens, not burden. There’s a lesson to be taken there.
David Andrew Henry (Chicxulub Puerto Yucatan Mexico)
Mexico is amazing...every pharmacy has a doctor's office and a consultation costs less than $5.00. The MD's are young and very well trained. If there is a major problem, they make a referral to a specialist. As a Canadian, it is painful to hear the stories of my American neighbours, where there is anxiety about coverage, co-pays and add-ons. Why is the USA the only industrialized country without universal health care? google henry ford health insurance He gave his workers health care insurance instead of a raise. They were shackled to a Model T. Then everyone got into the act. Private insurers have been ripping off Americans for decades. Economists, listen carefully: does the lack of universal health care impact labour mobility and productivity? Where's the research?
Mike (Milwaukee)
Who was it that cheered during the SC debate a number of years ago for the man that died because he could not afford treatment for an easily treated yet expensive illness? Republicans.
Clairé adis (New york)
You should not have to leave the United States to get health care. This is ridiculous and you are right. People do not realize how much safer and better they would feel if they did not fear going bankrupt in order to stay alive. As a country, we need to do so much better. We need universal health care for all Americans.
Randy Harris (Calgary, AB)
As a Canadian I have trouble making sense of the American approach to health care. I don't understand why having a health system that is available to all is such a bad thing. Why should it not be affordable? Why should any citizen be excluded for any reason? I don't get it. A society is more likely to thrive if all citizens have the means to remain healthy.
gbc1 (canada)
In Canada, the tax rate on income in excess of $150K per year is about 45%,increasing to 53.53% on income in excess of $220K. Spouses do not file joint returns. Mortgage interest and municipal taxes on a personal residence are not deductible. Health care costs (excluding drugs before age 65 and dental) are paid by the government.
Carol (NJ)
Interesting Canada. Haven’t know that before. High tax and no deductions ouch. But not filing jointly probably works out for most I hope. Health is of course most important and in the States it’s is stressful for sure. And expensive !
Mark P (Copenhagen)
How many Americans pay 300$/month for 30 genreic Lyrica Tablets? ???? How many Danes pay 300$/month for 30 generic Lyrica tablets? ALL OF THEM or they dont get the medicine they need! Unsubsidized prescriptions is something you dont want to ever mention!
Nick C (Montana)
The shame and the waste of our healthcare system: an example of profit motive running rampant over HUMAN lives, all in the name of free markets and capitalism. Free markets know best how to make money, not make decisions for the care and health of human beings. When profit motive ultimately makes health care decisions, we all lose. It is absolutely unfathomable how so many voters choose time and again identity politics over economic (or health) self-interest. But, Americans being Americans, will continue to choose to cut their noses to spite everyone’s face. Why does no one speak publicly of the competitive disadvantage our system puts American businesses at? All other developed nations’ businesses don’t have the cost of providing and administrating health care plans; why do American companies remain silent on the issue? I find it morally repellent, especially for a country that battles endlessly over abortion, that we bother very little over those suffering and dying with little or no healthcare. Equally repellent is profit taken at every level of the system. It is indefensible to have vast corporations making money off of sickness and suffering while throwing otherwise self-sufficient citizens into bankruptcy for getting hurt or sick. I am all for all healthcare providers to be compensated well for their talent and compassion, but I vehemently object to administrators and executives earning millions for what—denial of benefits and pumping up the stock price?
North American Citizen (Earth)
I had a valve replacement and my aorta repaired at a wonderful hospital in Mississauga Ontario. I didn't have to wait. The hospital was clean and well-run and the staff were for the most part, compassionate, helpful and professional. When I was discharged, I was visited by nurse to see how I was doing, given a 24/7 phone number to call just in case and entered into a rehab program at a local university. The grand total charged directly to me was under $700.00 Canadian. Every American, regardless of personal wealth, gender or race deserves the same and should demand it of their government.
DaveD (Wisconsin)
France no longer has an empire and therefore not the dozen aircraft carriers we have. It can, and does, spend its treasure on something its citizens actually need.
Peggy Sherman (Wisconsin)
Meanwhile, our representatives in government have the best health care money can buy. Have you noticed how old, yet healthy our Congress is? It's becoming a veritable assisted living facility. And these are the same people who accept big dollars from health systems and drug companies, keeping the rest of us indentured to out of whack co-pays and deductibles that are wildly above the average increase in individual salaries.
Mike Gee (Hudson, NY)
A few years ago I was traveling in Scandinavia and staying at a friend's place. Hundreds of itchy welts emerged over my face, arms, and legs over three days. I had no idea what they were, never before having been attacked by bedbugs. Scared I might be very sick, I walked into a hospital clinic in Stockholm. It was late night, and I was seen right away. After the diagnosis and the provision of a tube of itch cream, the office assistant asked for my health card. When I told her I didn't have one, heads spun and there was a collective gasp. The assistant, nurse, and doctor profusely apologized for having to charge me for my visit. I told them it was OK; I didn't have insurance in the US either, which they failed to comprehend. "But you're an American citizen, yes?" They were still sad-faced when I left the office, each of them wishing me good luck.
Mark P (Copenhagen)
Yes but the system (as in Denmark where I live) spends 90% of its health budget on 10% of professional dr seekers. I would trade my combined public and private supplemental for the worst HMO on the planet. The systems provide a system, but not a "doctor" or a personal accountability to a patient. You roll the dice every time you enter the system. Americans feel they have doctors, europeans feel they have systems... if you are homeless or unemployed it is a lifeline, but for contributors to society, it is a serious downgrade.
SB (Louisiana)
The idea that doctors in US are personally accountable to patients is not correct. Look at the vast majority of people who were pushed into opioid addiction by these same accountable doctors. Personal anecdotes shouldn't dictate public policy.
Candace C (Miami)
You have NO IDEA what you are asking for. Here healthcare is obtained through your job; get sick, be unable to work and you loose coverage. They offer continued emergency coverage for a year when you are unable to work for very steep prices (Cobra), but most can’t access it because their paycheck has stopped. Illness is the LEADING cause of BANKRUPTCY and people can and do loose everything in our greed fueled system. Insurance coverage means little, when for large expenses (ti.e. Transplants) insurance companies exercise their option for ‘preapproval’ requirements for surgery, and ‘study’ your case while your health deteriorates — knowing that healthcare delayed IS healthcare denied. Hospitals will do the surgery IF and only IF you can pay a healthy down payment 100K plus, while the insurance company ‘processes’ the claim. Finally we pay the WORLDS highest cost for prescription drugs, here, with insurance they cost more than Canada or Europe, without insurance. Politicians use ‘poor people’ feeding off the public trough rhetoric to placate US citizens and convince them that our greed filled system is the ‘best in the world’ when we actually place 27th on the list for outcomes! Beyond shameful!
Andy (Paris)
@Mark P The naïveté of his remark is hilarious. Or sad? I hope you never have to find out why first hand.
Leninzen (New Jersey)
Thank you for your insights into how medical care could be in the USA. I'm now on medicare but I remember quite vividly the anxiety associated with job loss and loss of medical insurance. Luckily I had no medical issues but I could have been unlucky. Leaving your healthcare to chance is no way to live.
jo (Jersey Shore )
I was just refused treatment by a urologist for a painful UTI because I did not have the proper referral in place. I waited 3 weeks for the appointment. I did call for the referral -the primary care physician's office did not follow thru with my request. I now have to wait another 3 weeks to see the urologist The receptionist at the office was rude, dismissive and uncaring. When I expressed concern about an untreated UTI she said "call your primary or go to the emergency room" something is very broken in our health care system. we should stand together and demand a change.
PSS (<br/>)
If we ever get the healthcare system straightened out in the US, to provide universal coverage, we may eventually see reciprocal insurance provisions, whereby not only can Americans be treated in France, but a French visitor can receive care in the US. We need to get the for-profit insurance companies, including those selling expensive travel policies, put out of business.
Steve (Seattle)
Ms. Rex, you are alive, you survived, Viva La France.
Mitchell (Colorado)
As a health care economist and an expert in medical reimbursement I can assure you that we Americans are absolute chumps; especially those that believe the lies of those that think a national health system wouldn't work here. What those in the industry know, and what every expert who has studied the problem can tell you is that almost 30% of the money we spend now as a nation is wasted. Wasted on duplicative tests, an administrative overhead of paper and electron pushers, an embarrassment of insurance company profits, defensive medicine and obsessive drug advertising. That 30% amounts to more than $1.2 Trillion dollars a year. Thats not a typo. For the most part, health care providers are not to blame. The system is. And the system we have is not one that was ever planned - by anyone. It's a disorganized, reflexive and arbitrary collection of responses to a "market" in which supply and demand curves are inelastic and invisible. If this country (and especially the Republicans) wanted something better, it would be better. Instead, we're being played for as chumps.
ac (canada)
@Mitchell, a health care economist says Americans are chumps---right on. They pay far more per capita for health care while national health outcomes are far better in nearly all industrialized countries. And that still leaves millions of Americans without any coverage. In Canada our government health care system, while not perfect, covers everyone and provides us with a much better national health picture. Bottom line--NO ONE loses his house and savings because he cannot pay their medical bills. Do we pay higher taxes?--YES Would we trade for your system?--NO While kicking and screaming at tax time, we have to admit that we are indeed our brother's keeper. Why do Americans tolerate a health care system we kicked out decades ago???
Peter Casale (Stroudsburg, PA)
@Mitchell when physicians surrendered health care to businessmen and and politicians the battle was lost.
Tina Schaefer (Pasadena CA)
I broke my ankle hiking in Gap,France in October 2016. The ppl I was with took me to a pharmacy and from there we went to a doctor’s office across the street. I had X-rays and got an orthopedic boot and pain killers. The cost of all that ? About $225. That included consultation and testing and boot and meds. I didn’t have insurance so that was out of pocket but so affordable ! In October 2018 my husband got a bad cough in Copenhagen and as it was Saturday afternoon we ended up at an emergency room since he has heart arrhythmia. He had a viral infection which a blood test showed. Cost of that ? $0. They had no way to take payment as health care is provided to all Danes and I assume their hospital visits are all included. Here in US we have MediCare yet still have high monthly bills and prescription costs. We need a better system. The US is all about money. I wish I were European.
Mark P (Copenhagen)
I am a Danish european resident of denmark with no "bluecard" for free treatment anywhere else in europe. Not sure how they gave free hospital visit in Denmark anyway but from ommision... NOT policy. Consider yourself lucky and not the rule to spread false rumors at dinner parties... and lets look at cancer survival rates PLEASE. The stats say this "much better system" will kill you much faster than any other health providers on the planet. It is NOT on par!!!!
Tom Shenstone (Toronto)
The feeling that one's health care is not going to disappear or destroy one financially is shared in Canada. It makes a host of things easier.
Fred (MA)
Many years ago, while visiting Parisian friends, I got what I thought was appendicitis. 45 minutes of emergency care later, I had prescriptions for food poisoning (oops). My total cost? $25.00 since I'm not a French citizen. My French hosts were truly embarrassed that I was charged anything. I told them not to worry; I had what was considered excellent USA corporate health insurance, and it still would have cost me MUCH more in America. If every American experienced single payer health care once, all politicians would support it.
Nancy G (MA)
I am tired of the difficulties involved in all aspects of America's life right now. This column shows what we should aspire to when it comes to healthcare. And perhaps the very nature of it and its simplicity can be applied to other issues in our land of the free (somewhat ironic now..."land of the free")
michael (Red Bay AL)
Here's a thought I have been mulling for a few years. One of the primary reasons why health insurance issues are so prevalent in the US is due to much of health insurance being tied to employment. Most health insurance in the US is sponsored by employers. This leaves those of us with individual policies subject to the whims of the insurance companies. Too many people who receive health insurance through their employers don't care because they're covered. How about we force EVERYONE to get individual insurance policies? No more negotiated groups would be allowed. If every American had to deal with the high deductible, expensive and poor coverage those of us with individual policies have to endure, I would bet things would change a lot faster. Even the congress critters would have to buy individual policies. Imagine that. This is the first step.
Kurt VanderKoi (California)
What is wrong with this picture? "I moved to Europe because I couldn’t afford to be a cancer patient in America." So you cannot afford medical care in the US but you can afford a move to Europe!
Jen In CA (Sacramento)
A move to Europe is much cheaper than paying out of pocket for cancer treatment. That’s the problem.
Kno Yeh ('merica)
@Kurt VanderKoi You are absolutely correct!!! It is incredibly wrong that a person has to uproot their lives and spend $200 - $2000 for a one-way plane ticket to England because they can't afford the $200,000 price ticket of cancer care for INSURED Americans.
rich (hutchinson isl. fl)
@Kurt VanderKo The cost of for profit cancer care can exceed the cost of moving. to the moon.
SR (New York)
Although the French system distributes what is available more fairly, I will opt for the US if I need tertiary care. The French system is overused by the people and the enormous costs of sustaining this system had led to regular cutbacks and the raising of prices. The moribund economy leads to half of the population paying to support that other half of the country which is unemployed or underemployed. In the long run, the French system, although very good in many ways, will be unsustainable on account of high costs and staggering taxes which are often disguised as "social contributions."
karen (bay area)
@SR, before you scoff at the French system being "overused," better take an honest look at Medicare. Hip replacements for dementia patients, pacemakers for patients who haven't moved off the couch in years, mammograms for women in their 80s and in poor health, cancer treatments for patients reaching the end of their natural life span and already in decline. I could go on and on. Further you have no stats to back up your thesis statement, but I do about our wasteful medicare expenditures. I think most Americans know we need single payer, but are very concerned about all the dollars of care spent on the very ill and very old portion of current Medicare users. That sense of entitlement on their part could be curbed except for the greed of our healthcare participants who wants their reimbursements, and the the sick fear of liability that doctors have about recommending no treatment.
SR (New York)
@karen "Scoff" is your word. I was describing the French system and some of the realities that it faces. It is overall fairer than ours, but with many problems that politicians there do not acknowledge with any honesty. Therefore, they "sneak" more and more limits into the system understanding its unsustainability. Medicare is entirely another problem but is not the subject of this forum. Medicare will likely have to also institute more cutbacks and limitations.
George Dietz (California)
In Portugal, an ambulance trip of more than 40 minutes to a regional hospital, a CT scan, surgery to repair the wound, and a prescription for pain meds cost the astronomical total of 300 euros, or 300 plus dollars. The care was outstanding, the healthcare professionals were just that, professional, but also warm and empathetic. The surgery was first rate. In the USA, you're on your own. We're constantly told by the GOP and their bedfellows big med, big pharma, big insurance, that the US has the best healthcare system in the world. Maybe, if you can afford it. Just maybe.
John Davis (Austin TX)
Under the flag of Conservatism, Americans lie to themselves, and - when they repeat the lie to others - feel confident they are speaking the Truth. These lies have resulted in our own (I know, my perception of a unified community of Americans is quaint and out-dated) people dying, sick and homeless in the streets. We seem to relish causing more suffering on those we view as different than ourselves: be we gay, born abroad, nature lovers, liberal or just not rabid right wing. More and more of us will be leaving this place because of this 'conservative' foolishness, now ruling our land because of a corrupt government, made more corrupt with each new Supreme Court Judge, the repeal of each law that protects us a a collection of Americans who have each others' backs. Being American was a lot more fun on the way up.
Jerry Smith (Dollar Bay)
We have insurance care in the US, not health care. Auto insurance, home owner's insurance, health insurance, dental insurance, optical insurance, RV insurance, pet insurance, life insurance; insurance for everything! And look at how well it all works. American exceptionalism at its worst.
jk (New York, ny)
US will not have universal healthcare in the foreseeable future. For that to happen, Democrats need to get the kind of power they had in 1940s-1970s. But because of democrats' support for illegal immigration, they will never get that kind of power.
karen (bay area)
@jk, who do you think it is who hires all these illegal folks? Democrats? Come on, most of the wealthy corporate operators are die-hard republicans. They like the cheap and silent workforce, they have come to depend upon it. Here in CA-- a blue bastion thankfully-- the ONLY areas that still vote red are the rural areas, where the subsidized big-ag so-called farmers vote GOP, while using exclusively illegal workers. I owned a very small business for 11 years: I conducted e-verify of every new hire. It was easy, painless, and kept my paperwork and staff honest.
Vizitei (Missouri)
Let's face it - this is a story of a "loser". According to the MAGA doctrine, she did something wrong or just got unlucky and now she wants the rest of us to pay for it. Typical socialist. People who are godly, don't sin, go to church on Sundays, succeed in their jobs and businesses, don't usually get into this predicament. And if something bad happens, well then get on Facebook and ask for prayers, and watch all your "friends" respond with fervent confirmations. Our failure to provide basic medical care is rooted in the fact that we are a religious, almost fundamentalists country on par with Pakistans of this world. We just happen to have a modern economy. Most Americans believe in magical thinking, faith based cures, and other aspects of a pious society circa 1919, not 2019.
Innocent Bystander (Highland Park, IL)
Everybody knows there's a better way but willful indifference holds sway, as ever. In America, we always prefer a racket to a solution. Instead of providing a decent basic universal system - as in virtually every other advanced industrial country - our priorities are more focused on country club tax cuts and bloating the Pentagon. Meanwhile, medical bankruptcy is alive and well. The recent Democratic wave suggests that, perhaps, change is on the way. Americans may finally be getting fed up with the corrupt, inefficient nonsense that passes for healthcare in this country.
Janice Badger Nelson (Park City, UT from Boston )
As a nurse, I have so many stories about how insurance issues and discharging people too early caused harm. But my strongest memory about the ridiculousness of our system had to be the 32 year old, newly married man who had put off having a mole looked at as he had to wait for his insurance with his new job to kick in. So he waited and it was melanoma. And it has metastasized. A cruel fate our nation deals out to us on a daily basis. Even with good Blue Cross I had to pay 1800$ out of pocket for an MRI for my daughter. We are lucky that we could afford that. But many cannot. And the hospitals are bad about letting people pay a bit at a time. They will send you to collections. It is so disheartening that we have a system like this. So callous and cruel. Too many people losing their lives, their homes, their livelihood because they cannot afford it when they fall ill. And here is a spoiler alert: we will all get something.
Peter Casale (Stroudsburg, PA)
@Janice Badger Nelson My young friend presented with abdominal pain to an urgent care center who recognized an appendicitis thus transferring him to a hospital. He had laparoscopic surgery in the evening without event & was discharged the following day. His insurance company denied the overnight stay!
My wife and I are SO FORTUNATE to be growing old in California under the Kaiser medical system. Excellent doctors accessible by phone or email and no wait times to see our PC physician with availability of nurse/MD phone appointments for concerns after hours. Specialty surgery is easily available and we live close enough to walk to our local Kaiser MC when going for a routine appointment. Medical records are on line so patients can compare test results from year to year. My wife had bilateral knee replacement last year (surgery was scheduled about two months out) and her total charge including ten days in rehab was the $250 deductible for her surgical hospital admission. Two knees for the price of one and with a top orthopedic surgeon. Three cheers for Medicare and Kaiser Senior Advantage. If we didn't have that, we might have to consider moving to another country for services unaffordable here in the USA.
VKG (Upstate NY)
About 15 years ago, my husband injured his knee while we were running to catch a train to Paris. Fortunately there was an orthopedic clinic just across the street from our hotel. I speak French so I ran over there asking if someone could see my husband. I was told an orthopedic surgeon would take a look at him. The surgeon told me he required €600 before we could go any further. I ran to the nearest ATM, praying that I could take out that much. It worked, thank goodness, and I paid the doctor. His diagnosis was correct. When we came home, my husband had surgery. Our insurance company reimbursed us for what we paid in France, a pleasant surprise. I don’t know what this says about our respective health care systems. I was just grateful that my husband got appropriate care and that my medical French was OK.
Fancy (Oregon)
As we all grapple with the cost of our healthcare, I drive by the Moda Center in Portland, Oregon and have clarity on why it all costs so much: "Moda Health -- a health and dental insurance company that operates in Oregon, Washington and Alaska and started as Oregon Dental Service in 1955 -- agreed to a 10-year contract [for the moniker of what had been the Rose Garden coliseum]. Terms were not disclosed, but the total value of the deal is believed to be about $40 million". That cost doesn't help any of us feel better.
Driven (Ohio)
Good for all those that have left the US for other countries where things are better.
LS (Maine)
Yet again, Americans seem to know the cost of everything and the value of NOTHING.
Peter (Toronto)
On a trip to Tuscany just over a year ago, I tripped over an unnoticed step, put my arm out as I fell and hyperextended the little finger on my left hand. The finger was dislocated and there was a tear across the inside of the finger that allowed me to watch my tendons at work. The Italian medical system provided me with: * a 45-minute ambulance ride with three attendants (I said I’d be happy to take a taxi, but the resort - perhaps fearing a lawsuit - insisted on the ambulance), * a total of 6 X-rays (at 75 years of age, they wanted to be sure of my heart as well as before-and-afters of the finger itself), * 6 tiny stitches to close my finger wound, * a custom-made splint, * a tetanus shot, and * the start of a course of antibiotics. There seemed to be no way for this large hospital to accept payment, but they provided me with complete documentation, and trusted that their bill would be paid when I got home. My (self-purchased) travel insurance sent the hospital a cheque. It came to about $75. God bless universal health care!
JayK (CT)
"Doctors here often ask how I landed in Europe. When I tell them, they shake their heads. American values are deranged, they say." Yes, just look at who we put in the white house if you have any doubts about that.
nub (Toledo)
I wonder what the British thought about an American who moved to their country to get coverage for expensive treatments, after never having contributed to their costs.
Phil (MA)
The British likely thought nothing of it. Citizenship is not a prerequisite since healthcare is considered a basic human right everywhere in the West except in the United States.
Michael Blazin (Dallas, TX)
Is the author just living in these countries or does the author have a job? I assume the latter because neither UK or France are interested in being abodes of Americans “walking the earth” as Samuel L. Jackson stated. If the author has a job, 50-60% tax rate will cover the share.
farhorizons (philadelphia)
Please tell us all how we can ligally migrate to the UK or France, if we are not super wealthy.
Rod Sheridan (Toronto)
@farhorizons You can migrate to Canada, we're much closer....Rod.
Christy (WA)
"American values are deranged, they say." Which says it all. Every other civilized country has universal health care that is cheaper and better than ours. And we call ourselves civilized?
Larry (NY)
The average doctor in the US makes double what the average doctor in France makes. Let’s start there.
Cowboy Marine (Colorado Trails)
@Larry And the average healthcare CEO and top executives in the U.S. probably make 100-300 times what they do in France...oh wait, their system is not run by CEOs...just reasonably-paid public servants instead.
Susan L. (New York, NY)
@Larry And French doctors don't pay a few HUNDRED THOUSAND dollars for Med School!
Cowboy Marine (Colorado Trails)
The biggest joke in the world...and everyone outside the U.S. sees and knows this...is that America is a "Christian nation." It's become a nation of abject greed at the top led and fully supported by Republicans and so-called "Evangelicals."
Peter Hornbein (Colorado)
Capitalism. What a grand notion when one is a healthy, wealthy, white male.
Dianne Jackson (Richmond, VA)
Yes, American values are "deranged." It's time we all admit that.
inter nos (naples fl )
American politicians relinquished the fate of American healthcare in the hands of the vultures and wolves of Wall Street. As an European I had my American companion move to Europe in order to have a life saving surgery , that in America would have caused a bankruptcy having this person lost health coverage on a “ technicality “ . The surgery was performed privately and successfully at a tenth of the cost in USA . “ America “ hates his own citizens , unwilling to provide them with education and healthcare, that are the pillars of a successful and civilized society . Just copy-paste and cut the healthcare system of your Canadian neighbors ...it would be simple , cost saving , just and moral . President Obama tried with some significant success, but american rapacious capitalism is right there ready to take away any humane solution to this humongous proble in order to accumulate more $$$$$$$.
JohnH (Boston area)
I'm treasurer for a small church of about 130 families. Our denomination requires us to pay 100% for our minister's health insurance through a group plan. It costs us $32,000 per year to pay this coverage--about 8% of our total budget. $2,667 per month for a healthy family's health coverage. Refer to the comment from Socrates for how much of this cost is due to our extraordinary inefficiency--our costs are higher than anywhere else in the first world. But the root cause is political. Medicare for all. I already pay extra for Medicare, but I'll gladly pay the taxes to live in a place where nobody needs to fear bankruptcy because of a medical emergency. I guess that makes me a bleeding heart libtard, doesn't it.
J.G. (Denver)
On a trip to France, my husband (age 82) had a ruptured appendix, with an operation in a French hospital. Subsequently his stomach wall gave way and he had a massive hernia, which required additional surgery. In all, he spent eleven days in the French hospital and received excellent care with daily visits from the doctors. The total bill was $14,600. This was eventually covered by travel insurance. When we returned home, he had a thrombosis in his leg, followed by a pulmonary embolism. We rushed to the emergency room where he was seen by several PAs and EMTs, but not one doctor. He stayed in the Denver hospital for about thirty hours. The bill was near $30,000, which was covered by Medicare and personal insurance. The difference is shocking, both in terms of the quality of care and the net costs. Can’t we learn something from the French system?
farhorizons (philadelphia)
Let's see what the newly elected Democrats do about health care. We know we won't get what we need from the big-business Republicans who dance to the tunes of their insurance and pharma lobbyists. Will the Democrats give us what we need and want?
Patrick MacDonald (Canada)
2019. Another year, and still the never-ending debate about American health care. My only comment is this: when I see the premium and deductible values mentioned by Americans, I blink. These numbers must surely be too large by a factor of ten?
denise (France)
I have lived in France for many years and know the health care system well. Five years ago, I learned I had cancer. I also learned that the percentage the health insurance covers for everyone, around 70%, actually increases to 100% without having supplemental insurance in cases of some very serious diseases. It is true doctor’s offices aren’t fancy, doctors never have nurses or assistants, hospitals are very good, but without the luxury I see in the US. Salaries are lower for medical professionals, and medicine, tests, operations, etc, all cost far less. My care here was beyond perfect. I feel very lucky that if I had to wind up with cancer, it was in France.
H (New Jersey, USA)
To add to this discussion, here is an anecdote. My family is from Germany and we live in the US since 2007. A few years back, my son needed a Hernia surgery. A children's hospital in Hannover (Germany) performed the surgery. The bill for the entire surgery was about Euro 850 (about $1,000) which we paid out of pocket. It was significant cheaper than the co-pay and the mandatory deductable if the same procedure was performed in the US with health insurance coverage. We have scheduled another surgery for one of my kids this year in a hospital in Germany for the same cost reason. You don't have to be German / European citizen to benefit from healthcare services in Europe / Germany, and the quality is top-notch.
Kim Carpenter (Los Angeles)
I would like to learn more the exact steps the author has taken to move to the UK and then France. In recent years it has felt that these countries are less receptive to American immigrants or of granting permanent leave to remain. Moving may be a life saving option considering the current political climate.
Rod Sheridan (Toronto)
@Kim Carpenter Check out Canada Kim, we're closer.
Chuck Smith (Omaha)
I lived in London for 5 years, and I continue hear that no one would want to pay the taxes to support a universal healthcare system. But, we currently pay at the very least double, per capita, for our healthcare. This money comes from somewhere, either in lower wages because employers are paying, and/or in higher prices to support this cost. It would take some real planning and cooperation to do this right, all of which is at best years away under the current misinformation and gridlock, but this will happen, simply because there's no other solution. Who are we kidding to think this is somehow free or cheaper at twice the price. The longer we wait, the harder this will become and the farther behind our economy will get trying to manage this extra cost none of our global competitors have.
Denis (Florida)
Frenchman living in the US for the last 20 years here. "... even as a high income country, the U.S. spends more per person on health than comparable countries. Health spending per person in the U.S. was $10,224 in 2017, which was 28% higher than Switzerland, the next highest per capita spender..." (Kaiser Family Foundation). Although the cost is high, the US people have (on a population average) a lower life expectancy, a higher birth mortality, and so on. This is the most ineffective system in the OECD. Obama's ACA is a starting point, not a viable long term solution. The US healthcare system re-design would benefit tremendously from a major OECD economies benchmark. The French system is excellent for care, is a mix of government and private insurance but requires very high taxation. The British system (NHS) provides a decent care but relies entirely on the government, making it pretty close to our VHA, with its good and bad stories. The Swiss system relies on a balanced public taxation and private non-for-profit insurance mix, providing excellent results. All these systems require one essential rule to function: participation from all citizens is compulsory. The same way one is taxed for road building and military means, one is taxed for healthcare. A government shall care for the well-being of its citizens, for security, convenience and good health. All citizens are willingly participating, because instead of waiving a flag, they take care of each other.
Boomer Vet (Greenville SC)
@ Denis what is the VHA you refer to? Did you mean the Veterans Administration (VA)?
Susan (<br/>)
I would move to France just to buy European SPF. Like 30 years ahead of the U.S. Plus the PPD rating which is much more sensible than the vague "Broad Spectrum". Plus my holy grail SPF is literally the French "budget SPF." Like $8 a bottle or something. Yay for eBay. (Plus online pharmacies.) On health care: My husband + I are seriously one accident or illness from abject poverty. Almost any place on the continent of Europe is better than here. Frankly I'd pay 50% or more of my income in taxes if it meant the government actually had my best interests at heart.
Steve (West Palm Beach)
Erica Rex's French doctors who say that American values are deranged are wrong. What ARE deranged are the values of some of the most powerful, wealthy, educated, and sophisticated Americans who try to feed lies to the rest of us about the implications of universal public health insurance. Even some liberals swallow the lies. At the beginning of the Obama era, a left-of-center workplace buddy of mine assumed that our taxes would increase by about $5000/year if Obamacare were enacted - and she supported it nonetheless! We saw no such tax increase, and our employer-based health insurance improved as a result of the reform. My friend has since retired on disability due to multiple sclerosis. I read a poll recently indicating that a slim majority of Republican voters now support Medicare for All. I'll bet they won't for long, once the campaigning for it really begins and the private health insurance industry lie machine goes into high gear.
N. Ray (North Carolina)
This reminded me of something a French friend told me in France last year. We passed a down and out person somewhere on a street. Someone remarked how sad that was. My friend replied that this pointed out a difference between French and American cultures. He said that when he, as a Frenchman, sees a person like this he silently asks himself, "How has the State failed in its duty to this person?" In America, what comes first to mind is that the "derelict" is "probably a drunk", or "probably a junkie", or some such. Either way, it's all about an individual failure, not a social failure. This is exactly why we have inflicted upon ourselves our expensive Rube Goldberg health care apparatus in the US.
Marieke (Le Chesney)
I have a suggestion: how about stopping this talk of "socialized medicine" in Europe (which seems to spook so many Americans) & talk about "solidarity" instead. Because this is what it is all about here. But then maybe the concept of solidarity with your fellow citizens is foreign to many in the States. A few reflections: OK doctors here might earn less but they don't start their careers with horrendous debts. Also advertising for prescription drugs is allowed only for media (journals, magazines) catering to medical professionnels. And generally speaking, money is far less of a God here than in the US.
ZAW (Still Pete Olson's District(Sigh))
People don’t realize, but France’s healthcare system is NOT “Single Payer”, “socialized” medicine. It is in fact a hybrid system - as the article points out - where most important healthcare is covered by the government, but where a lot of people buy private insurance to help fill the gaps. . This sort of “limited Medicare for All” system could be implemented much more easily than the left’s Single Payer proposals. It would put fewer people out of work, require less cost upfront, and make private insurance much cheaper by acting as a backstop to big payouts for serious illnesses.
Liz (Chicago)
@ZAW That system is common throughout Europe, to varying degrees. In Belgium, the basic system covered most of my expenses whilst the employer offered supplementary insurance took care of a private hospital room, repatriation etc.
David Holzman (Massachusetts)
I'd certainly feel better if I didn't have to worry about GOPers taking away my Medicare. We are the most backward of the western industrialized nations.
EmmettC (NYC)
The American healthcare industry, aided by politicians, keeps spewing the lie that this is the best healthcare system in the world. In fact, compared to other developed countries, the US has among the worst outcomes, highest prices, most inequity, greatest danger, etc. We’re not getting what we’re paying for!
J. Holoway (Boston)
It is a disgrace that the United States of America in 2019 still can’t get their act together when it comes to health insurance. Our so-called Congressional and Senate representatives, who continually vote against health care for their constituents, receive the best health care plan curtesy of the American taxpayer. Isn’t that convenient. I have traveled many times to Europe and always discuss our appalling U.S. health care system. The Europeans always just shake their heads in wonder and repeat the same questions. How can the U.S. want to bankrupt their own citizens? Why don’t they believe everyone deserves health care? The difference is that citizens come first in Europe - money comes first in the United States. I would gladly pay more in taxes to have peace of mind that no matter my job, health issues, etc., I would always be covered. I am hopeful that things will begin to change with a new Democratic Congress. It’s time to wake up and demand the same health care for ourselves that our supposed leaders receive.
E Karp (Rahway NJ)
Excellent article thank you. One of the readers pointed out that the US spends more per capital than any other nation. This is true. What is also true is that we spend more public money on healthcare per capita than any other nation. (Public equals total minus private funds). We spend more public funds per capita than nations with universal coverage like France, Sweden, Britain, Canada, Australia, etc. We could cover every American with a universal public healthcare system without spending an additional single cent if our systems were as efficient as France or Canada. see; https://www.visualcapitalist.com/u-s-spends-public-money-healthcare-sweden-canada/
Paul (Brooklyn)
This is our current "slavery" crisis, ie an aberration in this country re our other peer countries. A national disgrace here in America, like living in the Middle Ages re medicine. Like Lincoln, concentrating on saving the union, even before ending slavery, the democrats should make a universal, affordable, quality health care plan their greatest priority above all else. Don't concentrate and dogmatic, social engineering issues that either the public is not ready for or outright against. It may not work in the next two yrs., because of the republican senate and Trump but if the democrats play their cards right and publish/expose the names of any no votes for health care they have a very good shot of taking all three branches where they can either save ACA or improve with a plan like all our peer countries have. Nation Health care is even popular in purple and some red states. The frontal assault on ACA by the republicans but still alive proves it.
Dave Martin (Nashville)
Would the average American family,be willing to pay for a national health insurance through payroll deductions, at 1/4 or 1/2 the cost of their families current monthly premium? My guess is yes. Oh! Wait a minute the naysayers will cry out that’s socialism, what most Americans do not get we are a socialistic society. We have public education, government sponsored healthcare , VA , Medicare, 2million Federal employees, elected government officials and employees pensioned and provided healthcare for life, partially at taxpayer expense. Private healthcare insurance, you can think of it as another tax, “ cannot live without it” The hospital business is the big gorilla in the room, with all the side service businesses that have been developed to control healthcare dollars, a national healthcare program might force these companies to adapt or close their doors. There is no easy remedy to the current situation, what we do know the current situation is not sustainable.
Reasoned And Rational (California)
Most people are unaware that in the United States, people do not have the legal right to healthcare.
FJG (Sarasota, Fl.)
American capitalism screams the dreaded word 'socialism' at each attempt to introduce universal healthcare in the U.S.. No matter what the facts, a large segment of our citizens equate humane healthcare with being unpatriotic, because a vast propaganda campaign has been suffocating them with false information. The cost of human suffering and wealth, associated with U.S. healthcare and drugs, is quasi-criminal.
Jo Ann (Switzerland)
The main problem in the USA is the habit of calling in the lawyer after the doctor. My father was a medical professor in the States for several years and I was aghast when he refused to stop after we came upon a terrible car accident. Back home he helped anyone in need often free of charge. “I can’t stop. We wouldn’t survive,” he told me, explaining the suing business.
crankyoldman (Georgia)
Yes, the American system is perverse. Take HIPAA, for instance. The whole point of enacting this law was to make it easier for people with pre-existing conditions to essentially commit fraud. If insurance companies don't have easy access to patient records, it's harder to deny coverage based on pre-existing conditions, unless someone admits to it. It's insane that people are forced to hide their medical histories out of fear of financial ruin.
Justice Holmes (Charleston)
Americans all know by now that the only Americans who have stable health care are billionaires and members of Congress! As they attack health care for Americans the Republican members of Congress enjoy not just health care but also pensions for life! We live in a country with an aristocracy of mean spirited and cruel aristocrats who don’t even exercise nobless oblige. They only have obligations to their big donors. The American people don’t matter.
DanielMarcMD (Virginia)
Continue to trash our US healthcare system, and watch as doctors continue to flee medicine. Our problem is not the quality of healthcare, but how it is paid for, which is a huge bureaucratic mess. Better fix that first, or the lines to see your friendly doctor will be out the door and down the street.
DLP (Austin)
If France is so wonderful why is there so much unrest about social inequalities? Mr. Macron should be sent this article. It might ease the sting from the Yellow Vests during his last term in office.
Jcc (Paris)
France yellow vests protest has not much to do with French system per se. It is more linked to a mix of fear of the future , globalization, climate change and digitalization in which people own children will probably live worse off than their parents. At the same time the 0.7 %who own 40% of world wealth get richer and richer. When people feel they are robbed of their future, they tend to act aggressively.
Prairie Otter (Iowa)
The author dismissed the question about how she got her health insurance in France, but it isn't a silly question. It is a very reasonable one. Foreigners on certain visas have to buy their own very expensive health insurance. Getting the "carte vitale" is not an option for every foreigner in France. The French are, in fact, very much aware of immigrants coming to France and using a health care system that costs them a lot. It is 14% of government spending in France. Their taxes pay for it, which is why Ms. Rex receives affordable care. So could you explain how you managed to get the carte vitale?
WishFixer (Las Vegas, NV)
Well. good for the author, but what about Americans who don't have health insurance and won't ever be getting any.. The millions. What happens to them when they get a chronic illness? How do they die? Where do they go to die? Seriously, there are MILLIONS of them. What is happening to them? American health care is like American war, the media is complicit bcz it sanitizes the stories it tells. American reality is much worse for millions. It certainly isn't the myth exported by Hollywood.
Clarice (New York City)
I took a solo trip to the Loire Valley this summer. I was stupidly wearing new hiking shoes, not broken in. Rushing across the vast Gare du Nord to get my train to the country, I felt a sudden sharp pain in my left calf. I could barely walk and immediately thought I had a blood clot from my long flight. When I got to Angers, my destination, I took a cab to the emergency room and explained (I speak French, which helped) my situation. All the ER asked for was my home address and passport number. 3 doctors attended to me, including giving me an ultrasound. They prescribed a blood thinner and told me to get a more detailed ultrasound the next day (that doctor assured me it was just a muscle cramp--the waiting room situation was as described in this essay). The emergency room visit cost 14 Euros (yes, 14--I just got the bill). The detailed ultrasound cost 85 Euros (paid in cash). The blood thinner cost 29 Euros (paid in cash). I was able to move happily on with my trip, without having broken the bank, and having been treated well and respectfully by every medical professional I met. I paid cash at the second ultrasound and pharmacy, and was billed 14 Euros by the Angers emergency room. I kept thinking that if I had been a French visitor to the US, I would have been billed thousands of dollars and probably would have been treated poorly as a visitor. I completely understand why the author moved to France for the medical care.
KEOB (Idaho)
American’s pay the highest price - compared to our Western counterparts - and we receive least in healthcare. Republican Politicians tell us that Socialized Health Care is bad and that citizens of countries who have it, hate it. However, all conversations I have had with citizens with Socialized Health Care love it. Why would Republicans lie?
Liz (Chicago)
@KEOB Not only that, the US 1% receive the best healthcare in the world because our inflated doctor salaries attract the world’s best physicians and surgeons. Needless to say, Mayo Clinic and the likes are not in our networks.
Rod Sheridan (Toronto)
@KEOB Republicans lie about it because they own stock in the very profitable health insurance companies, and because they don't believe in society. The US could provide single payer healthcare for all, and save money as well.
Steve (Westport)
Everyone seems to loose the fact that we have the greatest and latest aircraft carriers in the world. There is not a single country that can hold a candle against our military. The other socialist countries just have their priorities all mixed up. Free higher education on top of universal health care - how outrageous!
Edie Clark (Austin, Texas)
On our adventure trip on a riverboat in the Ecuadorian Amazon we had taken a motorized canoe to an ecotourism lodge run by indigenous people in a small village. A member of our group complained of a painful, infected ingrown toenail. No problem, our Ecuadorian guide said. She could get it treated by the doctor at the clinic in the village. Doctors staff these remote clinics by working 2 week shifts, he explained. While we climbed up an observation tower to view exotic toucans and listen to howler monkeys calling, the doctor at the little clinic removed the offending toenail, and sent her on her way with instructions, and a supply of antibiotics and bandages - no charge. In Ecuador, healthcare is free for everyone.
rich (hutchinson isl. fl)
Trumpcare is all about "freedom" 1. The "freedom" to go bankrupt and lose one's home because of a serious illness or accident in your family. 2. The "freedom" of the insurance vultures to deny you insurance, or cancel your policy when you get sick. 3. The "freedom" for taxpayers to pay the $2000 when the uninsured go to emergency rooms instead of $100 for a doctor visit. 4. The "freedom" of the nation to spend 17% of GNP on healthcare, with poorer results than every other industrialized nation who are paying only 10% 5. The "freedom" to keep uninsured children from receiving the early care that might prevent us from having the taxpayers support them for the rest of their lives. 6. The "freedom" to keep working in the same dead end job because your very sick wife, husband or child will not be covered by a new employer's healthcare policy.
Susan (Boston)
Health care in the US is a for profit business. That's the difference.
ALB (Maryland)
Seems to me the author could have moved to Massachusetts and been covered under RomneyCare ("An Act Providing Access to Affordable, Quality, Accountable Health Care").
Mglovr (Los Angeles, ca)
The craziest lies are about profit and greed.I have been in Foreign countries where I couldn’t speak the language, but the Dr. & I communicated through a third language, and the only problem was when I asked how much to pay (he was insulted)If our system is so great why does the rest of the world do it different? Everywhere I’ve even gone I made it a point to ask, and NO ONE does their citizens so dirty. With 2-3 lobbyists per member of Congress, the lies are many, and the most-used one is about the taxes you’ll pay. We pay the most, receive the least and hundreds of thousands die annually due to greed. Our taxes go to war, past, present and future. At least the French get a medical system. You get the DR. even if you’re unemployed. It’s not like the tax man has an office in the hospital
Ted (Portland)
My first comment is where do I sign up, seriously I don’t understand the “sponsorship”? My personal experience with American medicine can best be summed up in a word, horrible! Most recently, last year, I had a routine colonoscopy, it was obvious the doc was way overbooked as I watched him going from room to room and the patients were wheeled out after about eight minutes, there were several of us in a large room laying on gurneys waiting our turn. Three hours later I was in ICU undergoing an emergency surgery for a perforated colon, eleven days later I was released, fifteen months later I realize there are permanent changes to your life with eleven inches of your colon removed, not pleasant. Yesterday I received a “final bill” after believing the $140,000.00 plus matter was resolved, it was not that large but enough to put me over the top, I’ve had it with American M.D.s and their Wall Street owned hospitals and practices, lawyer time. Additionally, In rural Oregon where I now reside(the surgery was in Florida), I have been unable to get an internist for four years, due to being on Medicare (with a supplement), since the ACA, when rates paid were reduced to help fund those without insurance, docs are required to take only so many seniors and they cherry pick, you have to fill out ten page questionnaires before seeing the doc, if you have any issues good luck, then they politely tell you they aren’t taking new patients. Look into it b4 you move to that cheaper area.
Andy.dB (Sherbrooke, QC, CA)
I wish this story had appeared on the front page, in prominence, highlighted etc. as a public service announcement, not to mention selling more newspapers! A well written article that stands on its own. I wish her well.
John lebaron (ma)
The part of this op-ed that struck me was the comment of the French doctor about how deranged American values are. We don't even realize this, captivated as we are by the nasty partisan rhetoric that surrounds health care and every other public function in this country. What worries me is that the rest of the civilized world seems poised to follow us in our plunge into political insanity rather than the other way around. Meanwhile, sick people get unnecessarily sicker and die prematurely.
JackC5 (Los Angeles Co., CA)
Life is certainly better when you can get free stuff. But in the long run this is not sustainable.
H (New Jersey, USA)
@JackC5 It's not free. "A premium is deducted from all employees' pay automatically. The 2001 Social Security Funding Act, set the rates for health insurance covering the statutory health care plan at 5.25% on earned income, capital and winnings from gambling and at 3.95% on benefits (pensions and allowances)." Source: Wikipedia: https://en.wikipedia.org/wiki/Health_care_in_France
Rod Sheridan (Toronto)
@JackC5 That's true Jack, however all the other western countries have better healthcare, for all their citizens for less cost. That's why the remainder of the western countries can't understand how Americans can be so stupid.
Thop (San Antonio)
Why are the Republicans so against people having health care? I heard one person explain it in basic capitalistic terms: the corporations/capital class need healthy workers, so you have company sponsored health care, if you can't find a job, then no healthcare, once you retire or get seriously ill, you are no longer productive, so they let you die. Makes sense when you think about it. Why do we accept this, as a society?
manta666 (new york, ny)
A dear friend suffered a return bout with cancer in France. Though an American citizen whose marriage to a French wife had ended in divorce, he received the full benefits of the national health care system - including a Europe-wide search for a bone marrow transplant. In the US, under similar circumstances, he would have been kicked to the curb.
George Shaeffer (Clearwater, FL)
Health care throughout the rest of the world is incredibly less expensive than in the US. When I got a bad case of diarrhea in Thailand, I ended up in the hospital for 4 days. Two doctor visits a day, nurses and nurses aids, private room, all meals & meds - short complete care. When I went to check out, 1st thing that happened was 20% discount on the total bill. The remainder of the bill was about $850. One cannot walk into a US emergency room for anywhere that little. While I was in France in April 2018, I developed a low blood pressure issue and kept fainting. A full day in the emergency room, plus some cranial imaging because I kept hitting my head when I fell, visits by multiple doctors, including the one who diagnosed the problem correctly, and the total bill (which I didn’t have to pay until they invoiced at the end of the month, was €341. I don’t know exactly where all the costs are coming from here in the US, but we are clearly getting screwed. George Shaeffer Clearwater, FL 33767
D. Ben Moshe (Sacramento)
And still, the profit driven US medical industrial complex (composed of the predatory triad of pharmaceutical companies, insurance companies and large hospital systems) continues to successfully propagate the self serving myth that socialized health care systems almost everywhere else in the world are disastrous. A quarter billion dollars spent by them annually lobbying Congress insures that their gravy train stays on track.
kmgh (Newburyport, MA)
I work with Canadian artists, who have viable businesses. They constantly tell me they would be bankrupt or would have no business of their own if they had to pay for health care for themselves and any employees the way the Americans do. One reason France and other European countries have less expensive health care is because they invested in computers, software, and a national health care card, much like our social security cards. They found efficiencies in administration that we don't even bother to look for here. As a self-employed person with a family of which one member is disabled, I would love universal health care. Maybe some of those big tax deductions for the rich and corporations could end so that taxes could flow towards helping We the People.
David Kannas (Seattle, WA)
While traveling by car in France in 1999, I developed an eye infection. When it became apparent that driving might become impossible, I stopped at one of the green crosses that one sees along the road side and throughout France and other European countries. I went in, and using my limited French while pointing at my infected eye, the woman behind the counter expressed concern, then went to a cabinet where she withdrew a box of vials containing a liquid. The cost to me was ten Francs (The Euro was just starting.). I returned to my car and applied the first drops. The effect was immediate. Within a few days my infection was gone. No appointment, no waiting room, no surly desk person. Small, I know, but a huge impact on me. I just wish it were so simple here.
Bruce Gunia (American expat in France)
My wife and I have been living in France for 6 years now and have never bothered with a carte vitale mostly because we don't need it. Most of our expenses are far less than the copays of our American insurance which we were required to have as a condition of our residency permits. The health care system here is viewed by most impartial judges as the world's best and, yes, taxes are higher but on balance we spend less here than in the US. Most Americans seem to have bought into the idea that everybody not having to worry about unforeseen medical expenses driving them into bankruptcy will somehow turn the country into a Stalinist gulag. The view from our window is substantially less bleak - and cheaper to boot.
Jeremy Ander (NY)
It is my fundamental belief that nothing will change as regards to healthcare given the politics and special interests involved unless something totally radical is done. The only way forward - and we are large enough in terms of our population, our wealth and our economy to do that - is to offer both universal healthcare and the private insurance that we currently have. A person should have 3 times in his or her life to make this choice and has to be stuck with the final choice for the rest of their life. First time - when the parent makes the choice for the newborn. Second time - when the child reached adulthood at 18 and make the choice Third and Final time - at age 30. The first and second choices should be penalty free and the third choice should carry some penalty. If choosing universal care, taxes should be appropriately levied for those who choose this option. Any federal appropriations above and beyond for funding universal care should result in a similar appropriation to a private insurance fund that can be disbursed to those who chose this option - including premium support, emergency care etc If no choice is made, an automatic enrollment in universal care should happen. Yes, I can think of several holes in my reasoning, but can you honestly think of any other option that will work or succeed given the misplaced antipathy to universal care for a section of the population and vested interests? It is time for people to be given a real choice.
Elyssia (Massachusetts)
If we were honest with ourselves it would be apparent but rather then ensuring people's health, we are creating an endless bureaucracy that is expensive an ineffective. Not only is it detrimental to people's health, it's incredibly detrimental to the economy. Many people stay in limited jobs to maintain their health coverage, only to find out that such coverage is limited. What a waste of human capital......
Craig Johnson (Expat In Norway)
The ‘freedom of choice’ in health care in the U.S. that conservatives boast of is a false one. Freedom to have a heart attack and be taken to an out-of-network emergency room, and wind up with a $100,000 bill. A couple working five jobs to pay for having a baby. Etc. True freedom is an inclusive public health system.
Thomas (Minneapolis)
I had a heart attack in France (Chartres) on 12/8. The care was A-1, the staff could not have been nicer. An ambulance ride, 2 nights in the hospital and heart surgery (a stent) - total bill: $2,500. What's with the U.S. healthcare system?
Liz (Chicago)
EU passports have never been more valuable. If anyone in my family gets chronically ill, we’re hightailing it out of here. The late stage US capitalism, characterized by raw greed at the expense of everything and everyone, is now barely tolerable for the upper middle class with decent private insurance. When our food chain is no longer safe because of heavy metal contamination and unreported pollution, watch the brain drain that will end the US economic dominance.
ssgardens (Marina, Ca)
I am 60. I am self employed and have paid my own health insurance premium all of my working life. At the beginning of ACA I received no benefit because my household income exceeded the threshold for a subsidy. This did not mean I was a wealthy fat cat. It meant my husband and I were in the middle class donut hole for government help. In 2017 when my $6500 out of pocket deductible insurance plan went up 40% I decided I needed to work the numbers and reduce my income so I could have some government assistance with the cost of the premium. I no longer believe we will have Medicare for all. As long as the majority of American families receive their health care through their jobs it will never happen. These families may be experiencing some higher out of pocket costs but those expenses are nominal compared to the scary world of the individual insurance market. I believe that large number of pre-medicare consumers want to retain the safety of the employer provided health care systrem. And remember, those health insurance premiums paid for by the employer and the portion paid for by the employee are all pretax money and provide a fabulous tax break for both the employer and the employee.
lou (Georgia)
@ssgardens Even people with employer provided insurance still get big bills. Co pays and all the other out of pocket hits add up and more and more things are questioned and denied. Not to mention the tier system for drugs, if the drug you need is even on their formulary. Everyone is worried now about how countries that pay workers a lot less than the U.S. are taking a lot of our good jobs. Jobs that had health insurance. And this also results in an anti-competitive environment for our industries. It is a drag on their bottom line, having to fund insurance for workers. Add this in to all the other downsides of the U.S. healthcare system. I am really tired of the greed that has so distorted the purpose of healthcare.
Bobby Clobber (Canada)
" . . . . . . Too many Americans do not realize how much better off they would be if they felt safer about access to medical care. . . . . . " Where universal healthcare exists, not even right wing politicians dare talk about replacing it with an American-style medical system lest they be wiped out in polling. Nothing is perfect and everyone in places with universal healthcare seem to have some sort of complaint about it but there is generally complete agreement they would never want to devolve into the medical care system America has. If no one else wants the American medical system, why do American's persist in re-electing politicians who reinforce it or make it even more difficult?
Theodore Seto (Los Angeles CA)
I have used the medical systems of Britain, the Netherlands, and India. All are superior to ours. We in the US are obsessed by the need to make everything profit-driven. "For-profit markets make everything better." Well, no, they don't; and we are suffering for our market obsession big time.
toni (costa rica)
I'm an ex-pat living in Costa Rica. My choice to live here stems from the fact that my sole source of retirement money - social security - would not allow me to live with any sense of security regarding the ability to meet my bills or be able to afford medical care. C.R. has universal health care. It's not the world's best, but if I need to see a doctor, have routine medical exams, fill a prescription, get an x-ray, and so on, I'm covered. A couple years ago, a severe medical condition had me in the hospital for nine days. No one asked to see my credit card and the care didn't cost me a dime. Yes, I have to pay into the system, but it's less than $80 a month. Private care, such as dental and vision, is also first rate and way below US prices. Why is it that a Central American country can afford to offer better care to its citizens than the USA? I blame it clearly and simply on US politics and the inability or unwillingness of politicians to understand the plight of the common woman or man.
njglea (Seattle)
Yes, toni, some people have no choice. However, I was living in one of the wealthiest, most highly-educated areas in the world in the early 90s and the wealthiest there were planning to move to Costa Rica for free health care. They did. It makes me sick. Don't work to make things better here just steal as much as you can then run away to a country where you can steal more.
Phillip J. Baker (Kensington, Maryland)
The reason ALL of us have to pay taxes to support social security, Medicare, and Medicaid is that these programs are viewed to be part of a SOCIAL COMPACT. We pay for these services, that are available to all, so that they will be there for us when we grow older and need them more. A Medicare for All program would be a splendid addition to this compact, one that could easily be financed if the cap on social security taxes were eliminated , physicians would work for a salary rather than on a fee per service basis, and the government could negotiate drug prices and the costs of other services/devices etc. Since there would be no profit motive for such a system (no dividends to pay to stock holders, or bonuses for executives, or advertising costs, the total tax on an individual would be the same -- or perhaps only a little more -- than what one now pays for social security + medicare+ a supplemental health insurance plan. This would indeed be affordable medical care. It makes good sense and is hardly a radical idea since so many developed countries have such programs that deliver excellent medical care at less than what we now pay in the U.S.
Jonathan (Oronoque)
@Phillip J. Baker - Eliminating the cap on SS would only collect a tiny amount of money, since very few individuals make more than $120K. My estimate is around $30 billion, but I might be off $10 billion one way or another. In order to provide Medicare for All, we'd need to raise about $2 trillion. You've just raised 1.5% of that.
paul (st. louis)
actually, most experts agree that eliminating the cap would "solve" any concerns with social security financing for the next 50 years. Medicare is a bit trickier, because our health care is so expensive
Jonathan (Oronoque)
@paul - I don't know where you found your experts, but we currently collect $980 billion a year in SS tax. Adding another $30 billion would certainly help, but it wouldn't come close to wiping out the deficits.
Thop (San Antonio)
Here are some thoughts from my 55 year old relative who has just retired (actually, the company he worked for at a high management position and had a small ownership stake in was purchased, allowing him to end 15 years of 12 hour days, but he is "comfortable" and not wealthy), is married, and has a grade school age child. He broke his foot, and is on an ACA plan. His comments are a great compilation of what our disastrous healthcare insurance system forces on us from both a financial and psychological standpoint. Two parts: 1. Open enrollment is now underway for 2019 and I received a letter from our current ACA provider stating that our current policy will be offered again through the ACA next year but my monthly premium (the part I pay after the Fed sends their subsidy payment) will be increased by +62%. Yes, you read that correctly, they are raising my annual premium by +62%. I've seen my share of +20% increases when I was working but this is akin to loan sharking! I had already poked around on the ACA website this week and found a similar policy to what we have for about the same money each month but.... it includes a $15K deductible! That's more than double the $6K we currently have in place and its through the same provider. So unless I want to more than double my current deductible, I will be required to increase my monthly payments by +62%.
Thop (San Antonio)
@Thop Continuation of comments: 2. Having said that, 2018 was an above average medical year for us with my foot, visit to the ER and numerous doc visits for {his child] and we still didn't begin to even approach our current $6K deductible so who cares if they take it to $15K. I've come to the conclusion medical insurance is more about protecting your family's financial health versus your actual physical health. $15K would be very annoying to us but we can absorb it should a worse case scenario occur. What about those that can't and are forced into bankruptcy on a daily basis? How this isn't the number one issue of our time is beyond me but let's keep talking about dangerous immigrants and sending armed troops to the border for photo ops. Insanity. ****** Additionally, his child had a rare blood disorder that she essentially “grew out of” over the course of a year or two, but the regret taking her to the doctor, who correctly advised a “wait and see” approach, because of potential “preexisting condition” issues for the rest of her life, should that protection be roled back, as the GOP hopes. People just should not have to think this way about healthcare.
Anjou (East Coast)
I'm a physician and also disgusted by this "deranged" system. My patients span all walks of life, from homeless people, working poor on Medicaid and the wealthy with private insurance. All of them, including the wealthy, are one serious illness away from complete financial ruin. No one should lose their home, their savings, their lives, due to the exorbitant cost of medical care. It is just sickening. Some doctors do make huge sums of money in the US (myself not included, as a hospital employed pediatric sub-specialist). Even many of those high earners are frustrated with their lack of autonomy, mountains of paperwork and data entry, malpractice insurance, and other costs. This system no longer works for the average physician - the only ones pleased as punch are the insurance companies, hospital administrators and pharma execs.
Jonathan (Oronoque)
@Anjou - I did a quick web search of 'hospital-employed pediatricians' and checked out the salaries. While your pay may be low compared to other doctors, you still are in the top 2% of all workers, and make about 6 times what the average employee makes. I'm not saying you're not a fine doctor and worthy chap, but when you multiply that by the 1.1 million doctors we have, and then let everyone else in the medical industry base their salaries on what doctors make, then you get a pretty large bill of costs. Of course, here in the US, we pay educated professionals very high salaries compared to everyone else. It's the same thing with top lawyers, executives, and IT workers.
Anjou (East Coast)
@Jonathan The average plumber in NJ makes about $70K. I make twice that. I don't find that ratio unreasonable given the time and money I have invested into my profession. I didn't even start working until age 31 after all of my training was complete. I'm not arguing that there isn't room to reduce some of the bloat; I just want to point out that while all doctors do relatively well considering average US salary is about 44K per year, and I am certainly grateful for what I have, not all of us are uber rich.
Tricia (California)
One need only look at the dysfunction in DC to see that they are all playing ego games with no real regard for the citizens. Then look at the insurance companies and the pharmaceutical companies, with the greed showing front and center. The US is in a very rapid decline overall. Perhaps we having living a myth for years. So many expats living elsewhere in retirement.
njglea (Seattle)
Imagine that. Doctors actually healing people. I went to a catholic emergency room in one evening in November because there was a piece of chicken lodged in my throat and it wouldn't budge. I could breath and talk but could not swallow. They kept he there over four hours and tried a couple of "relaxation" drugs for my esophagus . When that didn't work they called in a team of "specialists" to remove the chicken. The doctor simply pushed it down my throat with a scope. I got the Medicare bill summary the other day - over $10.000 dollars. Tax free. It's nothing but fraud. Our entire health care system has become corporate/academic/research/insurance welfare. We can't afford to have universal health care until they are all cut off. President Obama's administration made great strides in finding and prosecuting provider fraudsters and it must continue on a grand scale to get things back under control. Those will be some great government jobs for OUR new regulatory agencies.
KCox . . . (<br/>)
About 15 years ago I was CEO of a software company --via merger-- half based in Montreal and half based in Philadelphia. It was sort of a controlled experiment in terms of employee benefits, including healthcare. The results of the experiment? I was initially concerned about the socialist orientation of The Province of Quebec --which even more left-wing than the rest of Canada-- in practice I found it to be an entrepreneur's paradise. In the US renewing our health insurance was a nightmare. Our choice was top of the line coverage to retain talent and let people focus on work. Every year we found ourselves paying substantially more money but still forced to pick and choose what awful health conditions to cover and not cover. Corporate executives making these choices never made sense to me . . . surely there's somebody more qualified I'd think. In our Montreal office, our employees got comprehensive coverage that, by and large, they liked. Approximately 75% of the cost was absorbed by employee payroll deductions. Did they like that chunk of their pay check going to the government? The answer --surprising to Americans that have been drilled endlessly on how evil and incompetent the government-- is that yes, they actually thought they were getting fair value for their money. Meanwhile, the bottom line for the corporation was positive: our Canadian operations had better coverage, happy employees, and it cost my shareholders less. What's not to like in the Canadian model?
Michael Fine (Rotterdam, NL)
Our situation is similar. I'd been working in the Netherlands for several years with every intention of returning home to the US when I retired but we received a grim surprise when my wife was diagnosed with Multiple Myeloma. We were fortunate to live in Rotterdam where on of Europe's top specialists heads the program for this incurable blood cancer. I still remember going to the hospital office fearing that somehow, insurance was not going to be there for us, temporary residents. At the office, they quickly assured me that I had nothing to do except help my wife get better. She has had world class treatment and we have never seen a bill. Since then, we have become permanent residents - one step short of citizenship - but it has made no difference. Why does the system work? 100% inclusion of all legal residents. If you don't purchase insurance - there are a variety of plans and all are very affordable - the government will purchase a basic one for you and take the money from your bank account. If you are poor, they will subsidise your insurance. If you are illegal, you do not qualify for treatment other than emergency treatment. Of course, we pay high taxes to sustain this but I find it fair and equitable (and also appreciate having a first class public transportation system. I haven't owned a car in over a decade.)
Carol (Key West, Fla)
Yesterday, I went to pick-up my monthly prescription for Cor-Reg 10 mg. January 2, of a new year, one month supply was $248.00, usually it's about $110.00 monthly. I asked the Pharmacist what would happen if an individual couldn't afford this medication, he said they would do without. That is precisely, healthcare in America. The Republicans mantra is that we have the "freedom" to chose and pay for our healthcare. Too bad, if you cannot afford it.
M. Caplan (Near Toronto)
Years ago, I immigrated to Canada with my Canadian husband. I have always appreciated Canadian healthcare and have had many arguments with my American relatives that have believed the lies that were told. I have a husband who has had Diabetes since he was 23 and is 69 now and in reasonable health. In February, I am going for my 5th operation related to colon cancer. No waiting, excellent care. I recently added up the cost of the tests I had this summer if I still lived in the US and it was over $20,000. However, to have Universal Health Care in the US, a few things need to happen. 1) You have to want to pay taxes. Increases in taxes there need to be fought, increases here means more services for everyone. On the whole, we do pay less tax, but if one adds the cost of health insurance in the US, you pay much more than we do for less care. 2) Malpractice laws need to be changed and the huge settlements have to be limited. Do you have any idea how expensive your Doctor’s malpractice insurance is? Here, it has to be proven. There are none of the gratuitous suits here. 3) You have to stop being so selfish. You need to be your neighbor’s keeper because someday it may be you. I spent decades being very healthy, now I’m not. Someday, this may be you. And 4) In Canada, a medical degree is not a license to become super rich. Doctors get paid well here, but not super paid. Until these issues are addressed, I don’t see Universal Health Care in your future.
MK (Stiege)
I'm a dual US , CDN citizen and I have direct 20+ years experience EACH with CDN health care, insured and uninsured health care in the US and now Medicare. The Canadian system(s) - (1 for each province) and Medicare system do have limitations, but they are a far sight superior to what the US population as a whole can access. The existing regime makes US business uncompetative (if they provide insurance), cripples the public financially (unless your in Congress), and fattens the wallets of politicl lobbyists and donors on a scale unreplicated in any other jurisdiction. It is, a legalized form of corruption.
Jonny (Bronx)
Reading the comments below, as well as the author's, tell a story of difficulty and pain. It's also a question of public choice. And every commenter is a member of this public group. Health care costs money. Why it costs more than in Europe is a multifactorial story of big pharma, insurance companies, and lawyers. If WE want change, here are some ideas: 1. The secret about drug prices is that in the US we actually fund european health system by our tolerance of high drug prices, so big pharma can charge them cost while we pay the years of R & D. Want a change? Cap drug prices at 50% above average European prices. That will both lower our drug prices, and bankrupt Europe. 2. Cap the profits of private insurance companies at 5%. The howl will be incredible- from people on this list who have their pension funds tied to health care stocks. 3. 5% of health care is defensive. That is equal to greater than 1% of the GDP of the USA. Real tort reform is needed now. But that also will be defended buy commentators on this list. These suggestions are just a small list. It's just a question of priorities- will each of us- ALL OF US- accept the rise in taxes of 156% MORE than we are paying now (if you are paying 10000 yearly, will you be ok with paying 25600)? There is no soaking the rich on this one; this is a middle class problem and question. So the Disney vacations, the summer trips, the expensive cable TV bills, the SUV, the $1000 iPhone X- will WE sacrifice it?
Jonathan (Oronoque)
@Jonny - You've hit a sore spot there. Many affluent retirees have substantial investments in drug companies, hospital REITs, and such. They pay pretty good dividends.
Mark Gardiner (KC MO)
American skeptics of European- (or even Canadian-) style health care point to higher taxes there. So what if Europeans pay higher taxes? The total amount of money they spend on health care is a fraction of what Americans are paying. Americans spend by far the largest amount on health care, and American health outcomes and life expectancy put the country about 40th in overall health -- behind many countries no American can even find on a map.
RB (Korea)
I lived in Germany many years and can confirm similar experiences to this writer's. I now live in the US and can also confirm the other side of the coin that this writer describes. The article touches a very interesting point on which I have seen surprisingly little research. Specifically, there has been very little coverage of the impact of poor medical coverage on the economy overall, and I am not talking about the simple large cost of medical treatment. Rather, I mean the depressing effect of inadequate coverage on human economic motivation, such as whether a person should take a new job and possibly lose health coverage, or move to another state, or buy a new house or car, take a vacation, etc. These basic decisions of every person's life can be impacted significantly if a consequence of such changes means an economic existential threat to an individual. If there were no existential threat, what are the economic impacts for individuals? For society? Think about that.
Tom B (Atlanta GA)
Six years ago I had asthmatic bronchitis that could have developed into pneumonia because it has before (three times). I was in Paris and sought out a physician recommended by my hotel. I saw her, a radiologist, had consultations with both, a chest x-ray and a prescription. The total cost? €124. When I came back to the US and requested reimbursement, I was told that they just didn’t do that. Another cop out. We are being raped. In just more than four weeks, I am fulfilling a lifelong dream of moving to France for retirement. I have bought a house in a small village an hour south east of Toulouse. Because the younger French people don’t want to live in the country, these houses are cheap. Taxes are too. I will pay around €1100 a year in property taxes. After three months of residency, I can apply for the Carte Vitale that will allow me French health care. A supplemental policy to cover additional costs has been estimated to cost around €65 per month. Medicare and a supplemental plan I have in the United States cost nearly $500 a month. I will let them go and have substantial savings on an annual basis. We have our priorities all wrong in the US. Healthcare is a right, not a privilege. Taking care of people in an organized and civilized fashion is humane and economic. Politics gets in the way and sabotages our health and well-being. It’s time for a change.
lou (Georgia)
@Tom B Looks like we now have a system that forces healthcare refugees from the U.S. moving to foreign countries.
johnw (pa)
The US working class ROI on their taxes is ridiculously poor... ....the US has the second highest medical costs while ranking 49th in quality of car among 1st world nations; one major health problem bankrupts a lifetime of hard work, home security and retirement savings. ...at the same time corporations slurp up free government research and tax breaks while claiming some mythical ...independence from government welfare. ...why has the US government become a service primarily to corporations and the wealthy?
Sean Daly Ferris (Pittsburgh)
Yes when you go to the hospital in America the first thing they do in x ray your wallet
Louise (USA)
The US has a very unhealthy attitude towards anyone not the 1%... Everyone is supposed to be able to "pull themselves up by their bootstraps", make themselves into an "entrepreneur" in this country... We HATE anyone who can't do this, so penalize them by NOT providing decent pay, universal healthcare, etc. etc. and take away what little they may need (SNAP, Medicaid etc. etc.) to make their lives somewhat bearable... We're all slaves in this country serving the 1% and the corporations...
Matthew (<br/>)
So you moved because you had cancer. How was that helpful to UK? Now you're using French healthcare. You paid into neither of these systems yet you use them. If everyone did what you did: not work, move to a country with benefits, and continued to milk the system, then how could any healthcare be sustainable? You need to take some responsibility for yourself.
Julie B (New York)
She does work. Ms. Rex is a journalist. Furthermore, if she is living in France, she is paying taxes.
karen (bay area)
Author self identified as a French tax payer.
Steve (West Palm Beach)
@Matthew I see your point, but give her a break. She has had cancer, after all. And she probably pays to support the French system now if she resides there.
Charlierf (New York, NY)
The French actually like their public-private healthcare system while we Americans overwhelmingly dislike ours. The French pay less and get more. So then, a proven, time-tested system is there for the taking, while we mess about with unproven complexity. Some night, while they sleep, let’s just steal their system and make it ours. The French system or our current system - pick one. Dems, if the Repubs are dumb enough to go all ideological, this issue will win votes across party lines.
Vgg (NYC)
@Charlierf Where does it say that the writer is unemployed and not earning? She may not have a job per se but could be a freelance writer.
David Andrew Henry (Chicxulub Puerto Yucatan Mexico)
About forty years ago I was managing a project that required three American engineers with special experience. The big obstacle was higher Canadian taxes. We did an analysis that proved that when the cost of private US health insurance was added to the equation, the American engineers were better off in Canada. Have Americans been hoodwinked by some devious politicians and lobbyists who work for big insurance? Does the USA have the highest cost, least efficient health care system in the world? For Erica Rex...I note you are working on a book about PTSD. Please research PTSD in the French Military. The French Army never prescribed mefloquine, the neurotoxic anti-malaria drug, which produces symptoms similar to PTSD. Was the PTSD story concocted in Canada and the USA in 1994 to cover-up the much more serious problem of central nervous system damage caused by mefloquine. The US Army banned mefloquine in 2014. google nytimes mefloquine nevin mefloquine forensic croft mefloquine cmaj passey birenbaum ptsd (how did Canadian Forces LCdr Passey MD, a GP with no research experience "diagnose" 20% of the soldiers of three Battle Groups with PTSD in 1994?)
Kane (Austin,TX)
As a healthcare worker for many years, I have watched over and over how people who are ill become totally vulnerable, even if it's momentary. People with insurance, without insurance, young, middle-aged, old, it doesn't matter. It's a universal response. When you're sick, you just want comfort and to be taken care of, much as a small child expects a loving parent to do. It's the default setting for humanity. For those who do not support socialized medicine/national healthcare, I ask that they consider what "Life, liberty, and the pursuit of happiness" means, keeping in mind that it applies not just to themselves as having earned it, but to ALL citizens. To not have universal healthcare is uncivilized.
Jerryg (Massachusetts)
We need more articles like this. Many of the day-to-day struggles of life in this country, ones that we’re used to thinking about as inevitable, are human creations. This country is run for the benefit of the people who own it, and that’s only getting worse. The other Times article about being a parent is a case in point. All of the ink spilled about American exceptionalism and decadent Europeans (read Charles Murray for example) is supposed to inoculate us against thinking that anything could be different. Other people in the developed world are not terrified about getting sick or paying for their kids’ education. At the very least we should recognize the Trump tax cuts as another part of that same agenda.
James Wittebols (Detroit. MI)
This line in the subheadline is deceptive as it implies the health care was insufficient. Is there an ulterior motive behind this?
SW (Los Angeles)
Profits over people. If you realize that the nationalists want a sliver of the existing white people and no one else (i.e. non-whites to self deport), our healthcare system makes sense.
antiquelt (aztec,nm)
No one should have the added stress paying medical bills, bankruptcy, or losing their home while confronting their health crisis. We Americans have been duped by corporate greed and a totally corrupt GOP!
Stefan (PA)
Sounds like a nightmare. Long waits with crotchety people. No nurses and rude administrators. Just one doctor who despite being a “rockstar” in their system, clearly botched a surgery. I guess you get what you pay for. Expect more violent street protests as this house of cards collapses under its own weight.
Mogwai (CT)
America is mediocre where the rich are worshipped. If the rich say medical care must be bought then the sheep americans will bay as they die. Then the sheep americans will give the rich more money. See? That is the american way: mediocrity and worshipping rich people.
Susan L. (New York, NY)
Although I certainly agree that there are serious issues concerning healthcare costs and insurance in the U.S., the situation with French medicine comes under the heading of "be careful what you wish for". During one of our visits to Paris, my husband and I got severe food poisoning. I'll spare you the grim details, but meanwhile he began bleeding to death internally and he rapidly lost about 40% of his blood. We were rushed to what is purportedly one of the top teaching hospitals in Paris, where the totally hands-off staff allowed him to nearly die. My husband is a physician and knew *exactly* what was happening and what needed to be done (vs. the fact that apparently the French medical staff wasn't competent and/or was totally unconcerned about his rapidly-approaching demise). Further; I speak French well and was desperately attempting to translate for my husband, but the staff *evicted me* from the room (quite a contrast to American EDs, where a knowledgeable person accompanying the patient is a valuable resource). The *only* reason my husband survived is because there were no beds in the ICU. He was then transferred to a military hospital - but if he hadn't finally stopped bleeding internally irrespective of the medical care, he would have died.
bill (Madison)
'American values are deranged, they say.' Yeah, hard to argue with that.
James (LA)
Social safety in America today is more about building a wall to protect us from Guatemalan’s that want to work at jobs we need and won’t do for pay we won’t accept. America today is about protecting the rights of billionaires, to heck with health care for the masses. It wasn’t always this way and doesn’t have to be this way. Let’s fix it.
Mel Farrell (NY)
America, "the land of opportunity" What is not explained, in that statement, is this; it is the land of opportunity for corporate America, especially Banks, Insurance companies, and Pharmaceutical companies, affording them, and dozens of associated businesses, the opportunity to become involved in the writing of legislation which successive governments, nearly wholly owned by corporate America, create to subjugate, economically enslave, and reduce to penury, tens of millions of taxpaying Americans. Yes, that about sums it up. Oh, one other thought - has anyone noticed the dearth of input from medical Insurance companies, when discussions on universal health care for Americans is occurring, and does anyone ever see any medical Insurance CEO, take out a full page ad defending the rape and pillage they are engaged in, rape and pillage condoned by the government they bought and paid for, with your medical Insurance premiums, mine, and every other Americans as well. Corporate America, hard at work, keeping the serfs deaf, dumb, blind, and stupid.
Usha Srinivasan (Martyand)
I am an endocrinologist in the USA and I am fed up. I work in my office till 11 PM, completing cumbersome paper work that doesn't do a thing for my patients. Many of my patients are down and out, sucked in and spat out by American healthcare. I love them and I am at my wits end how I can make their life easier. Many are sick diabetics and even insulin is not available to them at a reasonable price. I get samples of insulin pens and vials for them from pharm reps which I give them to keep them going. Once I had to sustain a homeless man for a whole year until his medical assistance came through. He was living in a tent off a walking trail, didn't have a proper address and hence could not apply for medical assistance. Imagine, you need a proper address to apply for medical assistance and homeless Americans, who need medical assistance, are in a sea of trouble because they can't even apply. Another of my patients went into renal failure, as I watched because I couldn't keep her supplied with enough insulin, she stretched the amounts I gave her, took less to accommodate the scarcity and the cost of the insulin, the copay for which she could not afford and suffered from uncontrolled diabetes that killed her kidneys. It was too much for me to bear. Before ObamaCare there was a limited medical assistance program in Maryland called PAC. It was so limited I couldn't order essential tests. Insurance companies deny payments to docs after care is given. No, I am not rich.
Larry (NY)
@Usha Srinivasan, my endocrinologist does nothing but scold me about my blood work results and renew my prescriptions. For that, she bills me over $200. I’m still waiting for a physical exam.
jrinsc (South Carolina)
@Usha Srinivasan Your comment, as well as the comments from other doctors on this story, is heartbreaking. As a patient, all I can say is thank you for caring enough not to give up on us. All of us are caught in a terrible trap motivated by nothing more than greed, at the expense of people's lives and health.
Roy (Canada)
@Usha Srinivasan. Move to Canada!
vulcanalex (Tennessee)
Great for you. But I see something else. You gave a person medical advice that might have been fine but might have been totally incorrect. A second opinion is a desired thing for me if I suspect my doctor of not being good enough. The doctor wastes his time doing things lesser paid people could and should do. I sometimes talk about medical things that I know about but I always tell them to go to a real doctor for any issues. I also wonder how healthy the French population is in relation to ours, how much their providers are paid, and who pays the taxes that support their system. They are different, their solutions would not work the same here, they should be considered of course.
Lonnie (NYC)
Yesterday I sat in my doctors waiting room, it was very crowded, we all waited in silence. Why the different experience? The People in France all feel connected, their social system unites them, they are all the same. One is not on Blue Cross, the other on Aetna, the other on Medicare, we are in America are all separated from one another divided in a thousand way, while in France they are one. In America we go into our health battles completely alone. Even the doctors and nurses in France are part of the same social system, they trust the system and they go into their health battle connected to humanity. It must change for us here in America, it is insane the way we continue, we go into our health battles afraid and anxious, a number not a name, connected not to doctors and nurses with sympathy but rather to cold, far-away Insurance companies whose job it is to nickel and dime us at our time when we are must weak and vulnerable. Our system is a hell of our own making. At long last the time has come to join the rest of the world, in a system designed to save lives and ease fears rather than make money. The world feels sorry for US.
J.RAJ (Ann Arbor)
We have “global” healthcare here!! Let me elaborate.Last week I had an upper respiratory infection.Being a physician I took the usual measures.Vicks for $11 made in Mexico(Can purchase 30 bottles in India for the same price!!).Mucinex made in China for $13.Azithromycin made in Croatia for 5 cents a piece a pack that retails here for $120 without insurance and $12 with insurance.Ventolin inhaler made in Ireland $60.All these prices are absolutely usurious.We the people are screwed!!!
KCF (Bangkok)
As a long time American expat due to work and government service, I continue to be surprised at just how much better off people are in other countries, in terms of basic quality of life. If Americans ever really learned how their own government and leaders were screwing them over, there would probably be another revolution. But, in a country where only 20 percent have a passport and is so geographically isolated....that's unlikely to happen anytime soon.
tjcenter (west fork, ar)
We lost our medical insurance when I lost my job in September due to cost cutting by my employer. We are in our 60’s and previously had bought insurance though the exchange for approximately $1300 a month with a $6500 deductible, we are not eligible for a subsidy because of income. This time we took the COBRA for $1400 a month because there wasn’t the massive deductible. We are actively seeking to move out of the country because of healthcare. This is the most insane system in the world and we in the US tolerate it, why? I wish I knew. People’s eyes glaze over when conversing about it because it is just to difficult to envision a system that covers everyone, that we have the best medical care in the world, if you can afford it. Why do Americans put up with it? Until they loose employee sponsored insurance they don’t have a clue how much their coverage actually cost. Why do we allow employers to be the arbiter of our medical care? Until we stand up and fight for universal coverage you are never free from the whims of your employer, it’s what keeps them from loosing employees because of fear to be uninsured. We are slaves to a system that does not work for anyone except health insurance companies, explain why a CEO of say CIGNA, United Healthcare, BC/BS is paid millions while we tolerate for-profit care on the backs of those that pay, pay, until we die unable to use our insurance due to deductibles. Who does that, stupid Americans that’s who.
Chelsea (Hillsborough, NC)
I have medicare but what good is it when no doctor, at least no gynecologist will accept a new patient who have Medicare . I have heard from friends that outside of a hospital PCP no other Primary Care doctor in the triangle area of NC will accept new patients with Medicare. So for all those who think Medicare for all is the answer be aware that the reimbursement rate is so poor that Physicians can not even meet their expenses much less make a little income seeing Medicare patients. I really can't blame them for not wanting to work for free but that still leaves me without a Doctor. Wish I could move to Europe!
Richard Merchant (Barcelona, Spain)
Erica You made a wise if not a wholly satisfactory decision to move rather than be bankrupted by a medical condition. I live in Spain, and I had to buy private health insurance in order to get my residency (I luckily posess a British passport as well as an American passport). It costs me about $100 a month, has a 2 euro deductable, covers doctor visits, specialists and hospital stays. Nobody here even thinks about medical costs. I have never heard of millionaire doctors in Spain. That is an American phenomena. They get a lot for their taxes here. Even though it is not a rich country the streets are clean and safe, and the infrastructure is much better than in the US. America can learn so much from the rest of the world, but is too insular and so many Americans are blinded by the concept of American Exceptionalism.
SMKNC (Charlotte, NC)
I'm self employed. For 17 years I was able to purchase title relatively affordable health insurance. Last year I was diagnosed with Stage 4 cancer - treatable but incurable. I'm in remission, but a recurrence is statistically very likely. At the end of the year the cost of my renewal plan more than tripled. The insurer said my old plan had previously been grandfathered, but was no longer being offered. I had to wonder if $900,000 in treatment claims wasn't a more likely explanation. I've purchased new insurance via the ACA. My oncologist is in network but other providers are restricted to a single health care system in my state, and my deductibles and out of pocket limits are much higher. Should my now pre-existing condition return, and our government continues to try and restrict health care, my choices will be bankruptcy or death. I'm not big on either choice, and it'd be challenging to move abroad. Any other ideas?
frip (NY)
For someone like me with cancer in the U.S., I'm pretty lucky. Good health care plan with a job I like and a sympathetic employer. Back to work but I'm still fighting tens of thousands of dollars worth of "surprise" bills. If coverage for pre-existing conditions goes, my whole family is toast. And I know I'm lucky.
James (Wilton, CT)
Better baseline health, lower expectations, simple administration, and limited liability allow for a better French experience. In the U.S., the patient with the crutches would be threatening a lawsuit, doctor shopping to 3-4 other specialists' offices, and demanding a narcotic prescription renewal. The orthopedist would consequently order more tests and "buff the chart" in expectation of a tort lawsuit. Likewise, the other waiting patients are probably not going to 8 other specialists to get the "best" care for all their minor ailments (Americans want MRI for any headache), nor are they likely to be on a multitude of prescriptions like pill-loving Americans (#1 pharma consumers in the world!) The French also are likely not morbidly obese like their American counterparts, vastly decreasing their medical costs overall. The French orthopedist does not have to pay for an army of staff to deal with pre-approvals from 16 insurance companies, the workman's compensation paperwork game, or Medicaid/Medicare forms that make tax forms look easy. In his single payer system, the French orthopedist also likely does not deal with multiple levels of "middle manager" oversight by insurance companies, the local hospital, and state/federal agencies that do not add anything to care other than increased costs.
Metrojournalist (New York Area)
I've had six foot surgeries, including three revisions for surgeries that were not done correctly. Fortunately, Belvedere Podiatry in Manhattan were able to correct two of them. Not only did I not need crutches, I didn't even need pain killers. The system in France is no doubt better, but sometimes the skill here is better.
Erica Smythe (Minnesota)
The answer to this poor woman's misery is what Bernie Sanders' has been calling Medicaid for All for the last 30 years until someone whispered in his ear that regular folks like the sound of "Medicare for All" better. Medicaid for All would solve this woman's pain and suffering, though it would require the doctor's office to fire 70% of their staff since Medicaid reimbursements are less than 1/2 of what physician's offices require to remain operational.
Daniel B (Granger, In)
Labeling universal health care as a socialist concept is a purposeful and pejorative lobbying ruse. From an economic standpoint, uninsured people and high medical costs are a drain to any financial system.
CEA (Burnet)
While living in the UK on a 3-year expat assignment I experienced the UK National Health Service first hand. On January 1, 2013, I began experiencing what appeared Toby the symptoms of a heart attack and went to the ER to be checked out. No one asked for proof of insurance or the payment of a co-pay. Rather, I was taken in right away and attended by a wonderful team of doctors and nurses who ran the necessary tests, confirmed I had no heart attack and sent me home. Fast forward to February 1, 2015 when I was back in the US. This time I had to take my husband to the ER complaining of severe pain that made him unable to communicate coherently. We approached the ER admissions desk where, after inquiring what brought us to the hospital and telling us to wait, the first thing the attendant asked for was our insurance card. After waiting for 35 minutes, we finally were taken in. Vitals were taken by the nice nurses on shift, but before any doctor came in, the first person who approached us was the billing representative who told us how much we had to pay and that we could pay in cash, debit or credit card. In the UK I needed not worry about being able to pay; in the US I worried about how much it would cost to get the help we needed and whether we would be able to afford the final bill. When we argue the pros and cons of universal health care we fail to consider the “peace of mind” factor. If we did, many more of us would be in favor, even aware it is paid by taxes.
ScottW (Chapel Hill, NC)
Our medical system is immoral. Citizens live, die and go broke based upon their economic class. Congress and the President let it happen to please their donors. Even the most conservative Fox & Friend Republican would throw out any Legislator who threatened his or her Medicare coverage. The fact we cover everyone 65 and over, but leave the youngest, healthiest without coverage is all you need to know about living in America.
drspock (New York)
Welcome to the fundamental difference between our capitalist version of health care and the socialist version used by most other countries. In our neoliberal economic system everything must function as a profit center. Whether it's a bandaid to cover a stitch or the complex surgery to create the stitch, it is all calculated to generate profit. Humane care may be the intention of our doctors and nurses but profit generation is how the system is designed and how they are expected to perform. The coming struggle to create a single payer system has already begun. And the political and economic forces that profit from our misery have already started issuing false reports and flagrant lies about the viability of systems like France's or Canada's. They will always ask "who is going to pay for all this?" And when they do we need only site a detailed study commissioned by California that demonstrates how to transfer government subsidies to the private health care system into a Medicare for all program. The rest will be paid for by a modest tax on payroll of about 5%., which is substantialy less than what the average American is paying for health insurance. We now spend 18% of GDP on health care. Canada spends 12% and Germany and France spend about 8%. We can and must do better. And if our politicians can't figure out how, we need to replace them with ones that can.
Oscar (Brookline)
A friend was also diagnosed with breast cancer, several years ago. She's now in her late 50s and, after working for 45 years, 34 of them in a stressful profession, she would like to retire. But she can't, because she needs health insurance through her employer. She's not confident that coverage will remain available through the ACA until she qualifies for Medicare, and she's also fearful that the inhuman GOP will raise the Medicare qualifying age to pay for their tax cuts for the rich. She's tired, and worries about recurrence, how long she has remaining on this earth, and whether the stress of her job is taking a toll on her health. She is prepared to make the sacrifices that are required to retire early, and she is well aware that many in this country don't have that option -- whether or not health insurance presents a stumbling block. She feels fortunate to have a job that provides good health insurance, albeit at obscene, ever increasing premium contributions and rising copays, deductibles and coinsurance. But people shouldn't be tethered to their jobs because they worry about how they will pay for medical care should a need arise. In the "greatest nation on earth" (NOT), our "representatives" should be making choices that benefit the majority of us, not the tiny minority of rich corporations and wealthy families, who bankroll their campaigns in exchange for the sale of their souls. These are not public servants. They're just servants to the rich.
AJ (Oslo)
Tethered to our jobs, indeed. According to Bush, "they hate us for our freedom", I guess he meant "freedom" to go bankrupt from medical bills or "freedom" to be trapped in a job you hate because it's your life line to passable healthcare (more like sickcare).
mauouo10 (Roma)
It still goes Beyond me how the US does not have universal health care coverage. I guess it is yet another aspect of american egoism. In 'money we trust' would be a more suitable phrase to be printed on greenbacks.
Steven (Denver Area)
Ms Rex's example is comforting. Something to aspire to. Our system is distinctly broken. I am certain, though, that a single-payer health care system is worse. The details would require an op-ed piece of its own, but the number of Canadians seeking healthcare in the US (and now India) and that my brother pays for healthcare in the US rather than receiving such for free in Germany are two examples that should give pause. A key in Ms Rex's scenario is that many people buy a secondary insurance. Most "Medicare for All" plans exclude this. How many of those patients in the orthopedist's waiting room would have been able to afford their surgery without their secondary plan? Would the doctor in France have had the time to call his patient's from the waiting room if he was not buried in the mountain of documentation required by medicare, medicaid, and private insurance in the US? I am a family physician of 30 years experience. It now takes me the same time to see 16 patients as it took me to see 25 patients 15 years ago. The change is not because I am older and slower, but rather, the extra documentation required of me. How much does that cost the system? I am not certain of the ideal solution, but a single-payer system is not it. Some countries have the following: multiple non-for-profit insurance companies offering tiered health-care plans with a guarantee that all people will be covered. Somewhere therein lies the solution, methinks.
Bro (Chicago)
@Steven, why would Medicare for all not have supplemental insurance? That's part of the Medicare we know.
Jeff Hoffman (Ponte Vedra)
The claim that large numbers of Canadians seek healthcare in the US has been studied and not to my knowledge substantiated. any references?
Steven (Denver Area)
@Jeff Hoffman Personal experience when working/living north of Seattle near Canadian border. Hip replacement lag times, per patients, was about 2 years from time of doctor recommending such. There were also issues re: coronary artery stenting. Patients with colds, etc did not come to US. The patients we did see needed surgery or imaging (for example, MRI) with long delays.
john (Virginia)
Very much like my experiences in Germany when I lived there. The health care system in the U.S. is totally broken. Nothing less than Medicare for all is going to fix it. The argument that it costs $12T does not take into account the cost of the current system(s) which surely must be greater than $12T. Now, as to the profits that line the companies at the trough that is another issue.
AJ (Oslo)
The conservative Koch brothers recent study concluded that Medicare for all would save billions of dollars.
hen3ry (Westchester, NY)
Imagine what would happen if Americans felt safe enough to seek care when and where they need it. We might have a healthier population and one that's happier. It's hard to be happy when one is constantly worried about whether or not one's finances will allow one to receive care when and where it's needed. Americans get the best health care money can buy. Not enough money, not enough care.
Tom Mix (NY)
There is so much to say about this article. What is not mentioned in the debate is that the French / European collective health care and social security systems did not develop overnight. They are based on compulsory payments of health care contributions which are levied together with the other social security contributions. It took about 100 years of steady enforcement to be molded and accepted into their current state. Think about Franz Kafka, the writer, who traveled Bohemia in the beginning of the 20th century as legal counsel of the newly promoted Czech workers compensation and health care fund, promoting the advantages of this undertaking to employers and employees likewise (that was his day job). Cheating the system by working as “undocumented” worker on the side was, for example, rampant in post war Germany. But the system was perfected over time, in particular as after closing down the inner EU borders in the course of the Schengen accord an army of then jobless custom inspectors was retrained as social security inspectors. Today, pretty much every major or minor construction side, supermarket , etc. in France has a good chance of being raided by social security inspectors. Only seamless enforcement guaranteed that the young and healthy workforce pays into the system, a vital factor for its survival. Currently unimaginable in the US, for numerous reasons. People are in a phantasy if they think that with a flick of a switch a single payer system can be set up here.
Sarah (Massachusetts)
@Tom Mix It is set up here and we don't mind paying for it. We love it! I am on Medicare.
Tom Mix (NY)
To be entitled for Medicare, you must have worked and paid into the system for at least 10 years, so it’s not available to the army of people (I) who did not do so for a number of reasons and (II) are under 65.
Sarah (Massachusetts)
@Tom Mix I know that. My point is that, as Americans, we already accept paying for government health insurance on a month to month basis. We just don't receive the benefits until age 65.The "flick of the switch" would start benefits at birth. Your argument was that "people are in a phantasy (sic) if they think that with a flick of a switch a single payer system can be set up here". It is already done. The "system" IS set up. The date of eligibility is what needs to be changed.
NotNormal (Virginia)
Let's start with ending the for-profit health insurance companies in the U.S. It doesn't take a rocket scientist to figure out that the health care "industry" is just that, when profit is the motive then you and your health are just collateral damage.
sr (Ct)
The problem with healthcare in the US is the political system. It is so corrupt, with influence of contributions and lobbyists that even Medicare for all, which will improve access, will not bring down costs. Until that changes we will never have effective healthcare for all at a reasonable cost
Awes (NYC)
I badly broke my ankle in NYC in 2015. It was reconstructed beautifully, at a pre-insurance cost of 87k (and an additional ER bill of 17k). I was fortunate to have “very good” employer insurance and still paid thousands in copays. Extraordinary care, for extremely high prices. But if my spouse and I retire early, we’re likely going to take an investors’ visa route and spend years in Europe before Medicare kicks in, in part to mitigate against the extraordinary US insurance costs and chance that a similar event or a serious health issue would take a huge bite out of our savings.
Noel (Atlantic Highlands)
A big block to change in the US is the tax break corporations get to provide insurance for employees. Those covered don't see the real cost of their insurance - my share of the premium at my last corporate job was $30 per month for an excellent plan. The company paid the rest of the premium pre-tax, I got a huge benefit tax free. Why would anyone with a plan like that want change? Government policy can help. By analogy, in the UK, company cars were used in lieu of pay because the benefit wasn't taxable to the employee and the cost was an allowable expense for the employer - like US health insurance. This tax policy distorted the car market as part of the new car buying population was removed from the individual market. Companies bulk purchased cars for employees at low prices and car companies compensated by upping prices for the rest and focusing their products on the needs of the company fleet buyers - sound familiar? In the 1980s the government began to remove this market distortion by taxing the company car benefit. Companies then began to offer the option of a company car or cash compensation - over time most people opted for cash and then used the cash to purchase their own car. With fewer fleet purchases and more individuals in the market, the car companies switched focus onto the needs of the individual buyer, prices fell, finance options multiplied and more models came to market. A much better situation all round. Can we do the same for US health insurance?
AJ (Oslo)
Kudos for being lucky enough to have Cadillac health insurance. Now, how about the other 90% of Americans?
ASW (Emory VA)
Years ago l went to Scotland with the college choir and developed bronchitis. The choir director called a doctor who came to our hotel at midnight after a concert to examine me and he gave me some sulfa. It worked. No charge.
annabellina (nj)
Not to mention the money everyone would save if people who were in accidents or suffered malpractice at the hands of a physician or hospital were simply taken care of, not given millions of dollars in rewards for their suffering.
Tom (Port Washington, NY)
@annabellina this is a common misperception, that tort costs are a major part of high medical costs in this country. In fact, the few studies of the cost of medical malpractice litigation, including "defensive medicine" designed to avoid litigation, puts the total cost at about 2-3% of all healthcare costs. Just a drop in the bucket.
annabellina (nj)
@Tom It isn't just the cost, though removing 2-3% of costs would be mighty welcome, it is the anxiety, the long, long waits before money is made available to plaintiffs, and the knowledge by everyone that if they have an accident or are attacked, shot, burned, or mistreated by doctors, they may have to wait years for money to fix it. It is not only a monetary thing. THere is no reason why these tortures should be necessary. Just go to the hospital and be treated. One European friend broke his pelvis falling from a ladder on his vineyard, and spent months in a full-body cast in the hospital. They paid nothing. Americans carry a heavy burden of anxiety about numerous things. (Of course my European friend complains about health care, though his care, he says, was excellent and he didn't ever receive a bill. Humans will always complain. He just can't even imagine a society in which he would be left to dangle in the wind.)
Koyote (Pennsyltucky)
While vacationing in Italy, my then-wife suffered a miscarriage. We went to a hospital, a specialist was called in (late on a Friday evening), and he did the necessary surgical procedure and my wife was placed in a room for the night. The next morning my wife was given the proper medication and discharged, and we tried to give the hospital administrator our home address in the US, since we knew that our health insurance would not cover the bill. "Oh, we don't need your address," she said. "If your insurance doesn't pay this, the Italian government will cover it." Here in the US, the patients themselves often end up doing their own triage, since they have to decide whether an illness or injury is serious enough to warrant an often expensive visit to the physician's office. Much time and money can be saved, and much better outcomes can be obtained, if we just remove the steep costs of health care from patients' decisions. This is part of the reason why every -- and do I mean EVERY -- OECD country is able to spend smaller shares of GDP on healthcare while providing it to all citizens -- and even to some tourists.
Saul RP (Toronto)
I've read through most of the comments so far. Looking at the number of "recommends" in each comment leads me to better understand how appreciative Americans are of free or much less expensive medical care outside the USA. Living in Ontario, Canada provides my family with top-notch medical services basically for almost no cost at all. Drugs, after a $100 per year deductible, cost about $4.11 per prescription filled. Yes, there could be a minimal wait time for only some procedures, yet emergency services are rapid, thorough and efficient. Physicians are well trained at top world class medical schools. There is a second tier backup system for those with the funds and willingness to jump the line. Although some provinces police physicians offering private services, it does exist and it provides for quick, almost immediate MRIs when you are willing and able to pay for it. Of course I can purchase private insurance over and above costs our Universal health care provides. In the province of Quebec, for example, children up until their tenth birthday receive free dental care. Adults on welfare and their dependants receive free basic dental care as well. Canadian Medicare has just celebrated its 50th birthday. I'm certain Canadian public medical care has a way to go to reach the level of thoroughness of many European countries, however we also enjoy very inexpensive university tuition, when compared to the USA. Our higher education tuitions are also comparably peanuts.
Davis (Joachim)
All this sounds a lot like Canada and it’s health care system. That said, I’d love to have a doctor come to visit me like they do in France. Health care should never be a profitable business but rather a right and I hope that America will one day wake up to this.
Mimi (Dubai)
My husband and I have a lovely experience with health care in France and Switzerland last summer. A house call by both a doctor and a phlebotomist, a four-day hospital stay that cost one-tenth what it would have here, pharmacists who were astonished that they actually had to charge us money for prescriptions.... I cannot begin to express how much I despise and resent the U.S. system, which looks a lot more like organized crime than anything designed to make people feel better.
John (Hartford)
I had to have emergency surgery in France in the early 80's when I was working there and both the treatment and hospitalization were excellent. The French system is pretty good, better than the British which I also have experience of. This is not to say the American system itself is bad but it's extremely expensive and essentially rationed by affordability. If you have good health insurance it's fine, if you haven't you have problem. This is a national problem.
Amy Rosenfeld (New York City)
I agree, that what the US needs is universal health care. Maybe the Dems will help with this. I often tell my husband that we are moving to Europe, because I, too get frustrated with the health care system here, as well. well maybe one day we will have a better health care system.
WishFixer (Las Vegas, NV)
@Amy Rosenfeld If the health care system is the only thing you have a problem with in the states, lucky you.
Jane (New Jersey)
Americans are a farfetched entitled group. They are the most litigious group of people in the world who sue their doctors for everything and anything contributing to the high cost of healthcare. An entire Malpractice industry exists as a consequence. Albeit, it is not the only reason healthcare costs are high but unless laws change, they are unwilling to alter their behavior. Additionally, Americans refuse to pay high taxes. They grumble, cheat and sometimes don't even pay. They want something for nothing. Furthermore, they demand time, quality of care and YES, every expensive test in the book. If they leave the office without a prescription or referral, they think the doctor did nothing. Finally, had the author been 60 or more, treatment might not have been so readily available. Kidney dialysis, for example , has a cutoff of 60 in England. She might need to move back to the United States in this case! And as for all the stories about free medical care in the ER while on vacation in Europe, HELLO, foreigners are treated for free in our ER's all the time! No system is perfect. Tired of these anecdotal articles that reveal a very small picture with very little depth....
Amber (MA)
I seriously doubt it is so simple as "kidney dialysis has a cutoff of 60 in Britain". Can you provide a source for this information?
maisany (NYC)
Treatment in ERs, whether for foreign visitors or citizens is not free. The cost is borne by someone, and for us, it’s doled out privately and paid by the rest of us through higher healthcare costs. In Europe and other places, it is paid by the government, which means it is also paid by the rest of the citizens of that country. So it’s really just how that compensation is distributed which is very different. If U.S. hospitals have to charge $5000/day, that cost is the same to you, the patient, whether you’re rich or poor; in Europe, if the costs are distributed via taxes, the rich would pay more than the poor.
Ilona (planet earth)
@Jane That is not true about UK patents not being able to receive dialysis after 60. This was, excuse the expression, fake news spread by American conservative groups in opposition to universal health care. The UK system is not perfect but refusing treatment would be unethical. I fear a lot of resistance to universal health care stems from people receiving inaccurate information. https://www.theguardian.com/society/2009/aug/11/nhs-sick-healthcare-reform
Down62 (Iowa City, Iowa)
Beautiful and touching article. There are moral and pragmatic reasons to provide universal health care, as other commenters have written. But there is one additional reason for supporting universal health care that is rarely mentioned, and that is the overall economic benefit of a universal health care system. Businesses would be freed to deploy capital into their main missions, and not into health insurance. And entrepreneurs would be free to leave jobs that are dead ends for them, and start new ventures, unencumbered by the additional worry and expense of health insurance.
Mary F. Richards (Belgium)
Ms. Rex, thank you for yet again pointing out the fear and anxiety around health care experienced by most Americans. My husband and I moved to Europe almost 30 years ago. Even then, I was shocked at what we experienced. Our GP charged roughly half what was paid for an American office visit. We took the proof of payment to our insurance company and got ~80% of the fee back, cash in hand. No refusals, resubmits, etc. The medical system in Belgium has saved our lives figuratively and literally.
WCB (Asheville, NC)
Stunned all the time by how our healthcare system works, I think the two most remarkable moments came during the Clintons’ efforts and during Obama’s. I kept thinking somebody in the Congress or the administrations would have said — okay, let’s put together a small bipartisan group that’s going to visit the countries who seem to have everybody covered, spend a bunch less money, and have generally healthier outcomes for their citizens. Maybe I missed it but I never heard anything like that proposed by our elected officials. Clearly, American “exceptionalism” should not be thought to always mean better.
Doug (San Francisco)
@WCB - our elected officials do not pay for their own insurance and do not have to use Obamacare. They also get large donations from the drug and hospital corporations. Follow the money and you'll have your answer for why it's still such a poor system for delivering healthcare.
SDW (Maine)
The cost of healthcare is so prohibitive in this country that people are afraid of getting care for the simplest ailments. As a French expat who is living the other side of the coin from Ms. Rex, I see that as we are getting older, my husband and I are grateful we have put money aside, not for a big vacation, not for a fancy mac mansion, not for a brand new car, but for healthcare. My family in France is dumfounded when I tell them what kind of premiums we pay. In America, you are on your own,everything works around money and if you don't have it, if you are sick, it's your problem. We,m the voters all know that it is the corner stone of the Republican mantra: you are on your own for everything. No government should help you even if you are sick and destitute. Healthcare should not be a privilege, it is a right. A right given to people by most nations. Unfortunately, here it is not a right. Along as the Republican machine and money barons rule and own this country, the sick will not have the right to decent free health care. I don't understand why people have not descended into the streets for this one. It is really worth a revolution. Unfortunately the only thing We, the People have for a solution is the ballot box. It cannot come soon enough!
Michael Hill (Baltimore)
My then 90-year-old father had a medical emergency in Paris a few years ago and I had to go over and bring him back. The hospital was a dreary place, just this side of run down, a contrast to the medical palaces in the US. But the medical care was excellent. The French were spending their money on the right things.
Equality Means Equal (Stockholm)
The author has had an experience that is unique to her. Her experiences do not represent all Americans, all Brits or all French citizens. There are pros and cons with the US system - the primary pro being taken care of promptly and professionally by the best medical staff in the world (this is not subject to debate, it is a fact). That, of course, depends on where you live and if you are covered by employment based health insurance. The primary cons being that the poor, and especially children, are often not covered and that a serious illness can bankrupt a family. I entirely for health care for all, paid for through high taxation of the population but to paraphrase the author, too many Americans do not realize that their individual experiences overseas do not necessarily present the entire picture.
Danielle Treille (Brussels, Belgium)
@Equality Means Equal Being taken care of promptly and professionally by the best medical staff in the world? This is NOT a fact, just your opinion. Moreover, having experienced medical care both in the US and Europe, I disagree totally.
Wayne Spitzer (Faywood)
@Equality Means Equal...."the best medical staff in the world (this is not subject to debate, it is a fact)."....Why is it then that so many of the doctors we see in the U.S. were foreign born and trained?
Suzanna (Chicago)
Being taken care of promptly and professionally?!? Perhaps if you’re very rich and can afford- what do they call it- ‘consigiere medical care.´ I had to wait two months for an MRI after a back injury because my insurance company initially rejected my doctor’s request for approval. Again- that’s WITH insurance.
Paulie (Earth)
As I write this my brother is sitting in a hospital recovering from a lung infection. He will need a IV bag of antibiotics for six weeks. The IV has to be compounded so of course it is expensive. He was supposed to be released today but the insurance company is balking at the expense of the IV, so instead of paying for the IV they're paying for another day in the hospital. Talk about penny wise and dollar stupid. He has United Healthcare through a employer.
MS (Vietnam)
Having lived and paid taxes in both the UK and the US. I say both systems have their advantages and disadvantages. The US system is simply bad for people who have pre-existing conditions and no employment. The European system works because companies and people PAY into it, the doctors earn less and the legal system doesn’t allow people to sue as easily as the US. The author of this article took advantage of her position being a citizen or being sponsored and basically enjoyed benefits that she didn’t very contribute into and she is not apologetic about it. I find that distasteful. What is worse are comments by people of European descent who live in the US and take advantage of the benefits of the US (low taxes, better salary etc) and then retain their citizenship to take advantage of free healthcare in their ancestral country. Do they not feel the need to actually contribute to the country of your origin or just take advantage of it? A “socialist system” or any system works because you contribute to it not mooch off it
Yuri Pelham (Bronx, NY)
Corporations rule the US which is a fascist dictatorship. This confirms my many posts. If you want medical care free of existential financial terror... emigrate. Or if 65 and covered by Medicare you're ok....unless you need long term care.
Bernardo Izaguirre MD (San Juan , Puerto Rico )
A few years ago , while on a vacation trip , I opened my luggage in Barcelona and realized that I had forgotten my medications back home . I became quite worry when at the drug store they informed me that I was not going to be able to get the 10 days I needed of the 4 prescriptions medications I used , but that I will have to get 30 days . I thought it will be very expensive since I was not going to be able to use my health insurance . To my surprise it was about one fourth of the copay I paid at home using my health insurance . On another occasion in a follow up visit for my wife breast`s cancer she realized that the medical insurance was not paying for some services that were previously covered . I talked to the insurance people and they told me they were covering those services . I talked to the hospital and they assured me the insurance was not paying . After a lot of back and forth it turned out that the insurance was supposed to pay , but the hospital were making a mistake when submitting their claim to the insurance . I am a 74 years old retired pediatrician . During the long years I practiced and later as patient , I have many examples of the chaos and disfunction of our health care system .
Martin (Chapel Hill, NC)
Why not let companies or individuals buy into USA medicare who are under 65 years old. The system is already there. Private insurance companies already manage parts of American Medicare. Younger folks would be expected to use less medical services than people over 65. Medicare could even make a profit. Those under 65 years old would follow rules similar to Medicare part D in signing up so that people could not game the system and only buy in when sick.
larry (fl)
I totally agree. I would also suggest that every veteran receive Medicare instead of the bloated VA system.
November-Rose-59 (Delaware)
Insurance companies rule in the U.S. dictate what treatment we can or cannot have, limit length of stay in pt care facilities, limit recommended testing due to costs, and take responsibility for decision-making away from the physicians who know their patients best. It's an all-for-profit system over well-being. I suspect if insurance providers were required to take The Hippocratic Oath to uphold certain ethical standards, heretofore sworn by physicians, the outcome would be totally different.
craig (Canada)
As a Canadian serious illness will not ruin me and my fellow citizens and everything is covered including all pre-existing conditions. We have some lengthy waiting lists for non urgent interventions. They are being worked on and the waiting times are being reduced. Emergency life threatening care is always available. Tomorrow I have cataract surgery on my second eye completely covered by medicare. There was a wait but in no way did it limit the quality of my life.
Den Barn (Brussels)
Getting treatment for being in good health and not dying is the most basic human right. Funny that in the US being able to worship some god (does it help a lot?), being able to dole out money to poiitical parties, and being able to carry a gun (to shoot someone?) seem to be the most basic human rights that SCOTUS care about...
fc123 (NYC)
Quick Google search: Ave us doctor makes about 195k, French doctor around 100k France is no 4 in no of doctors while US does not make top 10 USA regulations restricts supply and increase demand. Time to stop complaining about the 1% and capitalism and go after AMA, force nurse practitioners to be used for basic care and open more med schools without a stupid 4 year general undergrad degree requirement and then see what happens to prices...
Anjou (East Coast)
@fc123 Firstly, approximately 30% of US healthcare costs are due to physician compensation. That is a sizable chunk but clearly not the predominant driver. And yes, doctors make more in the US, but it is very much dependent upon specialty and location: Average pediatrician salary: 205K Average dermatologist salary: 409K Average orthopedist salary: 535K I am all for evening the playing field and reducing some bloated physician salaries, after providing free (or greatly reduced) college and medical school to those smart enough to get in.
greg anton (sebastopol)
twenty years occupying afghanistan or free high-quality health care for everyone...simple
Snip (Canada)
The author could have moved to Canada, closer to USA, and gotten the use of a fine health care system here, too.
MartinC (New York)
Great article Erica. As an Australian who moved to New York about 14 years ago, I still tell people about socialized medicine and they shale their heads in disbelief. Disbelief that it is possible to pay the same rate of tax and get free medical care. That it is possible to buy additional (top up) private insurance if you want a private room or your choice of a specialist and elective surgery for cosmetic reasons. That if you cut the defense budget by a few percent (mainly to the military contractors) everyone in America could enjoy humanitarian health care and medicine and drugs at affordable prices. It's only the very stupid and the very rich in America that don't want an affordable health care system.
Rosie (NYC)
"American values are deranged" says it all. Anybody who has lived abroad for an extended period of time knows how dysfunctional, unhealthy, emotionally and spiritually broken the United States is right now.
Colenso (Cairns)
Hmm, bunions. Unfortunate choice. Shame that the article uses the example of bunion surgery when there are so many types of sickness completely outside our control, which, dare I say it, are more deserving of our sympathy? In France, bunions went away briefly following the French Revolution because for a while everyone wore sensible shoes so as not to irritate revolutionary sensibilities. As time wore on, women started wearing high heels again and bunions returned. https://journals.sagepub.com/doi/abs/10.2190/GA2M-FLA2-17FB-V5PE
Z (CA)
Thank you for your article Erica. The way Trump and Republicans are gutting Obamacare which was the beginning of something for the middle class and 40% of people are still support this guy shows where this country is. Although Obamacare benefited white people more than people of color, a lot of these white people would rather die than see people of color and poor people and others have the same quality of care.
Daniel (Kinske)
Yeah, like the French would want anything to do with "Americans" today--we are a cruel country now and I hope no other country shows us any mercy--we don't deserve it and we are all complicit.
The woman seated opposite me tells me she’s on her second bunion surgery. Her doctor, a top orthopedic surgeon, charges more than the normal Sécu compensation, as do many specialists. Most French people purchase a supplementary insurance plan to cover costs not picked up by la Sécu. As a French resident and taxpayer, I have one too. http://www.translationservicesworld.com/french_translation/
Sasha (<br/>)
This is one of the reasons that I became a French citizen.
Thomas David (Paris)
OK let's make one thing perfectly clear....the social system in France is under attack by the current President and his party that received only 20% of the vote. Every American living in France that heaps praise on the Marcon government is a FOOL. This story by Erica Rex can be repeated a number of times. Examples: My FRENCH mother in law had cancer and EVERYTHING WAS PAID FOR. I had knee surgery by the best surgeon in Franc and the cost was 46 cents..for a phone call..the rest social security paid. Why Americans are so afraid of a system like this is beyond me. Must be the propaganda supplied by the insurance companies and everyone that makes money off of sick people. Bernie Sanders has been a voice in the wilderness...hopefully soon this country will wake up.
Meredith (New York)
A long-needed op ed from the NYT, an intl paper--- with real people/concrete facts from h/c abroad. So why do “too many Americans not realize how much better off they’d be if they felt safer about access to medical care”? Because our press & TV cable news don't live up to their duty to keep us informed on how other capitalist democracies have financed and used their h/c for all for generations. Thus we’re left vulnerable to propaganda against our interests----by big insurance and their indebted politicians. They shape our norms --that Medicare for All is 'too left wing liberal unAmerican.' Our voters lack the ammunition to assert their rights. Citizens in modern nations wouldn’t put up with Obamacare that uses our taxes to prop up insurance profits. Abroad, if not single payer, it's normal for govt to regulate premiums for the citizens that elect it to office. We fail that test of democracy, with the world’s most expensive and profitable medical industry. Before ACA we had violations of intl standards of 20th C human rights. The dead, disabled and bankrupted piled up. Our media owes us the big story contrast abroad. US media is proud of its constitutional protections from govt censorship. But it is subject to other pressures to conform to a warped political center shaped by big profit corporations. Americans are swamped 24/7 with TV drug ads. We once prohibited this. Today most other countries ban them. What does that tell you?
Alpha (Islamabad)
I continue to be puzzled by American foreign policy, if Israel does not consider ISIS as existential threat then why US 8,000 miles away feels threatened? Perhaps better use of American tax dollars will pay for American Universal Health Care.
Kirsty Mills (Mississippi )
Exactly the experience we had of French healthcare living there. Great care, no frills in terms of office decoration or personnnel (our doctor kept the cash box in her bottom drawer to take the 7 euro fee, making change herself). Any fear you have is for your medical prognosis, not your financial one.
Hawk (US)
Just wondering if we would be having a different kind of conversation if the lady's name was Maria Gonzalez (from Mexico)? Would the conversation be less about health insurance, and more about Immigrants/freeloaders? (this woman married a Brit for the sole purpose of getting free health care)
B (NJ)
In America it is all about money. That is all anyone seems to care about.
Casey (New York, NY)
I had a Canada relative with early onset dementia. He became paranoid and violent....and was committed. The family was able to keep the house and their lives. They worried about Dad, not bankruptcy. I saw the same with a friend's father here. The nonsense and hoops needed to get him on Medicaid were a huge burden to the family and it only finally happened due to a persistent daugther and a very helpful navigator. What a horror show. If you have good insurance, you are in a tiny minority in the US. Civil Servants, Police, Legislators, high corporate or professionals only (and NOT if you are self employed, thank you) have it. For the poor, Medicare and huge lines/waits, the middle class gets to "play" rich if they get ill, spending big with big deductibles till the bills come, and then it's to the bankruptcy attorney. Those who don't have to actually worry are a minority...and, very sadly, include those in Congress working day and night to make sure we remain "health insecure", to steal a phrase.....
RLiss (Fleming Island, Florida)
The Democratic party MUST make "medicare for all" it's flagship issue.... Don't let us be highjacked by the "squeaky wheels" that made the 2016 election seem to somehow be about transgender bathrooms. Yes, LBQ etc issues are important, but a national political party should be able to prioritize.
Midnight Scribe (Chinatown, New York City)
Insanity? No, that's too uncivil. Stupid? If you can't say something nice, then don't say anything at all. Not cost-effective? OK. Now you're getting on ground that we might hoe a row on. The American healthcare system is a nightmare. It's "for profit" on a Frankenstein tour of the ER. But the ER is where all those poor benighted types with no health insurance get their primary care. And, at $3,000 bucks a whack. And who pays for that? The people with private health insurance because of "cost-shifting." And why do private health insurance premiums go up 10% a year like clockwork (or more)? Because there is no control over what you can charge for health insurance (not until Obamacare, pre-existing conditions, etc., which we're getting rid of next week if we're lucky). Hip replacement surgery in Belgium costs $12,000 (unless it's free). In the US, at a good hospital with a good surgeon (not the guy that sells the prosthesis), it can cost $120,000. And, the clinical outcomes in Belgium are better. Vote Republican: "Make America Great Again," and avoid a socialist takeover of healthcare and the Staten Island Ferry.
Pb of DC (Wash DC)
Healthcare, like life in general, is expensive in the USA. If you’re middle class, life will be hard; you probably will never retire. If you’re poor, you’ll die working. If you’re upper class, you’re in the right place. America is for the rich, paid for by the lower and middle classes. Don’t believe me? Who just got a big fat tax cut recently? The rich.
kathy (SF Bay Area)
"American values are deranged", said the French doctor. True, and so tragic. We'll never know how much human capital our sociopathic system has crushed. We the people are not in control. We can learn, and we had better do it fast.
Pat (NYC)
Deranged is a good word for our health system and our political system.
David (Brisbane)
This is just wrong – to stick taxpayers of a foreign country with a huge medical bill by taking advantage of a loophole in their legislation and a lax attitude of their government. Nothing is free – French people pay for your treatment, while you enjoy the benefits without having to contribute a lifetime of taxes to their system. That is not much different from theft really. How long do you think this loophole will last if more and more foreigners took advantage of it at the expense of the French taxpayers? Did you even try to fight for a decent health care system in your own country before country shopping for medical care?
JQGALT (Philly)
The problem with socialism is that eventually you run out of other people’s money. - Thatcher
When the French wise up to American medical refugees arriving to take advantage of medical care in France - "WHAT THEN!" ... as Peter Ustinov sternly states in my favorite recording of "Peter and the Wolf".
John (NYC)
HA! "American values are deranged." We American's, and our privileged caste of leaders, squabble over the costs for a wall that will accomplish nothing, expending endless amounts of political, and real, capital in pursuit of it. Yet we give short shift to the health, education and general needs of average America. What is wrong with us? Deranged, indeed. John~ American Net'Zen
JND (Abilene, Texas)
We can only hope that disgruntled Bernie voters will move to France soon.
Claudia (St Paul MN)
Recommend T.R. Reid's book. "The Healing of America. " Amazing what can be done when there is a will.
realist (new york)
All the smart Americans realize just fine how much better off they would be if there was normal health care in this country. Unfortunately, most Americans are not very smart, otherwise such system would already be in place and we wouldn't have this scary Toad as the leader of the country. When you faced life without dignity in the United States, you voted with your feet. For most Americans that will not be an option. People better get creative or end up in the poorhouse.
Mr. Bantree (USA)
I will never understand how the millions of people who pledge allegiance to the Republican party have swallowed hook, line and sinker the idea that anything other then free market and for profit healthcare is a pinko commie socialist threat to our society. Especially when they themselves fall victim to that very same healthcare system where access now comes with a potentially bankrupting sticker price. Even the smallest of attempts to provide some minimal assistance back to us for our healthcare, with our very own tax dollars, is met with attempts to destroy it, rather then help to improve it as we witnessed with the Affordable Care Act. The argument they will give you is that we don't want a socialist society of slackers. Well, if someone is capable of working and ducks that responsibility to live on the government dole I would find agreement in their sentiment but sickness and injury chooses you and you cannot metaphorically pull yourself up by your own boot straps...even if you're a Republican...unless money is no object to you and perhaps therein lies the main root of the system's evil.
Mathias Weitz (Frankfurt aM, Germany)
Just look at the list of countries by total health expenditure per capita https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita It is totally nonsense that "socialized" healthcare is more expensive, it is quite the opposite. Not even taken into account that socialized healthcare covers all people and has higher standards. This "american" health care is just a skimming scheme for the white rich robber barons. They play the american citizen for fools. Why is it so hard to give people a good account on the facts, and what they get sold by the spin-doctors ? Is it all about manipulating the public will. And the only difference to 1930 is, that they use this propaganda to turn the people against themself ?
Le Michel (Québec)
''Imagine what might happen if everyone felt safe — safe enough to talk about ailments in waiting rooms.'' My guess... a white male with a loaded gun?
chambolle (Bainbridge Island)
American exceptionalism in a few easy lessons. One: 35,000 deaths by gun per year, and no will to take any meaningful steps to rectify this horrific situation because FREEDOM! The Second Amendment and the god-given right to acquire firepower and use it wherever and whenever we see fit - often for suicide among despondent, marginally educated, middle-aged white rural males. Two: 75,000 deaths per year by drug overdose, increasingly concentrated in stagnant rural towns. Rather than address this crisis, our government rails at ‘illegal immigrants’ and blames them for our ills, such as drugs and violent crime. See item One, supra. Three: Virtually everyone, save the very wealthiest among us, and including people with health insurance, high deductibles and copays and all the other bells and whistles of the privatized system, live in fear of falling seriously ill and becoming destitute as a result. We continue working well into our dotage and stick with jobs we may despise just to keep the insurance we have, inadequate though it may be, because it’s still better than nothing. Four: Post-secondary education that leaves millions of young people deep in debt before they’re 25, behind the eight ball before their careers and adult lives get off the ground. Five: A land where ‘pensions’ have gone the way of 8-track tapes, and where the money we paid into ‘Social Security’ is gone, pilfered and squandered on senseless wars. MAGA! USA! USA! USA! We’re Number One! No, we’re not.
Tom Miller (Oakland)
But beware if you are a foreigner caught in the U.S. Without travel health insurance! You may be paying for your treatment the rest of your life unless, hopefully, countries who provide free health care to visitors refuse to enforce the United States' profit based health care system debts.
Geraldine (Sag Harbor, NY)
I was 12 and visiting my Gran for the summer in Scotland. I fell off my bike and broke my forearm. She took me to the Stirling infirmary and there was no waiting room. The triage nurse took me right in, made a big fuss over "the wee Yank" and sent me on down to X-ray. The doctor put a plaster cast on my arm and I made the mistake of boarding the plane for home 4 weeks later! My Gran paid nothing. NHS even paid for our bus fare. We had no insurance in America and removing a cast is not an emergency so none of the docs would see me unless they could order x-rays my parents simply couldn't afford. We waited a little longer for it to heal and my Dad elected to cut the cast off my arm with his pocket knife in our living room. I had no follow up care. Welcome home to America!
S Sm (Canada)
As someone who is a duel citizen and in possession of a British EU passport, I have to ask, how on earth do you acquire "leave to remain" through an acquaintance?
Patrick J Hickey (South Melbourne Australia)
The author of the story made no contributions towards her own health whilst “an American.” Then moved to the UK and thence France billing their respective taxpayers for her health misfortunes. She now appears to be quietly complaining about having to live in France, rather than the USA, whilst the French taxpayer funds her health care. The French nation, its people and their healthcare system are exceptionally generous. The author and her home country - not so much; it wasn’t always thus.
Tim (DC area)
I wish the article had elaborated more about how Erica obtained French citizenship.
Gordon (Canada)
Elites in America value a massive, massive military as a means to grow and protect international business. Elites in America have nothing to gain by providing national health care services.
Chris (South Florida)
I can surmise the whole healthcare mess in the US this way. Conservatives are all about me. Liberals are about we. Until Americans wake up to this essential fact and vote differently nothing will change.
Nan Socolow (West Palm Beach, FL)
Fascinating piece, Erica Rex, thank you. Obviously health care in France and UK is not "deranged" as it (and our current president) is. Absorbing your words and hearing your medical experiences in Europe are lessons to those of us who are still physically and mentally able to consider immigrating to France, UK or Canada to sidestep the scary state of medical ill-health and for-profit health insurance in America. In the US, people can't afford to be sick unless they're like Trump and the 1% who can afford mortal illness.
Mat (Kerberos)
I still don’t understand why you guys haven’t had a second, albeit peaceful, revolution over healthcare. Divide and rule at work again, as those in hock to lobbyists work their wicked magic and convince you all that healthcare is not a right. What happened to “Life, liberty and the pursuit of happiness”? Replaced with unnecessary death, insurance ransom and fear of insurance refusal.
jenna rosen (jersey city, nj)
@Mat Couldn't agree more, Mat. The last line of the Declaration of Independence says, "And for the support of this Declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor." Somehow that pledge of the mutual obligation at the root of the American concept of citizenship has been stripped from our memory, buried by the selfishness and greed for profit that are unleashed when democratic values do not properly reign in the effects of nearly unbridled capitalism on the human soul.
Peter Hornbein (Colorado)
@Mat The American psyche, our frame of reference, is founded in the notion of Independence, Strong Willed Men who can Pull Themselves Up with Their Bootstraps. They don't need anybody, and if they do, then they are not Real Men. The problem is, these same men - White, Wealthy Men - have slashed the bootstraps while maintaining the illusion that we (all of us) can have it all if we just work hard enough - we're guaranteed Life, Liberty, and the Pursuit of Happiness if we work hard enough. One can cite the Declaration of Independence and the Constitution, but one must also keep in mind that those documents were written by and for landed, white men, not women, People of Color, the working class and so on (I parenthetically note that working class includes professionals like Teachers, Police, Fire, Military, Nurses, etc.). The inclusion of others, e.g., women, is only an afterthought.
washingtonmink (Sequim, Washington)
@Mat for generations Americans have been raised with the message that the only thing that counts is hard work, dedication to your employer/job and to ask for or expect any security nets from the government deems you to be lazy and non-productive; two words that terrify Americans. "Life, Liberty & the Pursuit of Happiness" are just that - words that sound good in a sound bite and sales pitch. Reality is quite different.
Theni (Phoenix)
All my siblings are in Canada and I sometimes envy them about their health care. Americans, especially GOPers, are notorious about dishing the Canadian healthcare system. No Canadian I've met ever wants to go back to the "bad old days" of no single-payer coverage. Canadians vote is higher numbers than us Americans and no politician would ever suggest changing the present healthcare system there. Not even the so called Conservatives of Canada! No wonder Faux news does not broadcast in Canada.
RNS (Piedmont Quebec Canada)
It's truly astonishing that even with a president who undoubtedly would be the best doctor in the world, if that's the career path he had chosen, you are still floundering around when it comes to health care.
Jethro (Tokyo)
Americans assume that healthcare is crushingly expensive. They therefore believe that universal coverage must be inferior. But where citizens are protected from exploitation by the healthcare industry, prices drop and everything else -- including universality -- is suddenly no sweat.
Danielle Treille (Brussels, Belgium)
20 years ago, my husband (a US citizen working in Belgium) had a blocked artery in Denver. He was only admitted to the ER after a friend produced her credit card... He was told he had also suffered a heart attack and needed triple bypass surgery which would have cost $120,000 (with a 10% discount if we paid cash!!!). I spoke at length to our Professor of Cardiology in Brussels, who told me that if my husband could get back to Belgium, he would see him immediately. End of story: no heart attack, no bypass surgery. The bypass surgery was eventually performed last year: cost 0 because we also have an extra insurance which picks up what the national health insurance doesn't!!! The cost of this insurance per year covering three people (and two cars!): 2300 euros per year! Everyone can afford to be ill in Belgium...
philip (texas)
MAGA? It was never great and this story is just more evidence of the facts. And why would Congress address this? They have a Rolls Royce health, retirement, long term care horn of plenty. In Texas docs and hospitals got rich on another Bush act of tort reform. Medicare cant require bids for drugs. We cant import cheaper drugs due to Congress. And beware, Obama let the industry write Obamacare. Couple this with Brady and Ryan and the tax cuts. This country is in decline for the ordinary citizen.
David Bone (Henderson, NV)
I've been on government run health care since I signed up for the USAF in 1973. I retired after 20 years and have used the military retiree insurance Tricare for free ever since 1993. Thanks for paying your taxes. In 2005 during a physical they found a tumor the size of a golf ball on my left kidney. Doctors said to take it out ASAP and we found a surgery slot at my preferred hospital that night. Tricare had already approved the surgery over the phone. But lo and behold my employer provided insurance said to wait for their doctor to assess my condition from his office over 1,000 miles away. Needless to say we lost the slot and they also delayed it until the weekend! I actually had to wait because a private health insurance company would not approve the surgery that a government run insurance company had already approved. Tricare is secondary to private insurance. The "death panels" are in private insurance companies and they are called actuarial data miners. I would love to name this private insurance company but would probably be sued by their highly paid lawyers. We have a for profit sickness industry not a patient focused health care system. Insurance, hospitals, doctors, pharma are all working together to maximize their bottom lines. They do this by keeping us all afraid of the "socialized medicine" boogy man. I now gladly pay for Medicare! Thanks for all the fish, Dave
Susan (Paris)
Although the French have some inkling that healthcare coverage in the U.S. is unevenly available and exhorbitantly expensive - information gleaned from listening or reading news reports about America’s struggles with healthcare- they still look at me with disbelief when I tell them that you can lose literally everything you own if you are have a medical crisis or an accident and have inadequate insurance. When I explain that in America, the number one cause of personal bankruptcy is medical debt they are shocked and incredulous that this is possible in such a rich country. The French may pay high taxes for their generally excellent public healthcare system aka “socialized medicine,” but as any French person will tell you without hesitation “When you do not have your health, you have nothing.” The continuing lack of affordable healthcare for millions of American men, women and children is a disgrace.
Dana Charbonneau (West Waren MA)
What's missing here is the doctor's explanation of why he can't pay nurses, thereby freeing his time up to spend more of it attending patients.
Marcus Brant (Canada)
I was born and raised in Britain before emigrating to Canada. Consequently, I have enjoyed the benefits of socialised medicine in both countries and have had need, on frequent occasion, to use it. My wife, born and raised in Moldova where she trained as an anaesthetist in a publicly funded health system, now practises rheumatology here in Alberta. Neither of us, from our respective homelands, have ever experienced the plight of myriad Americans so burdened by prohibitively expensive health programmes designed with profit in mind. President Obama made a conscientious decision by introducing the ACA, and we can’t comprehend why Republicans would seek to dismantle it except to maintain an obscenely profitable status quo inherent in the US system that must kill or torment hundreds every day. It is heartbreaking to read about intolerance of illness experienced by ordinary Americans by the vile talking heads of the Republican movement who would ensure their own longevity while squandering that of lesser wealthy. It is immoral, amoral, cruel, ignorant, and despicably crass to force a compatriot to leave the land she loves simply so that she has the better chance of survival. Republicans, and those who support the destruction of the ACA, bask in nothing but sheer ignorance and ruthless greed.
Robert Dole (Chicoutimi Québec)
Thus it seems that I am not the only American who had to leave the USA in order to be eligible for health care. This is truly a national scandal, almost as bad as America’s gun violence or its never ending warfare. The rest of the world wonders whether it should laugh or cry about what the United States has become.
Autodiddy (Boston)
but what would happen to the standard of living of CEO's of health insurance companies (typically $20,000,000 per annum excluding perks) if the US were to adopt French style health plans....there's always a cost
Rocky (Seattle)
How un-American! Isn't Ms. Rex proud to be a citizen of the United States, where the First Freedom is the right of those who gain leverage through wealth or power to rip other people off?!
BettyK (Sur la plage de Coco)
I'm very happy for you, Mrs. Rex, for drawing the jackpot and actually coming across a French administrative office that functions. My experiences with residency in France and health insurance are quite different: I submitted about one thousand documents- including international birth certificate, three months bank statements, tax return, property tax return, etc.,.etc., for admission to the French health insurance system in June of 2018 and since then, I have been sent on a crazy, Kafkaesque runaround without success. Documents are lost, others I sent twice, missing. The thing is, I wouldn't measure my personal experience against yours for fear of sounding like a universal health care opponent, which I am not, or petty, were it not equally crazy in France to obtain a car registration and my U.S. husband's French residency. It is way worse than I have ever experienced in the U.S. In the meantime, i am stuck with a 650$ a month -German- insurance with a 2400$ annual deductible - and that is my best bet for comprehensive coverage after trying and trying. People who believe European health insurance comes cheap for foreigners or ex pats, are wrong. It is NOT cheap, nor easy to obtain if you are self employed. The doctors may be good and the medication very affordable, but you're still up against a uniquely crazy bureaucracy in France. Good luck to all who try. It's worth it to live here and for the holy Grail of the Carte Vitale.
Meredith (New York)
Our political culture upholds profit as 1st priority and many see it as un-American to interfere with it. How else could our high profit opioid epidemic become so destructive? Our govt did not regulate in our interests. Our h/c system has allowed early death, disability and bankruptcy. Our political culture lets h/c, drugs, and insurance to be big profit centers. Govt regulation, common abroad is called un-American. Other cultures try to control greed for the public good, while still operating in a capitalistic system. To get at the root of our health care cost and access problems we need comparison data on how other countries with h/c for all, also fund their election campaigns. They limit private money and use more public funding for shorter, lower cost campaigns. Many countries ban the costly campaign ads that swamp our media and voters, needing medical industry donations. Other countries ban the high priced, direct to consumer drug ads that swamp our media day and night. We used to ban those. Most other countries still do. I'm waiting for some NYTimes columnists to show some interest in grappling with these underlying factors calling the shots in our health care policies. These are what keep the US lagging 1st world nations. If our media keeps all this under the radar, politicians will never be freed up to fight for our medical care rights in a democracy.
Melpub (Germany and NYC)
Oh, I'm in the same boat. Born and bred in New York, but moved to Germany for love--and I'm lucky that when I came down with breast cancer after a lifetime of health, the German insurance system covers all. I'm on Ibrance and Fulvestrant, which are saving my life--without them, I'd have been dead months ago. A month's supply of Ibrance costs slightly less than 3,000 euros here--I pay ten of those euros. In the States, the exact same 21-day supply costs slightly under $12,000. Plus, I'd probably have to sell all my worldly good to buy it, since I'm sure my former insurance company there would never have been so generous. http://www.thecriticalmom.blogspot.om
Kevin (Dc)
A healthy workforce is a productive workforce. Why don’t republicans get that??
JeezLouise (Ethereal Plains)
What I can't quite believe is that, with apparently absolutely no connection to the country save for a sponsor, the UK allowed you to come in and paid for your (expensive) cancer treatment, despite you never having "paid in" one penny in taxes to that country's health system. While that's great for you, it's an insane way to run an economy. And thanks to the EU rules, you could then simply cross through to France to benefit from both its health system and more pleasant lifestyle. No wonder the Brexit vote got up, and no wonder the yellow vests are rioting. None of this is free, people. Someone (ie the citizen) is paying for the largesse of these governments.
Kenneth (Copenhagen DK)
American expat resident in Denmark for 28 years. Besides the obvious advantages of European health care systems for the great many (despite minor disadvantages noted in some of the comments like waiting times and access to specialists), the general quality of life and standard of living is much better here than for most in the US. I have long suspected that one of the other advantages of European life, cheap or free high-quality higher education is something that is directly feared by Republican and conservative forces in the US: As long as these forces can maintain a pool of uneducated and naive voters that they can hoodwink with lies and untruths, they have an electoral pool of votes. It's not University educated voters that support a con-man like Trump.
Steve (West Palm Beach)
@Kenneth I wish it were that simple. You might just be surprised by the kinds of people who support Trump. Plenty of them are wealthy, powerful, Ivy League-educated, very sophisticated . . . and very nasty.
Ronny (Dublin, CA)
The Greed is Good GOP believes Americans should only get the healthcare they can afford, and the justice and education and food and shelter, etc., etc.
Robert (Out West)
I agree with the general point, but in New York you could have gitten at least a catastrophic coverage “minimum value,” plan, on the Obamacare exchange, and your total costs would have been capped at around 9% of annual income. This looks like taking advantage; hard to believe that if you coukd afford to uproot and move to France and buy a supp plan...
Carling (Ontario)
In fact, the French medical system is the world's best, not only for cost, but for quality, and so is medical research.
DaveS (Byram, New Jersey)
Living with my wife and child in Taiwan on a working visa back in the early 00s for a year, the country supplied my necessary - but unexpected - universal health coverage. With epilepsy in USA, I had paid for constant neurological scheduling hassles, ambulance/EMT & ER-hospital extreme cost and billing > collectors nightmares, pharmaceutical inconsistencies and anti-seizure medicines cost blowouts, plus independent doctors that just tried unsuccessfully to "stabilize" me for 25 years. In Taipei, I was SO PLEASED to get instantaneous, outstanding treatment from top-notch epileptologists and their nursing staff by just walking into University Hospital. NO APPOINTMENT! The concierge was just like, "Epilepsy? OK, walk 50 m down this hall and sit down in the waiting room." I was alone; next; met my personal doctor for the year in the year in his office in 10 min.; received a full skull MRI with interpretation!; and, then walked out with a full bottle of my medicine in 60 minutes. ANXIETY RELIEVING SHOCKER! Yet, the BEST PART was yet to NOT come. Not only did the State/Hospital not charge me at all (all year long); they DID NOT SEND ANY BILLS! There was zero bureaucratic nightmare associated with Taiwan's medical system. HOW RELAXING. The stress of American-style billing is eliminated, and the anxiety [which itself shortens lifespans] of paper-internet-bank/charge-card-mailings-deadlines-apologies-and worst-case-scenarios simply vanish in every SINGLE-PAYER-SYSTEM.
Tim Barrus (North Carolina)
I am sick with a fatal disease. I can't say which one. Stigma around it is so American, so uninformed, and so mean. Although there are actual celebrations in the streets (regarding what is called progress and is a public health campaign slogan), there has been no actual progress whatsoever. Big Pharma has not reduced, only increased, pricing in huge and dramatic ways. Greed in disease is an old American kidnapping. You pay it or you die. Robbery. My own twelve different medications clock in at $150,000 a year. This renders American medicine into a death wish. I prefer the death wish. A group of us, all with the same disease, flushed our pills January 1, 2019. We will die. It is okay. We prefer death to kidnapping. We are now keeping a journal that record the pain, the decline, and the agony of our deaths down to the last one of us to live. The journal will also record our funerals. Let us be real. America does not care. and never did. We care. And we are sad to go. But we are resolute. We cannot afford to live. Personally, I welcome death. Health insurance companies are kicking people off the rolls if they become as sick as we are. This is not legal. Again, Americans do not care. We twist in the wind, and not all of us can afford the price of flying to France. To sue also comes with a price tag none of us can pay. Health insurance companies know that, and they kick us off with impunity. They know the law will never be enforced. I greet death with open arms.
Karen (New Jersey)
The stress of getting sick in this country due to the real possibility of bankruptcy from medical care makes us all sicker. The USA is the ONLY 1st world country that does not provide insurance to all it's citizens. This is a punitive country. The cost of providing medicare for all is less than not providing it.
@Nicholas Rush/Colo Springs Vote what? Democrat? Need I remind you that is was a not-very-involved-in-anything-Obama that gave you the privatized, expensive and pretty-poor healthcare system that is currently available in this country !
Michele K (Ottawa)
While I have to admire your determination to inform Americans of their foolhardiness re: healthcare, I have to wonder how it is that you thought it appropriate to go to another country and let its citizens pay for your care. Americans should be ashamed. A rich country that refuses to look after its own.
Outer Borough (Rye, NY)
Did our esteemed MBA’s and firms like McKinsey figure out a long time ago that ‘monetizing’ just about everything and now just about everyone (I.e. Facebook) is the key to corporate growth. Disgusting that our health is included in a monetization scheme.
George Jackson (Tucson)
Excellent opinion. America needs to run Health Care more like it runs Defense. Remember, our Constitution says ".. to provide for the Common Welfare..." 1. Nationalize all Drug production and R&D 2. Make all Generics at a minimum low cost plus based FAR contract. Result: Instead of monopolies on Generics at $200/month, a true cost plus woul yield about $5/month for EVERY GENERIC 3. Give CONTRACTS for DRUG Development. We give CONTRACTS for MISSLES and FIGHTERS .. works right !!! 4. Hospitals - every M.D. in the National System on a Salary. A very good salary. Be better than the VA - like Mayo or Cleveland Clinics. 100% Elimination of 100% of all Health Insurance Companies. They are ILLEGAL. Replace wtih Center for Medicare Sercices - ie CMS ie. Medicare. Medicare works. it is easily scalable and improved. Finally, raise the Medicare tax to 5% minimun on all Corporate Revenues to 3% on REVENUE not Profits and fake hidden profits.
Turgid (Minneapolis)
Why did the French not call out the military to confront this immigrant at their doorstep clamoring for health care? The author should have been made to wait in the Atlantic ocean while France considered their call for financial asylum.
Abraham (DC)
America is the Guatemala of health care. Next we'll be reading about waves of sick Americans forming "caravans" trying to gain entry to Europe as health refugees. Is just a merger of word getting out. How will the Europeans react? Reasonably. Tear gas and walls, no doubt, to keep out all those "disease ridden" Americans.
R. Littlejohn (Texas)
Even Medicare is very expensive. Part B does not cover prescriptions and only about 80% of medical bills, it does not cover dental care. In Europe, one premium covers all that no additional insurance is needed, there is a small copayment for prescriptions. American seniors need several policies and still pay hundreds of $$$ for prescriptions and co-payments. Almost 20% of GDP for health care and still a rotten system.
Fran Eckert (<br/>)
@R. Littlejohn the author stated that many people buy supplemental insurance, for better doctors who don't accept the government reimbursement as payment in full. This is similar to Medicare here. You can join a Medicare Advantage Plan which will reduce or erase the Part B premium and cover everything - but you must stay within their network. We choose to pay for a supplement that frees us to see any doctor and use any facility we choose. It is better than any employer provided coverage I had prior to turning 65. The author of the piece does not mention the tax burden she has assumed for her French residency to pay for the liberty of discussing her ailments with fellow patients in waiting rooms. Doctors don't work for free in any society (except Cuba). I would love to hear how the "Medicare for All" people feel about it if someone informed them what their tax bill would be to pay for it. BTW - I shudder to think what the HMO's pay providers after seeing what Medicare actually pays my providers vs. what they charge, and my heart goes out to the uninsured who pay full sticker price to make up for those miniscule payments.
vulcanalex (Tennessee)
@R. Littlejohn Great points, but a system that is appropriate for the US, the French one would not be in my view. It would create chaos as providers refuse to take the lower payments, patients see massive wait times, and tax payers revolt in the amount that it would cost.
vulcanalex (Tennessee)
@Fran Eckert Almost nobody pays full sticker price. Otherwise great points that few even consider. They just want their care for free.
Cindy Powell (South Korea)
I have been living overseas for three years with two years in Poland and now one year in South Korea. I have received very good and affordable health and dental care and my employer pays 30% tax for me. What I have noticed is that the doctors do not get rich in these countries. For instance the average salary in Poland is $13,000 and a physician makes $26,000. I am concerned about the health care costs in the US. I have also seen my father receive so many needless and costly procedures in the last couple years of his life. He is dying so why did he need a colonoscopy? There seems to be a big difference of profit and greed which raises the health care expenses in the US.
Gazbo Fernandez (Tel Aviv, IL)
My cousin is a radiologist in America. She makes $700,000 to read x-rays. These is something wrong with that. I’d like to hear a justification of that salary from an American doctor. And please don’t start with the cost of medical school and how long you were studying.
Bruce Stafford (Sydney NSW)
@Cindy Powell, it's litigation fears which are the driver of needless and costly procedures. They're done just in case some obscure and rare condtion is otherwise overlooked.
John (Santa Monica)
@Cindy Powell Physician costs make up roughly 20% of the health care dollar. Where is the other 80% going? Over a third goes to overhead (including insurance overhead). Be upset about that.
Diane (Cypress)
Traveling many times to the UK, and other European cities health care always comes up when speaking with the locals. No, they don't love the taxes, but they wouldn't trade their system for ours. ever. The peace of mind to know their families and themselves will always be covered for any illness large and small is one less worry one has living in this mixed up world. One aspect of Universal health coverage, or a Medicare for all here in the U.S. is some seem to have a real distaste for covering everybody. You will hear many saying, "why should my taxes go to the bum next door who doesn't work, why should my taxes go for maternity care, I'm a male, why should my taxes go for - you name it. We have to get over that destructive attitude. The truth is that with everyone covered not only does it help level the playing field with young and healthy versus older and less so, but it makes for a healthier society, a healthier community.
Ted (Portland)
@Diane Medicare for all is no solution, indeed Medicare still leaves you liable for enormous medical expenses. We need single payer and the willingness to fund it, easy if we would stop fighting wars for others and spend on healthcare, education and infrastructure. This is a bipartisan issue, both parties are guilty. The ACA should have been written on one page, forcing insurance companies to cover those with existing conditions, that’s the only good thin* about it, as a senior my coverage and the ability to get coverage has worsened dramatically since its implementation: the Docs get paid less for seniors on Medicare, even with a supplement so they take as many as they are required to, indeed in rural Oregon I see exclusively well meaning but poorly trained nurse practitioners and can’t even get one of them for an internist. This country has a huge problem as 20% of our gdp is spent on a mediocre healthcare system that makes insurance companies and Wall Street owned medical practices and hospitals very rich. The ACA was very little help aside from the preexisting issue, indeed it was terrible for seniors. Thank you Joe Lieberman for shooting down single payer to keep your insurance company constituents in the deep clover. Don’t expect any changes no one wants to pay taxes.
Adrienne Raymond (Vermont)
@Diane, you have hit on the real problem. The US is a very selfish, judgemental society. We judge people and decide whether they are worth supporting. Our mythology is that everyone should be entirely self-sufficient. It is a ridiculous belief that is encouraged by trump and his followers. I really doubt we will continue as world leaders given this inability to recognize this falsehood.
RPbeans (Morgantown, WV)
@Diane. I think the attitude you describe in America is prevalent in part because so many citizens have adopted a very selfish form of Christianity. I have what I have because I am obviously blessed by God and deserving. Others not as fortunate as they are obviously aren’t blessed by the all knowing, conditionally benevolent being. We are at heart a cruel even hateful nation. And we have a political party that has for political gain leveraged hate and self pity for decades.
Anne-Marie Hislop (Chicago)
Americans are not willing to make the trade-offs of higher taxes and (somewhat) less choice in order to have healthcare there when we need it. When folks are well they resent the higher taxes; when they become ill it is too late to try to change the system. There is something distinctly non-generous in our culture which drives us to think that healthcare is the problem of those who are ill or disabled.... until we ourselves join them. Look at all the resentment which built up around the modest effort of the ACA to require folks to buy insurance (the "mandate"). Such an outcry! How DARE the government require folks to be covered 'just in case.' It's my "right" not to have insurance (then my "right" to use "charity care" when I hit a tree with my car). Until we figure out that we are all in this together and that no one - no one - is immune from a sudden illness/accident needing expensive care, nothing will significantly change.
Susan (Paris)
@Anne-Marie Hislop Thank you for your comment which is a perfect summing up of the attitude of many Americans to paying for healthcare.
Ilona (planet earth)
I live in Europe and I have noted before that I have never filled out an insurance form, except once -- for travel insurance -- when we were in the States in Lyme disease country, and were unable to fully remove the head of a tick embedded in my son's arm. They did it at the emergency room for a thousand dollars. When I told my son's pediatrician back home, he said next time just fly me over and I'll remove it. It would cost less. Also, for those who have noted they have received free care in Europe. It's probably in part because most doctor's offices don't have cash registers. Why would they?
RobT (Charleston, SC)
US health care is stay young, stay healthy, or go bankrupt while life expectancy decreases. It's an inverse ratio of health and financial solvency.
Henry Rawlinson (uk)
As a "Brit", I have needed hospital care several times. It is probably less luxurious than the facilities in the USA, but the actual care has been excellent and no huge and unexpected demand for money to pay for it. It is possible to get private health care here, but that is usually for elective care, rather than emergencies. I am sure that there are pros and cons for any health care system, but personally I like the fact that any person needing health care, receives it as a right without the additional worry of the financial repercussions.
WishFixer (Las Vegas, NV)
The solution hasn't been discussed: EVERYONE needs to be paid an amount equal to health insurance company CEO's. Problem solved, right?
RF (Arlington, TX)
The responses to this column by those opposed to universal healthcare are true to form. Someone points out that people in the U.S. pay into the medicare system and receive nothing from the system until they retire. Another points out that a particular treatment was not available (or prescribed) in Europe but was in the U.S. Then another points out the higher tax rate one must pay in European countries compared to the U.S. All of these miss the point of universal healthcare: EVERYONE IS COVERED!
Marie (Texas)
Just a thought. In reading some of the responses here, it struck me how many retirees relocated to some of the European countries to benefit from their excellent medical sytems. In my mind that is quite unethical to benefit from a system you never contributed to.
Rob Kneller (New Jersey)
@Marie Don't worry yourself. Those countries don't worry about it. And those retirees are probably paying taxes on their retirement income. So don't fret.
Patrick (Larson)
This is the attitude that keeps us from moving toward universal health care. Many new citizens would get free health care under Medicare for All. Is that fair?
Mike Law (Newtown Square, PA)
If taxes are collected and spent for the common betterment I would say we got a good return on investment. The price we pay for civilization is taxes. Our wealthy few percent have never had problems obtaining health care or eluding their fair share of the tax burden. The US has a pretty good health care payment system in the form of Medicare. Make Medicare universal covering about 70% of basic health care, the difference of 30% also paid for the very needy and for the rest, the 30 percent deficit paid for by private insurance. This is roughly how the French system works. For most French about 70% is paid by general revenue and 30% by a system of insurance.
Geof Rayns (London)
I have company paid private health insurance here in London. Almost two years ago I found out - a lucky break so to speak - that I had stage one stomach cancer. I could choose to go privately - and the consultants would be paid, handsomely - or go to my local hospital (University College) or of course a private facility. The NHS hospital was recommended as having the best equipment and all round expertise. Recommended, I might add, by the consultants who would do the same work privately. One year and a half later, following a gastrectomy, I am able to return to running and exercise (I am 68) and feel pretty good (albeit lacking 90 percent of my stomach). The treatment, aftercare, GP and nursing services and drugs cost me precisely nothing. My treatment (allowing for the obvious difficulties of the surgical removal of my stomach was wonderful.) And by the way, the NHS saved my life before when as a child I had a fractured skull. Yes, this is an anecdote, but I wonder why it is that the US has such a costly, inequitable and fragmented system compared to any in Europe? There is actually a simple answer. Health care is seen as a consumer good where the providers - from doctors to drug companies - can get super rich. And they are very prepared to bribe politicians to support their interests. Sure, the situation is great for the super wealthy but is a disaster for the majority, including employers who pay the bills. When will the Democrats spell out a proper alternative?
Mark (Cheboygan)
@Geof Rayns I have been waiting a long time, Anyone who gets active for it is told they are a dreamer or unrealistic. We'll get there gradually when we reach the vanishing point.
Thomas (Vermont)
The comments here are so encouraging in the sense that the the sheer number of anecdotes and opinions add up to a conclusion that is obvious: Americans will support universal healthcare. That we don’t have it points to another conclusion: we don’t live in a democracy and haven’t for quite some time.
tom boyd (Illinois)
@Thomas "we don’t live in a democracy and haven’t for quite some time." That's why we need to correct this flaw. Find strong Democratic candidates to run in red states and emphasize health care first and foremost in their campaigns. Hopefully this will elect a few more Democratic Senators.
Thomas (Vermont)
@tom boyd my entire extended family is from Iowa, not one remains there. How can you fix that? The Senate has to become more representational. This isn’t the nineteenth century.
Patrick (Larson)
The senate is not necessarily representative. The house is (House of Representatives?).
Cathy (Hopewell junction ny)
The reason we call healthcare "socialism" here is that the folks who make money off the system have really good representation. They can afford to demonize the sensible to keep the money flowing. What always amazes me is how people buy into the fairy tale being spun for them, mostly by people who are protecting their investments. There are solutions - other countries all run on different models - and we could choose one that works best here. But instead, we let corporations and lobbyists choose our plans, fearful that the government doesn't work in our interests. And a CEO does? Insanity.
navybrat (Apex)
I'm a cardiac acute care RN. I can't count the number of times I've done an admission for an out-of-control blood sugar caused by the inability to pay the $700 a vial of insulin costs, or newly diagnosed heart failure patients who would had been diagnosed and treated but never went to the doctor until they can no longer breath, heart failure greatly worsened by the delay of treatment. My Trump supporting daughter recently lost her own insurance when an agent committed fraud and pocketed her funds. She has medical bills that will be unpaid and preexisting conditions against her, but still believes that the ACA is the worst thing that ever happened to health care.
reader (nyc)
The CEO of the large hospital I work for makes $4 million/year. Do I need to say more?
Steve (West Palm Beach)
@reader I wish insurance CEOs made that little.
Marj Woldan (Stamford, CT)
Aren't higher taxes for ALL cheaper than, say, individually paying the medical debts of your sick, injured, uninsured parent, child, etc., so they don't go bankrupt, wind up on welfare, which everyone's taxes pay for anyway? If higher taxes aren't cheaper, why have social security, medicare, medicaid. Instead: "it's your own fault: you chose to live a careful, healthy life and lived to very old age"; or "invested in a college education instead of health insurance".
Zinkler (St. Kitts)
We have monetized every aspect of health care and taken the caring out. The costs of our system are incredibly great and although we lead the world in cost, our healthcare system was ranked 37th by WHO. Our costs are currently subsidized by tax money via 20% of the work force being employed by government and public healthcare programs picking up the tab when the patient is unemployed, bankrupt or old via Medicaid and Medicare along with other lesser programs. Health care is not something that can be "insured." Insurance requires a sharing of risk that like home owner's insurance, where insured events are low in frequency. Health care expenses are not a risk, they are an eventuality. We all need healthcare and in a country with our wealth and power, we should be able to provide it for all. Imagine a country in which clean drinking water was dependent upon employment or special support from the government.
Hap (new york)
I am baffled that we continue to call it "insurance". Catastrophic insurance where we can spread the risk and cost for unexpected illness or accidents, maybe, but "insurance" to cover my basic, expected, necessary health needs? Ridiculous. Maybe it shouldn't be free to all, but can't we figure out how to make it reasonable??
Jason Q. (Omaha, NE)
The author is correct that many Americans don't realize the benefits of a universal healthcare system. Unfortunately, there seem to be many more who simply don't care about the well-being of their fellow Americans.
Ron Adam (Nerja, Andalusia, Spain)
My wife and I are retired Americans living in Spain. We have private health insurance coverage here, although recent political changes may make it possible to receive government provided healthcare. We pay less here for comprehensive health and dental insurance coverage then we paid as our share of our employer-provided private health insurance back in the US. My wife is receiving excellent, caring, up-to-date treatment for Stage IV Ovarian Cancer, including hospital stays, chemotherapy treatment, and many medical procedures and tests. We keep our daughter, an Internal Medicine Doctor in Atlanta, informed about our treatment, and according to her, my wife's treatment here follows US best practices, and has produced excellent well-documented medical results. We are so relieved! Our out-of-pocket costs for months of extensive care has been less then a thousand dollars! I am sure that our direct costs would have been much more in the US. We've had continuity of care, compared to almost annual changes of carriers we experienced in the US (with changes in covered doctors). We've had no surprise "out-of-network" bills, and we have received prompt authorizations for every medical procedure, including expensive genetic testing (not that I know the actual cost, my co-pay was minimal). We get prompt copies of all our records. We always assumed that if one of us got really sick we would go back to the US. After six months of extensive care, we are so very glad we stayed here!
Kate (Dallas)
I am planning to retire abroad in 10 years because of health care cost. It’s a no-brainer.
P Dunbar (CA)
In my opinion, the key comment in this article is the worry aspect. Countless studies have shown the detrimental aspect of worry to overall health. I get really annoyed at the notion of "socialism" as a negative when it comes to medicine. European medicine is not perfect, and it is a huge improvement on what we experience in the US. Making sure that our citizens on a day to day basis have good care is an honorable goal.
Richard (UK)
Even the most hardened right wing conservatives/ nationalists/ republicans, in Europe, would not deny universal health care. As with democracy, it is a right, for which we pay our taxes. In the UK the tax rate is below 30% so not that bad. We don't view it as a 'socialist' policy in terms of political bias, more as socialist in involving everyone. Yes we can't get all the most expensive treatments, but if you have a modicom of health insurance that will cover it. We have all the latest scanners and techniques tho'. My wife (65) has private medical insurance £55 a month - less than that for our dogs, that covers all cancer treatments forever amen. Last year on the NHS she had XRays, MRI scan, ultrasound, ten or more doctors appointments, four consultancies for the precise cost of nothing as she doesn't pay for prescriptions (£10 a drug for a course) as she is over 60. I had tests for cancer, two weeks maximum from referral including consultant and endoscopy, all done in ten days - all clear, no cost. As the writer pointed out, we all know we have health cover for life, including own fault accidents, which is why we all take up tight rope walking at 60.
Jonathan (Brookline, MA)
My daughter is an anesthesiologist in the Central London deanery and has also practiced in the EU, so this subject is something we constantly talk about. She has also done stints Massachusetts General Hospital in Boston. Basically, if you live within walking distance of one of our top US hospitals, and if you have a full insurance or indemnification plan, as I do, the medical care is second to none anywhere in the world. The quality of the equipment and the medicine they practice it is outstanding. They have tremendous resources. The doctors are busy, but they are wonderful. And they give out a lot of care for free. They do not turn sick people out into the cold. But as the article points out, not to have those things is a threat to your existence. It is amazing that there are large numbers of people here who are actually against some form of universal coverage. It seems hard to believe. But it also seems hard to believe that anyone voted for Trump, and here we are.
Carolyn (Netherlands USexpat)
When I was first an expat--in Japan, the first day on the job I was taken down to the city hall to sign in as a resident, and there I received my health insurance card. Wow! I had been living without health insurance for years in Seattle (working full time as were all my uninsured friends). Now I live with universal health care in the Netherlands. We pay enormous taxes and live in a small row house, but I don't worry about health insurance, paying for university, getting sick and missing work for a few weeks, taking time off with the kids during vacations, the cities' infrastructure. I will advise my child to live in Europe, don't move to the US. It's a cruel society, sad to say, but it is now. It's depressing to see how the US has changed since the late 1990's. I used to plan on moving back once my husband retired. Now I've moved away from that idea.
EC (Australia)
I am in Sydney Australia and have a local 'Medicare" card. (Medicare for All). I had an MRI the other day. I paid nothing. I had to have a 2nd MRI, after the rebate, I will end up paying AUD$130ish. THANK YOU SOCIALISED MEDICINE!
Robert (Out West)
Mike s (Tucson, AZ)
Erica, would Canada have worked out better or as well as France and the UK?
DKS (Ontario, Canada)
Welcome to the reality of a universal, single payer system. Rex's experience is also common to Canada. Treatment is based on triage or seriousness of illness, not who pays and how much. Going to the head of the line is determined by your illness, not the size of your wallet or your insurance benefits. Wait times for serious illnesses are minimal. ER waits are acceptable. There will always be the stories, seized on by the political Right, of exception, but that are exactly that, the exception. The Canadian health care system is just as efficient, has better outcomes and our taxes are no higher than American taxes (although an apples to apples comparison isn't easy and we do pay a general sales tax). The US shows the rest of the world how not to run a health care system, a lesson we continue to see play out.
Gvaltat (French In Seattle)
When I still lived in France, it was common to hear from politicians that the French medical system was on the verge of collapsing due to its costs (‘on the verge’ being then 20 years in the future, before actions were taken to remedy to this issue). Then I moved to the US as a legal resident. Discovering the US system was more or less what I expected from my reading and conversations, but it was nevertheless a series of shocks that I have never got used to it. First, for the common people, the system in the US is less efficient even if numbers show that the cost of healthcare per capita is twice as expensive as in France (by the way, people talking about a European system are wrong, such system doesn’t exist but the systems share more or less the same philosophy). Second, we couldn’t afford to pay for healthcare and be covered for a few years, which was quite a traumatic experience as it should be for any reasonable human being. And third, what is not commented here is the stress and dehumanization generated by the system that I can experience even if we are now lucky to be able to afford a very good coverage. I have a high risk of cancer, and need to be followed preventively every year. The problem is that whenever one’s situation changes (new job, company moving to another healthcare network -which is very common-), one may need to move to another network, and very often to other facilities and/or doctors. I had 4 doctors in 4 years, including within the same network!
MaxCornise (Washington Heights)
One morning soon after I had moved to Paris, and not being accustomed to the different sized grilles on the stovetop, I replaced a carafe of steamed coffee onto the large grille and it immediately tipped over onto my bare foot, causing a severe burn that required emergency care at Hotel Dieu near Notre Dame. A home visit by a physician, an ambulance to the hospital, 7 treatments for the burn, cardio grams, medications, crutches, and more--the entire out-of-pocket was E 750, about $1,000 USD! In the US that would have easily topped out at $15-20K. And the medical staff were extraordinary--calm, compassionate, efficient. My BP climbed to 180/130, and the physician said "c'est pas grave" (no big deal) and administered A medication which brought the pressure down to normal in 10 minutes. In the contrary here in the US the situation is "tres grave"!
Robert (Out West)
A few years back, I had a serious injury that required hospitalization and surgery. Total cost, ER, transport to a Kaiser hospital, three days in, surgery, followups, six months of PT, was $99 American bucks. For the transport ambulance. Oh, and some minor charges for OVs, maybe $100 total, including some basic pain meds I barely used. Literally spent more for an on-sale basic exercise bike. By the way, Americans: Do Your PT Like Your Life Depended On It.
Karen (Yonkers NY)
I am appalled. This is not how we deserve to be treated.
Joan (Belgium)
My husband and I are Americans living in Belgium. We have Belgian healthcare. The cost of healthcare and social security are connected, but we are still paying less than €7000/year for health care. My husband turns 65 this year and when he 'declares' that he is retired, to the government, we will not longer pay into the system, yet our coverage will remain the same. When we joined the system, we opted for more coverage, as it was so inexpensive. Five years ago my husband had a knee replacement. He went to a top knee specialist, and did have to wait a month for an appointment. In the hospital, he had a private room (you have to bring your own pajamas and towels), a 4 night stay, and physical therapy. Afterwards, the insurance paid for 6 weeks of daily PT (5 days/week). The entire cost was just over €6300. Our out of pocket costs were around €350. Taxes are high here. Universities are free. Doctors don't become multimillionaires, but the are not saddled with debt either. Each and every job comes with healthcare. Part time, full time all are covered. Holidays are also included even for p/t work.
katy890 (UK )
I believe that if Americans really knew about universal healthcare in Europe, and what socialism really means, your political landscape would be completely different. Who wouldn't want free treatment and preventive care, and never have to worry about the cost? Healthcare in the U.S. seems to be run in the interests of insurance and pharmaceutical companies, not the people. Hardly surprising, then, that universal healthcare is derided as "socialism" and its benefits not widely publicised. Can't see Fox News running an hour long special on the subject, somehow. The NHS in the UK is becoming more flexible, utilising private sector facilities to improve services and reduce waiting times. I had a bunion operation a few years ago under the NHS in a private hospital, with an excellent surgeon who worked in both. The op was under local anaesthetic so I took in my phone and earphones to listen to music during the procedure; not needed because a lovely nurse was there to hold my hand and chat to me throughout. None of this cost me a penny. Being sick is one thing, but the additional stress of wondering how to pay for treatment is something that no one in a civilised society should have to deal with.
Kathleen Larson (Des Moines Iowa)
I’ve been told my whole life that patients from other countries come to the US because of long waits for treatment and doctors leave those countries to practice here because they can’t make money - I’ve been told of the evils of socialized medicine my whole life - which is crazy because our current system - bankrupting people for basic care - is evil. We’ve been told that the government being involved in health care will be so bad because there will be ‘death panels’ deciding who gets treatment and who doesn’t, but currently big for profit insurance companies do that No system is perfect but the American system needs to change and hopefully we can do so before I get old and sick and really need care (I’m 36) but I still hear the old statements against ‘socialized medicine’ from my conservative family as if it is gospel truth - so I fear we have a long way to go
Rod (Seattle)
Years ago I was visiting France. I’d been grinding metal the day left n got a small metal speck in my eye. No big deal until a 13 hour flight dried my eyes out. Upon arrival my eye was swollen and red and in pain. Went to the local ER on a Sunday. Spent 1.5 hours with an ophthalmologist. She found the speck and cleaned my eye right up. Afterward they asked for my insurance card. I didn’t have one. They sadly told me I’d have to pay. They gave me a $35 bill. I thought it was a mistake, but no, that was it. I put it on my card with a smile.
Utahn (NY)
My husband and I worked in France thirty-two years ago after we completed our pediatric training in Seattle. Medical technology may have been equivalent between the regional center in Amiens and hospitals in Seattle, but health care delivery in France was clearly superior. The “business” of medicine there was to deliver care without all the fuss and stress of dealing with myriad insurance companies – a problem that has only grown worse over the last three decades. I saw this both as a mother-to-be who received exemplary care during my pregnancy and as a physician working in a neonatology unit. My husband and I were amazed at the strikingly better birth outcomes among patients with lower socioeconomic status in France compared to similar patients in the United States. While Americans may pay lower taxes than the French, we get little in return for the taxes we do pay. In contrast, the higher taxes paid by French go in part to pay for a health care system that will pay much if not most of their medical bills. They also have the security of knowing that they will continue to get medical care even if they need to stop working. By nearly every metric, Americans pay too much for a uncoordinated health care system that delivers too little.
Christopher Delogu (Lyon France)
Thank you for that. Should be required reading for every registered Republican in the U.S. who seeks to revoke the Affordable Care Act instead of expanding it. In my case it was the "cancer" of downsizing the humanities and eliminating the foreign language requirement that caused me to seek employment in higher education in France 25+ years ago. I too would have preferred to get a job in my own country without emigrating, but the early tenure (after only one year of "tenure track") and the fantastic health care system, have brought me around to seeing that the France is overall a saner society for both the life of the mind and the body. At age 65, or earlier if I see substantive and sustained changes going in a healthier direction, I'll move back, but for now it's "Vive la Secu !" for me ... and I don't mind paying 2/12ths of my $60,000 annual salary to pay for the peace of mind it affords me and my my two Franco-American children when we have ailments, fractures, prostate woes, etc.
Aki (Japan)
A merit of having universal health care is having an opportunity to mutually check on runaway greed of doctors, patients, pharmaceutical companies, medical equipment suppliers, etc. which apparently hurt the have-not. Although it is difficult to satisfy all the players it is essential to exercise self-restraint in a way like this. I once went to see a doctor in Paris without insurance and found that what I paid was not much different from what I would have pay with public insurance in Japan (where the co-payment is hefty 30 percent for all treatments).
S North (Europe)
Getting cosy in the doctor's office isn't just pleasant, it's useful. Talking about illnesses and exchanging information can point people to better doctors, suggest questions they should ask their surgeons, or make them read the side effects of their medication more carefully. This, too, is part of a good healthcare system. The US economy, it seems to me, is based on fear - and not just of illness.
Mark (Cheboygan)
I am waiting for the Democratic House majority to get serious about some plan to improve health care in America. We can do better than the ACA. I fear that the Dems won't move, because of the donations of Pharma and the medical insurance industry. Today the House will vote to restore Pay-Go. This maneuver will tie Democrats own hands should they try to to write a Medicare for All bill. It's funny that the republicans never do Pay-Go when it comes to tax cuts or wars, but the Dems are the adults and will always fix the mess that the departing republicans leave and never do something that helps the middle class too much if it costs. How much health care could have been bought with the last $1.8 trillion tax cut or the $5.6 trillion Bush tax cut? Nice way to squash enthusiasm. Democrats don't really seem to want to do Medicare for All and I can only guess that it because it will put them at odds with the donors.
Louis (Berkeley, CA)
For those who say that French federal taxes are higher than the US, keep in mind the US has state taxes. France doesn’t.
Susannah Allanic (<br/>)
I'm American. Living in France. I'm married to a French man. We have been paying high taxes so that we can have a civil society to live in. For us, a civil society is best managed by a government that uses its citizens' taxes for the infrastructure of our civilization, and for the management of unforeseen circumstances such as nature disasters, applying the law as it is written, for the general welfare of the entire country. Yes, we get what we pay for. The roads here are well maintained, even in small villages. We live on a back road that has 4 houses on it in a small village. It French name translates to 'Path of Pits', which it was when we moved here 6 years go. It's been paved now for a month. For a year now we have had 3 street lights and updated pipes and wiring that will accommodate more houses on our little Path of Pits that is now smooth. My experience of going to the Dr is different. I talk to the Dr and not anyone else except to say a brief Bonjour. My copay to her is $20. I generally see her once a year. My surgery I had 15 years ago cost us out of pocket a bit over 300€. That was to replace the dead talus in my left foot with a grafted bone fusion so I could stand and walk. The total care of 8 months was included in that out of pocket. My husband was recently diagnosed with Type 2 Diabetes. His prescriptions and education cost us nothing out of pocket. We know when we are not using the system someone else is. That is how society should work.
Pauline Hartwig (Nurnberg Germany)
Thank you for your information about the health care system in France. I am also American, however moved to Germany to wed my second husband. We also have a health system very much like France. Americans fear the word 'socialism'. They actually refuse to believe the difference between Socialism and the out of control Capitalism that has for decades been the platform of the Republican Party's Conservatism; was somewhat subdued until the 60's. Americans must first accept the fundamentals of a Socialist Democracy - then and only then will they also benefit from health care for all - affordable and fair. Pres. Obama was on the right track. The rest of the story is disgraceful.
eben spinoza (sf)
there's no system in the us, just layers of perverse incentives driven by the delusion that medical care can be financed through an insurance model.
kirk (montana)
As a retiring physician, I can report that Erica is correct in her condemnation of the for profit American medical system and it's underlying greed. Our system of medical care costs over twice as much as European systems with much inferior results. As intimated is Erica's piece, it is not only the high cost of care that is so outrageous, it is the fact that hundreds of thousands middle class Americans go bankrupt because of the medical care and their lives and their families lives are ruined for at least two generations. Who is going to fix it? I don't think it can be fixed. It has to collapse first and then rise from the ashes and hope what is risen is superior to what we have now. With the people presently in charge, that is not likely.
Paul (Palo Alto)
We need to get financially real about health care. First, it's better to have a healthy population than a sick population because they can work and produce wealth. Second, nobody in their right mind is suggesting unlimited government (tax financed) health care for all medical problems including all self inflicted problems. Third, we, the electorate, can decide what fraction of the GDP we want to spend on health care, and then use those funds will be used to 'do the greatest good for the greatest number' consistent with the first point. There still will be a robust private medical care system of fee for service practitioners for those who want the ultimate in care and have the money to pay for it.
Overseas American (France)
French health care starts with medical school education which, like all higher education in France that is public, is paid for by tax payers.....so, doctors here do not come out of medical school with hundreds of thousands of dollars of debt. They also do not expect to earn hundreds of thousands of dollars. They earn a decent income, but put in hard labor to get there. As a long term resident of France and now a dual citizen, there is no doubt that we are staying in France for retirement in large part because of the health care system here. We could not afford to pay the cost of Medicare and supplemental insurance, co-pays, deductibles, etc in the US. We definitely have paid enormously in ‘social charges’ for ‘Securite Sociale’ - but that’s what health care IS - Security. We have American friends who recently moved to France to retire - it is much cheaper for them to pay into the French system than to remain in the US on their current health insurance. French health care may not be perfect and there are problems but it is health CARE not simply insurance, which in the US still does not guarantee care, as this article states. The cost in the US is also mind boggling - in France an MRI might cost 300 Euros, in the US 8000, in France a Ventoline inhaler costs about 5 Euros, in the US it could cost 250$....the list goes on and on....and in France, we are fully reimbursed for these expenses (including glasses and dental), no deductible.... GET WISE Americans!!!!
Thank you for a wonderful article. I live in Poland and have dual US and Polish citizenship. I have national health insurance but also pay an additional $1000 a year to belong to a private HMO (the lines are shorter and my internist is a gem). Drug costs? Three months supply of my thyroid medication just cost me $3.00 and the medications were manufactured my E Merck Darmstadt. Four months of cholesterol medication, a branded generic made by PolPharma cost $5.00. Plus my internist weaned me off high blood pressure medication three years ago and my reading last visit was 125/74. Maybe it is because I do not have to worry about being bankrupted by my health costs.
Ricardo (Spain)
In Europe you can also take out private insurance, which gives you a choice of doctors, and no waiting for operations and/or treatment. I took out the platinum grade at the age of 65, which covers me for everything, except dental work, which is a separate insurance. It also does not include medicines after you leave the hospital or treatment. Hospital treatment is in private bedrooms, in excellent private hospitals, with immediate attention. Now at the age of 90 I pay € 3400 ($ 3,868) per year.
Gabriella (Bologna)
To those who say that Americans would not put up with the long wait times of a more socialized system: I used to live in the US, and now live in Italy, enjoying the benefits of Italy’s single payer system. On the whole, wait times in the two systems are comparable. It’s a bogus argument.
GDK (Boston)
I believe that single payer system is the way to go but Erica Rex's story is over dramatic.Retired from medicine after 40 years of practice I find the US system is still better than anything in Europe a Medicare for all would make it even better.
Robert (Out West)
Why? It certainly ain’t overall outcomes.
Blinker (Hong Kong)
I'm a US citizen who lived 8 years in Hong Kong, where I was officially resident, hence covered by the HK health system. In 2015, I gashed the back of my hand with a heavy, high speed sander, cutting nearly to the bone. While less painful or bloody than one might expect, since it was Sunday, I was taken by ambulance from my primary hospital to another where an orthopedic surgeon was on weekend duty. The OR team decided full anesthesia was best, as they had to probe and clean out the gash before suturing. (Indeed, a fragment of sandpaper had been driven in.) I was put under, emerging 20 min. later with a stitched and bandaged wound. Stayed overnight in the hospital, and paid the bill next morning. For everything, all of $25 USD. Bear in mind this was not China, but Hong Kong, where medicine is generally up to 1st world intl. standard.
liz (Europe)
I've always felt that the superb, pathbreaking show "Breaking Bad" would never have occurred to, much less been developed by, European TV producers. Walter White's downhill spiral was prompted (and justified?) by a singularly US issue: unaffordability of medical treatment. I don't remember seeing any critic pick up on this but it was the first thing that struck me on the European side of the Atlantic.
Steve (Birmingham, UK)
There was a Canadian meme of Breaking Bad in which a teacher got cancer, received treatment under the Canadian system, and went back to work as a teacher.
liz (Europe)
@Steve Ah, well, there you go. It’s what would have happened here (Europe).
L Martin (BC)
The French, other European, Canadian or other similar models provide a template that, however welcomed etc., would find a difficult fit across America...probably very difficult at first. The spectrum of profit motive and patient expectations would be quite problematic for any such health care plan. But with consensus and cooperation, any plan will work.
Steve (New York)
Ms. Fox talks about the feeling of security here in France concerning medical care, the idea that you go through life with the expectation that this care is a right and it will be delivered professionally and democratically to all. It is impossible to place a value on that; if affects everything else and makes life so much easier. Also, what many Americans do not understand is that the healthcare providers are private and one can, indeed one should, shop around for the best care possible.
Stevenz (Auckland)
The practical reason that so many nations have public health systems is simple: the country runs better. The answer to the moral question, “who is going to be healthy?” is equally simple: everybody.
JU (Sweden)
When I visited the US as a student I had a hard time getting the university to accept my insurance (provided at no cost by the Swedish government). The main issue was that it didn’t list a roof where coverage ended, an obvious error in their eyes. In the end I had to get a clarification from Sweden that yes, I had the best insurance in the US since it covered any procedure at any cost (at no cost). It was the same as the diplomats got.
Fenella (UK)
I worked for a time in the Australian medical system, at a private diagnostic clinic. We had many American tourists come in for the MRIs or CT scans they couldn't afford at home. They would stand at the counter, results in hand, loudly marvelling at the low cost. But there's a cost they weren't aware of. Australian clinics are well resourced and can cope with the odd American paying full freight. In other countries, though, the best medical staff and facilities are increasingly being used for medical tourists, prioritising foreigners and pricing out locals. I'm glad that you have been able to get good medical care in France. But it's not fair to ask the French or British taxpayer to foot the bill for America's lousy healthcare system.
Michael Kittle (Vaison la Romaine)
As an American expat living in France for sixteen years I am privileged to have my carte vital card for French national health care. My g.p. visit costs nothing since the twenty five euro fee is reimbursed by health insurance. The quality of care is excellent and available on short notice. Almost every small town has its own E.R. and hospital in France. Moving to France as a retired expat is the best decision I’ve ever made!
Stephanie Orsini (Tours, France)
I was very happy to read all the compliments paid to the French health system, which I am very proud of, as we French all are. On the other hand, this very system we cherish is on the verge of bankrupcy while the tax we pay on our salaries to fund it tend to increase. Though it seems incredible to me that someone should be unable to afford treatment for cancer, I think it would be fairer if all the people who profit from it would participate in its funding. Especially when the country you come from is as wealthy as the US. How does this Work?
Michael Kittle (Vaison la Romaine)
@Stephanie Orsini........I should add that expats retiring in France from the United States are required to pay a fee to Carte Vitale of 8% of their retirement income. This is the same as purchasing health insurance from a private company and represents a significant contribution.
D. Priest (Canada)
Healthcare is now the main reason I will never return to the US. Medicare is a joke for coverage and is so complex. Now, in Canada there is single payer, but it isn’t the ‘full meal deal’ that the French have; it is what I would expect an American single payer system would look like... no frills, but still offers comprehensive coverage. Oh, it should be noted that Canada isn’t a great medical tourism destination. As an American showing up in a hospital or doctors office you will have to pay or provide insurance. But the rates are quite reasonable compared to US hospitals.
Brian Hogan (Fontainebleau, France)
There is no such thing as The European System. There are the French, the British, the German System, etc. Each has differences. The U.K. system does not have a good reputation here on the continent. UK citizens are known to frequent French hospitals near the Channel. When US elected officials bad-mouthe the "European System," or the Canadian System, they are talking about the U.K. system - knowingly or unknowingly. If I were as rich as George Soros or the Koch brothers, I would pay transportation costs of US citizens willing to come to France to try out the health-care system.
nolongeradoc (London, UK)
@Brian Hogan "The U.K. system does not have a good reputation here on the continent." The UK doesn't have a good reputation in the UK either! Nor with UK doctors, like myself who worked for the national Health Service for nearly 40 years. But, that's only recent. The NHS improved immeasurably during the 13 years of the Blair/Brown centre-left Government. There was real additional investment in the service which - at least in my field of oncology - was well spent and carefully targeted. The last eight years of GOP style Cameron and May Conservative leadership has unravelled most of that - in the name of 'austerity'. It IS a matter of money. The UK's healthcare spending is on a par not with Germany and France, but more like places like Latvia and Greece. It doesn't have to be like that. The UK economy was until the Brexit vote the 2nd largest in Europe and the 5th largest globally. The funding is there. British hospital specialists are, to my my mind, the best trained in all Europe. And, you'll find many more French citizens waiting in London hospitals than Brits in places like Calais and Boulogne. French nationals are the British capital city's most prevalent ethnic group bar none.
William McKinley (Madrid, Spain)
Ditto every positive comment from here in Spain. I try to explain it to my friends and family in America by saying, “You know how, when you go to the hospital or the doctor and you have to stop by the office that handles payment? There. Isn’t. One.” They just don’t get it. They just can’t wrap their heads around a system that takes care of everyone (with healthcare rated significantly higher than in the USA yet), and even sadder, they can’t begin to fathom what it’s like to live without fear of getting sick and losing everything. Single-payer healthcare. The only answer. And yes, my husband and I buy extra healthcare. Our joint monthly premium (no copays, either): €74. I used to pay $750/mo for my premium, with a $3000 deductible, and co-pays on office visits and medication. Please wake up, America. Healthcare is a right, not a privilege.
Robert (Out West)
Soain doesn’t have a single-payer system. What it has is excellent universal coverage, with a sliding scale of payroll deductions, and fees for such servuces as an office visit...150 euro, if what I just read is true.
Andy (Paris)
150 euros for an office visit? I don't believe that for a second. That is 5 to 10 times what I'd expect to pay.
Stevenz (Auckland)
There isn’t one here, either. I’m still trying to figure out how that makes me less “free” than I would be in the US.
Carlos Santaella (Greater Boston Area)
This story, once again, confirms our own personal experience. My dad, a US citizen married to a french woman, had the benefit of the Sécu. He was diagnosed (in the US) of skin cancer. He lived in Boston at that time, so fortunately he had access to top medical advice. After testing and extensive consultation my dad's prognosis was confirmed: chemo, radiation and surgery; he was 81 years old when his condition was confirmed. We both sat and assessed the financial reality of a lengthily treatment in the US. He had MEDICARE and a small supplemental insurance. After pondering numbers we concluded that he would deplete his retirement savings if he was treated in the US. The aftermath of such reality was too daunting for him -he always had been a financially independent person- after working for over 50 years continuously. The other alternative was to move -permanently- to France, and access fully his Sécu benefits. He moved to Paris and immediately was treated at the prestigious Institut Gustave Roussy. There he received his chemo, radiation and had surgery -twice- plus all his prescription medicines and -on top of that- he was assigned, for almost six months, the visit of two nurses daily at his home, one in the morning and one in the afternoon, who checked, tend and cleaned his wounds (all at a nominal cost) almost free. My dad was humanly pampered by the french medical system, and he was able to live another year before succumbing to this wicked illness. VIVE LA FRANCE!
Marilyn (France)
I too, live in France and have my Carte Vitale. Everything in this piece is true. I decided to retire in France after the election in 2000 made it clear to me that the USA was no longer a Democracy. To me this was intolerable, and I was lucky enough to be able to make the move. I had hip replacement surgery in 2017 at a private clinic near Toulouse and my experience was pretty much as described here. My out-of-pocket cost was 500 euros because the surgeon is one of only 2 in the region who use the new front entry method. All of the physical therapy was covered at 100%. In the US I would be on Medicare if I still lived there, and this is a good system for many people, but I have a friend there who was told she was not a candidate for hip replacement and is now in a wheelchair. Another friend had the surgery but no physical therapy and is therefore having trouble walking. I'm glad I moved to France, but still follow politics in the US, and worry that trends in Europe are not as progressive as I'd like to see.
Edward (Milan, Italy)
I'm a dual-national and have been living in Italy for almost 50 years. My two children, wife and I have had to be cured for various reasons: from a broken nose occuring in a basketball match to pneumonia, to detached retinas to emergency surgery for two fingers almost lost to our daughter about 16 years ago. Sure I pay takes, all of them, but I've never ever had to directly pay one dime for any of these health services. Excellent care, caring doctors and nurses and emotional attention are part of the Italian Health Service. Sure, our taxes are high, but as one of your commentators has stated, excellent schooling is free and state universities cost about $3,000 a year at the most. So is it worth the extra taxes? I can assure you it is. I am astounded that my fellow Americans can't understand the benefits of such a system.
See also