jbk

On Fri, 05 Mar 2004 23:09:21 +0000, "Donna Evleth"
<[email protected]> wrote:

    >
    >Dans l'article <[email protected]>,
    >[email protected] a écrit :
    >> Not
    >> to mention that they then get to wait endlessly in line for any
    >> treatment other than an emergency. Sometimes for years. What good is
    >> the theory of universal coverage if, in fact, when you want it you
    >> can't get it?
    >I have chronic colitis. Periodically I get excruciating cramps, always in
    >the middle of the night. It's not life threatening, however. And everyone
    >knows this. So, you're telling me that for this non-emergency condition, I
    >wait for years here in France to be treated.

Just like your husband, you can't read. I said sometimes and I said
Europe. Go talk to people waiting for heart transplants in England
for starters.

    >In fact, what I do is call SOS Médecins. These are roving doctors, who
    >patrol all night, and are dispatched to the homes of persons in distress.
    >Like me. I call. Now, since I am a repeat customer, I am on their
    >computer, and they don't ask me a lot of questions anymore. They know who I
    >am and what my problem is.

Just like doctors here.

They tell me the doctor will be there within the
    >hour. In fact it's usually more like 20 minutes. I do not have to get up,
    >get dressed, go out in the cold (remember I am in horrible pain) and wait
    >around for hours in someone's emergency room. The doctor comes, examines me
    >in my own bedroom in my own bed, gives me the shot I need to stop the
    >cramps, and I go back to sleep. I check in with my regular doctor the next
    >day (yes, I do get an appointment the next day).
    >Don't tell me I don't get universal coverage when I want it. There are
    >places in this world where my only alternative would be a hospital emergency
    >room. When I visit those places, I carry codeine tablets with me. But I
    >don't really like to use them, because when I do I sleep all day the next
    >day and don't enjoy my vacation.

Fine. And what has all this to do with the assertion that was made
that if you don't have insurance you don't or can't get medical care
in the US, which as I said is completely untrue?

jbk

On Fri, 05 Mar 2004 23:23:12 +0000, "Donna Evleth"
<[email protected]> wrote:

    >
    >Dans l'article <[email protected]>,
    >[email protected] a écrit :
    >> Well, that's your cover. I can go to my doctor here anytime and see
    >> him without any deductibles at all. Just a minimal copay. And
    >> housecalls are routine in rural areas for the same reasons. In an
    >> urban or suburban area what's the problem with going to the office?
    >I already posted on this above, but this calls for a repeat. Do tell me
    >about your "minimum copay". How much is it?

$20, so it cheaper than yours and I don't have to pay a fortune in
taxes to prepay for it either.

I can go to my doctor here in
    >France anytime and see him without any "deductibles" OR "minimum copay." He
    >charges 20 euros per visit. Our universal health coverage covers this 100%.

So does mine and I don't have to pay a fortune in taxes to prepay for
it either.

    >This same doctor will also make housecalls - right here in the city - if the
    >occasion warrants it. Agreed, we do have to pay something for that.

So would mine and I would pay the same if I needed it, which I never
have.

    >What's the problem with going to the office in an urban or suburban area?
    >Try excruciating pain from chronic colitis, in my case a hereditary
    >condition.

Then get home healthcare like I would here.

Earl Evleth

On 5/03/04 23:43, in article [email protected], "Keith
Willshaw" <[email protected]> wrote:

    >
    > <[email protected]> wrote in message
    > news:[email protected]...
    >> On Fri, 5 Mar 2004 19:13:38 -0000, "Keith Willshaw"
    >> <[email protected]> wrote:
    >>
    >
    >>
    >> Well, that's your cover. I can go to my doctor here anytime and see
    >> him without any deductibles at all. Just a minimal copay.
    >
    > Copay doesnt exist here

Our system is mostly "no pay"

A 20 euro office call is completely remcourse.

My last copay was 0.44 centimes on an drug bill of about 81 euros.
One of the items "only" had a 95% coverage.

In essence I already copaid by years of contributing to the system
while young when I, fortunately, "collected" nothing.

Earl

Earl Evleth

On 5/03/04 23:58, in article [email protected],
"Mxsmanic" <[email protected]> wrote:

    > Earl Evleth writes:
    >
    >> Have you even been in Paris and called SOS medicins? They are in
    >> you apartment within 30 minutes. That is not emergency care
    >> but guess what, a "house call". Do they exist in the US?
    >
    > Are they free?

In the sense I get a complete repayment, yes.


    >
    >> SAMU is faster.
    >
    > Never had the misfortune to need SAMU, but I've seen French paramedics
    > arrive in record time. However, Parisian fire and paramedic services
    > are known to be among the best in the world (at least by people who
    > follow such things).

I have not used them! But occasionally I have witnessed a motorcyclist
"get it" and the ambulance got there within minutes. One time I
stood around to see what they do, which I guess is standard. The immobilized
the victims neck area and carefully lifted him on a special stretcher.

They spend some time at the scene, and in fact in the accident which
killed Princess Diana this was criticized, why not get her as quickly
as possible to a hospital? I don`t know but I think the press mentioned
that French practice is to stabilized the victim as much as possible
before risking transport.

Another motorcycle accident I witnessed was the a collision
with the side of a car, the victim flew over the hood and landed
10 or 15 feet on the other side. He immediately go up and limped
around. He looked OK but I read he died from internal injuries later.

Another accident involved a pedestrian crossing illegally in heavy
traffic, one car coming illegally in the bus lane hit him
and he went flying. It was in front of a drug store and the
help rushed out to perform first aid, the ambulance people took
over on arrival.

Pharmacists are trained in first aid in France and we have used
their services twice. Once I cut my finger badly in a hardware
store, it was bleeding like mad and I went to the Pharmacist
next door. He or she, ot a pan out poured hydrogen peroxide into
the wound and bandaged it. The usual advice is for you to go to
a doctor afterwards but in fact I did not.

Another time on a trip back on vacation, our dog got ill and bit
my wife on the hand. We stopped at a drug store and the pharmacist
treated it. He asked about the dogs vaccination etc, So they
are half a doctor in some sense. Many are students who did not
make it in med school, the rejection rate is high the first
year. Pharmacists give a lot of advice here. Their inventory
is not complete but they have an efficient delivery system
so if an item is asked for in the morning they will have it
in the afternoon (they use minitel for this ordering).

The French system has "medecins de garde" in which a designated
doctor in an area is on call, day or night. They usually come to
the house. If one is in trouble in any town or city
find the police station, they will know who is on duty.

Once a friend, staying in a hotel here in Paris, called me
saying he was very ill with a bronchitis and needed a doctor.
I told him to go to the hotel desk and have them call
SOS medecin, which he did. Later he said the doctor came within
30 mintues, treated him, gave him something.

SOS is conventionné and will charge what a person here gets
reimbursed. While a normal doctor costs 20 euros, the SOS is allowed
to charge extra, for off hours (like 3AM) and his displacement,
I think the last time we used one it costs a total of 60 euros.

When one calls the central switchboard of SOS, they asked questions
to make sure you are not having a heart attack. My wife
is already on their computer so they know the symptoms and
don`t waste time.

Almost all recently arrived Americans who get ill here want to head off to
the American Hospital in Neuilly, which has a clinic. They figure
they are going to get "American treatment" (they do get American prices!)
and will encounter English. Most of the doctors and help are British
or other nationalities, not American so that part is an illusion.
It has the reputation of being a rich man`s hospital and some of the
very wealthy of Europe go there.

Lastly there also exists SOS dentiste, which is useful in emergency
situations on a weekend. I have used them now and then, an inlay coming
out or filling out. One has to go there (Porte Royale in the 14th)
and one needs an appointment. Even so one can wait with other people
for 30 minutes beyond the appointment hours (the French tend to respect
more the appointment hour than Americans but not here!). Most of the
people have bad tooth aches, so the waiting room is full of people
in misery.

There is also an SOS vet service, including home visits! Clearly the
French treat ill dogs better than the Americans treat humans! Also
there are 24 hour a day vet clinic services, our first dachs died
at 5 AM in a clinic on Christmas Day.

Earl

Earl Evleth

On 6/03/04 1:35, in article [email protected],
"[email protected]" <[email protected]> wrote:

    > On Fri, 05 Mar 2004 22:52:17 +0100, Earl Evleth <[email protected]>
    > wrote:
    >
    > >>
    >> SAMU is faster.
    >
    > Says who? You?

Eye witnessed by yours truly.

    >
    >>
    >> Try and get yourself informed before you write nonsense.
    >>
    >
    > You're the one writing the nonsense.

I write from experience, what is yours??


Earl

Mxsmanic

Earl Evleth writes:

    > In the sense I get a complete repayment, yes.

That's not the same thing. Paying and being reimbursed is much more
difficult than having it free.

    > They spend some time at the scene, and in fact in the accident which
    > killed Princess Diana this was criticized, why not get her as quickly
    > as possible to a hospital? I don`t know but I think the press mentioned
    > that French practice is to stabilized the victim as much as possible
    > before risking transport.

It's the same practice for good paramedics everywhere. There are many
things that must be done immediately, not after arrival at a hospital.
The patient has to be stable enough to transport.

    > Another motorcycle accident I witnessed was the a collision
    > with the side of a car, the victim flew over the hood and landed
    > 10 or 15 feet on the other side. He immediately go up and limped
    > around. He looked OK but I read he died from internal injuries later.
    >
    > Another accident involved a pedestrian crossing illegally in heavy
    > traffic, one car coming illegally in the bus lane hit him
    > and he went flying. It was in front of a drug store and the
    > help rushed out to perform first aid, the ambulance people took
    > over on arrival.

You sure see a lot of accidents! I walk the streets of Paris
practically every day, and I'm not seeing all these accidents.

    > Pharmacists are trained in first aid in France and we have used
    > their services twice. Once I cut my finger badly in a hardware
    > store, it was bleeding like mad and I went to the Pharmacist
    > next door. He or she, ot a pan out poured hydrogen peroxide into
    > the wound and bandaged it. The usual advice is for you to go to
    > a doctor afterwards but in fact I did not.

Did he tell you to get a tetanus shot, too?

    > Their inventory
    > is not complete but they have an efficient delivery system
    > so if an item is asked for in the morning they will have it
    > in the afternoon (they use minitel for this ordering).

They have often told me they could have something the next morning if
required, on occasions when they didn't have what I wanted.

    > Once a friend, staying in a hotel here in Paris, called me
    > saying he was very ill with a bronchitis and needed a doctor.
    > I told him to go to the hotel desk and have them call
    > SOS medecin, which he did. Later he said the doctor came within
    > 30 mintues, treated him, gave him something.

Does SOS Médecins speak English?

Is SOS Médecins a private company or a government organization? I don't
see how it differs from the SAMU.

    > Almost all recently arrived Americans who get ill here want to head off to
    > the American Hospital in Neuilly, which has a clinic. They figure
    > they are going to get "American treatment" (they do get American prices!)
    > and will encounter English.

They are mostly right. The American Hospital is the only JCAHO-approved
hospital outside the U.S. The prices are _not_ American, though--they
are far, far lower for many services. I've taken people there for
emergencies a few times, and I was amazed at how low the bill was. Some
procedures cost about the same as the least expensive hospitals in the
U.S., though.

    > Most of the doctors and help are British
    > or other nationalities, not American so that part is an illusion.
    > It has the reputation of being a rich man`s hospital and some of the
    > very wealthy of Europe go there.

It's no illusion that it's a very good hospital. I recommend it to
nervous Americans. Just the fact that they all speak English is a very
important factor to someone who is very ill (one of my friends got
treated at a purely French hospital in the 'burbs for a minor accident
injury, and she was traumatized by her inability to understand or
communicate with anyone under such trying circumstances, even though she
got excellent treatment).

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Go Fig

In article <[email protected]>, Mxsmanic
<[email protected]> wrote:

    > Earl Evleth writes:
    >
    > > In the sense I get a complete repayment, yes.
    >
    > That's not the same thing. Paying and being reimbursed is much more
    > difficult than having it free.
    >
    > > They spend some time at the scene, and in fact in the accident which
    > > killed Princess Diana this was criticized, why not get her as quickly
    > > as possible to a hospital? I don`t know but I think the press mentioned
    > > that French practice is to stabilized the victim as much as possible
    > > before risking transport.
    >
    > It's the same practice for good paramedics everywhere. There are many
    > things that must be done immediately, not after arrival at a hospital.
    > The patient has to be stable enough to transport.

The U.S. generally practises 'scoop and run', the comparative data is
still not conclusive yet. However, treating trauma requires technology
that is just not available in the field yet.

jay
Sat Mar 06, 2004
mailto:[email protected]

Earl Evleth

On 6/03/04 12:05, in article [email protected],
"Mxsmanic" <[email protected]> wrote:

    > Earl Evleth writes:
    >
    >> In the sense I get a complete repayment, yes.
    >
    > That's not the same thing. Paying and being reimbursed is much more
    > difficult than having it free.

Not so much in France with the Carte Vitale. One pays the doctor up front
20 euros, he puts the card in his computer and the Secu (I have a mutual
too) processes it within 4 days and the 20 is in my bank account.

For the pharmacy bills I pay nothing, except the copay (44 centimes
on my last 81 euro payment.


    > You sure see a lot of accidents! I walk the streets of Paris
    > practically every day, and I'm not seeing all these accidents.

That is over nearly 30 years in France. I have never seen anybody die on the
spot. In California, I came up a head on, the police had not arrived yet
and in going to the vehicles I found the guy in the pickup truck
in bad shape. The passenger car got it worse, the driver was moving
and his passenger crumpled up on the floor. I did nothing because
the ambulance would arrive shortly, it did. They wrote the passenger
off, saying his heart was fluttering but he was dying. The driver
made it, according to the papers, as did the pickup driver.
The driver was drunk and got charged.

One can go years and see nothing in Paris so your not seeing things
is just a problem of probability. How long have you been here? 5 years?


    >
    > Did he tell you to get a tetanus shot, too?

I don`t remember.`


    >
    > They have often told me they could have something the next morning if
    > required, on occasions when they didn't have what I wanted.

One can go to the next Pharmacy. Our Pharmacist will often to
to the nearby one to get the item if I am in a hurry. I tend
to anticipate. He/she (they are partners) does not carry veterinary
items, our dog is currently getting eye drops for a cornea problem.
That takes a day.

    >> Once a friend, staying in a hotel here in Paris, called me
    >> saying he was very ill with a bronchitis and needed a doctor.
    >> I told him to go to the hotel desk and have them call
    >> SOS medecin, which he did. Later he said the doctor came within
    >> 30 mintues, treated him, gave him something.
    >
    > Does SOS Médecins speak English?

A lot of doctors speak some but I don't know. There is something in the
both of use which automatically goes into French, even if some French
person tries to use his/her English. I was always surprised on how
well my colleagues in the lab could speak English to visiting Americans
but it was hard wired in both of us to speak French. It is not snobbery
but the idea one speaks the language the "group" speaks the best.

    > Is SOS Médecins a private company or a government organization? I don't
    > see how it differs from the SAMU.

I think it is totally private but possible under contract with the state
like many "private" clinics. I don`t think the Government wants to
get involved with making fonctionnaire out of everybody! It is probably
a mixed public-private system. For instance, my mutual runs on a social
security contract. This mixed system seems to work fairly well in
France, they have had a long time to perfect it.

    > They are mostly right. The American Hospital is the only JCAHO-approved
    > hospital outside the U.S. The prices are _not_ American, though--they
    > are far, far lower for many services. I've taken people there for
    > emergencies a few times, and I was amazed at how low the bill was. Some
    > procedures cost about the same as the least expensive hospitals in the
    > U.S., though.

I suspect that have some special contract with the state. A history
of the hospital has been published recently but as I remember they
French gave them a special derogation to have two American doctors
not licensed normally to practice in France.

The last time we were there is with my wife`s cousin 15 years ago,
so I am not up to date. We figured out a long time ago how
and why not to use the American Hospital. But we are not negative
towards it, we just don't need them.


    > It's no illusion that it's a very good hospital. I recommend it to
    > nervous Americans. Just the fact that they all speak English is a very
    > important factor to someone who is very ill (one of my friends got
    > treated at a purely French hospital in the 'burbs for a minor accident
    > injury, and she was traumatized by her inability to understand or
    > communicate with anyone under such trying circumstances, even though she
    > got excellent treatment).

Communication is the problem, right. My wife had one incident of
short hospitalization, no problems and in fact the level of treatment
was better than expected. On the other hand, getting seriously ill
in the summer when nearly everybody is on vacation is a problem.
This was observed last summer with the heat wave but it is a yearly
problem. For general care there is no problem since one`s personal
doctor always has a "replacement" in the quartier.

We had a friend who broke her leg badly in Greece and her husband
(Greek) did not want her treated in Greece, so she was flown
back to Paris, in mid-August. We picked her up by ambulance
at the airport and the normal "bone" service at Cochin was closed
so she was finally placed in a clinic in the banlieue. She needed
an operation to pin the bone, which was separated from its partner.

Another friend, however, an American who had a hemorrhaged ulcer
got good treatment in the summer. At the end of his stay, his
not having insurance presented some administrative problems but
no medical problems. He had a $30,000 med bill! He did pay it
so did not stiff the French. They did effectively save his life
since he was found in ³poor² condition in a rest room surround
by his own blood, passed out.

Earl

Keith Willshaw

<[email protected]> wrote in message
news:[email protected]...
    > On Fri, 5 Mar 2004 22:43:07 -0000, "Keith Willshaw"
    > <[email protected]> wrote:
    > >
    > ><[email protected]> wrote in message
    > >news:[email protected]...
    > >> On Fri, 5 Mar 2004 19:13:38 -0000, "Keith Willshaw"
    > >> <[email protected]> wrote:
    > >>
    > >
    > >>
    > >> Well, that's your cover. I can go to my doctor here anytime and see
    > >> him without any deductibles at all. Just a minimal copay.
    > >
    > >Copay doesnt exist here
    > No just endless, expensive prepay.

Like health insurance in the USA

Keith

Keith Willshaw

<[email protected]> wrote in message
news:[email protected]...
    > On Fri, 05 Mar 2004 23:09:21 +0000, "Donna Evleth"
    > <[email protected]> wrote:
    > >
    > >
    > >
    > >Dans l'article <[email protected]>,
    > >[email protected] a écrit :
    > >
    > >
    > >> Not
    > >> to mention that they then get to wait endlessly in line for any
    > >> treatment other than an emergency. Sometimes for years. What good is
    > >> the theory of universal coverage if, in fact, when you want it you
    > >> can't get it?
    > >
    > >I have chronic colitis. Periodically I get excruciating cramps, always
in
    > >the middle of the night. It's not life threatening, however. And
everyone
    > >knows this. So, you're telling me that for this non-emergency condition,
I
    > >wait for years here in France to be treated.
    > Just like your husband, you can't read. I said sometimes and I said
    > Europe. Go talk to people waiting for heart transplants in England
    > for starters.

The wait is for donors , just as in the USA

Keith

JohnT

"Mxsmanic" <[email protected]> wrote in message
news:[email protected]...
    > Earl Evleth writes:
    > > In the sense I get a complete repayment, yes.
    > That's not the same thing. Paying and being reimbursed is much more
    > difficult than having it free.
You pay a very small number of Euros and then you get repayment of them. How is
that much more difficult than not making a payment at all. And isn't it a
typical feature of the French Health System where several "procedures"
(prescription medicines?) are on a repayment basis.

JohnT

Earl Evleth

On 6/03/04 13:13, in article [email protected], "Keith
Willshaw" <[email protected]> wrote:

    >> No just endless, expensive prepay.
    >>
    >
    > Like health insurance in the USA
    >
    > Keith


Effectively one pays more in the US. Since the global GNP % is
15% in the US and averages around 10% Europe (lower in Britain)
the "copay" in the US is 50% higher than in Europe.

It is even higher if one takes into account the higher percapita
income in the US, the absolute figure comes close to being twice
as much.

There is a old saying in the US when encountering outrageously high
fees. It is: "Where is your mask and gun, Jessé"

Jessé James, that is. American has a Jessé James Medical care system.

Earl

jbk

On Sat, 06 Mar 2004 10:44:36 +0100, Earl Evleth <[email protected]>
wrote:

    >On 5/03/04 23:43, in article [email protected], "Keith
    >Willshaw" <[email protected]> wrote:
    >>
    >> <[email protected]> wrote in message
    >> news:[email protected]...
    >>> On Fri, 5 Mar 2004 19:13:38 -0000, "Keith Willshaw"
    >>> <[email protected]> wrote:
    >>>
    >>
    >>>
    >>> Well, that's your cover. I can go to my doctor here anytime and see
    >>> him without any deductibles at all. Just a minimal copay.
    >>
    >> Copay doesnt exist here
    >Our system is mostly "no pay"

No pay? In Europe? HAHAHAHAHA. Try all those taxes you pay every
day to pay for your healthcare.

jbk

On Sat, 06 Mar 2004 13:12:40 +0100, Earl Evleth <[email protected]>
wrote:

    >On 6/03/04 12:05, in article [email protected],
    >"Mxsmanic" <[email protected]> wrote:
    >> Earl Evleth writes:
    >>
    >>> In the sense I get a complete repayment, yes.
    >>
    >> That's not the same thing. Paying and being reimbursed is much more
    >> difficult than having it free.
    >Not so much in France with the Carte Vitale. One pays the doctor up front
    >20 euros, he puts the card in his computer and the Secu (I have a mutual
    >too) processes it within 4 days and the 20 is in my bank account.
    >For the pharmacy bills I pay nothing, except the copay (44 centimes
    >on my last 81 euro payment.

This is sheer nonsense. You simply can't count. Get everyone to stop
paying their taxes in France and then come back and tell us what it
costs for your healthcare.

jbk

On Sat, 06 Mar 2004 11:25:49 +0100, Earl Evleth <[email protected]>
wrote:

    >On 6/03/04 1:35, in article [email protected],
    >"[email protected]" <[email protected]> wrote:
    >> On Fri, 05 Mar 2004 22:52:17 +0100, Earl Evleth <[email protected]>
    >> wrote:
    >>
    >> >>
    >>> SAMU is faster.
    >>
    >> Says who? You?
    >Eye witnessed by yours truly.

Let's see. You witnessed this SAMU outfit then did a comparative
study of the same events being handled all across the US huh? Then
post this magic study for all to see in said of making silly
assertions like this.

    >>
    >>>
    >>> Try and get yourself informed before you write nonsense.
    >>>
    >>
    >> You're the one writing the nonsense.
    >I write from experience, what is yours??

Right. The typical refuge of those that make silly posts that don't
support the view they are asserting but is just a lot of blather.