THE FRENCH HEALTH SYSTEM (The French Health System)

Member Name: thingywhatsit

Product:	The French Health System
Date:	13/04/06 (1449 review reads)
Rating:

Advantages: Availability of doctors to talk to you.

Disadvantages: Waste of medicines.

THE FRENCH HEALTHCARE SYSTEM.

For the last nineteen years, I have been witness to changes within the French Health care system, and my review is written in order to explain some of the intricacies of the way in which it works, and ways in which to me, as a resident of France, it fails.

When I first arrived in France, I was very impressed with the treatment that people receive in hospitals here in France, and compared it favourably with the British National Health system. It was alien to me that when you approach a doctor here in France, you have your consultation and then have to pay there and then for the consultation. Of course, in the UK, this doesn't happen and it gave me a feeling of imbalance between commerce and caring. I had three operations, and an emergency where I fell down a flight of stairs onto solid concrete, and I felt that the treatment I had had was more efficient than that offered by the UK. For example, I fractured my skull, and was sent immediately for an IRM scan, which has actually proven very useful for the health pattern that followed and I liked the fact that when you have examinations of this nature, the results are explained to you in full, and you are actually given the X-rays or results in your hand to take to your GP.

Little by little, I have seen the health care system in France erode, to the point of being worried about it, which is one of the reasons I am writing this review. Any resident of France who has a social security number (the equivalent of the National Insurance Number), is entitled to health treatment. What this means in the majority of cases is that the government will reimburse you part of the cost of your health treatment. In order to have full cover, a resident of France is expected to have an insurance policy to cover the difference between what the government pay back, and what they don't.

When you have your “top up” insurance in place, one would think that all would run smoothly. You would pay for treatment, and be reimbursed, and here I believe that doctors are caring enough to realise that maybe you don't have enough money in the bank to pay, and let you forward date your cheque to the same week that your reimbursement arrives.

Waste.

On of my biggest bugbears with the health system in France is waste, and instead of tackling the problem at its' roots, here I feel the government have put their heads into the sand and ignored what is costing them a small fortune. Let me demonstrate the problem. Say for example I need one pill for one appointment at the scanner. It's stressful and they let you take a pill to calm you. You are given a prescription, you go to the chemist to get it, and what you are presented with is a box of 30 ! This is not an isolated case. Most people that I know have cupboards of medicines that they do not need, and I actually urge people to take them to charitable doctors who need them for poor patients who cannot afford the cost of insurances, and thus lose money.

Over-prescription is rife. If you visit a doctor in France with a cold, chances are that you will leave the surgery with a huge prescription of over four items to help you ward off the infection. What is worrying here is that many of the medicines are superfluous, given almost in an attempt to shut you up, and here, I really do believe that questioning what you are given is important, as in my case, many times I have found that doctors prescribe drugs that react in a negative way with other drugs that I take. In this instance, I actually prefer the British method of giving you only what is necessary.

Hospitals.

The hospitals that I have encountered in France are amazing. Their staff are efficient, the rooms are clean, although here a new trend is affecting those people without resources. In the past, you could chose your hospital based on knowledge of your doctor as to who is the best specialist for which treatment. Thus, fairness ruled and everyone won, and got the best treatment available. Times have changed, and the people that lose out under the new system are the poor. Now, you must go to the hospital nearest to your home, or be penalised by reduced reimbursements, and that to me stinks. It means that those who have the money can have the treatment they desire, and not give a fig about those that can ill afford to be penalised.

Mental Care

Mental care is an area that I believe excels compared to mental health care in the UK. I have had experience of both, and what I particularly liked was the fact that staff are so well trained, are there when you want to talk, and do not pressure you to open up about your problems, as they seem to in the UK, with group sessions, and the almost obsessional weekly reviews (a meeting where patient and welfare people and doctors gather to assess your situation). You do see a shrink on a regular basis, but the main difference to me is the importance of the individual, who is left to talk when they feel ready, rather than pressured because of lack of resources.

One area that I would fault in the French system is that in my particular area of France, the Psychologists seem very young and inexperienced, although that's the luck of the draw, and a flaw of the French system is that if you do not take medication of any kind for psychiatric problems, you do not get to talk to a shrink. Instead, there are a variety of other channels open to you, such as relaxation, psychology, etc., although I feel that the efficiency of these is limited in the area in which I live.

New Changes.

There are changes to the health system in France that are now restricting which doctor you use. I actually agree with the premise that if you have a family doctor, i.e. One that sees you on a regular basis, that doctor will understand you better than visiting random doctors at will. Here, again, patients are penalised for seeing a different doctor, and I feel this is wrong, in that sometimes a second opinion is wise. For every visit to a doctor, the government now take one Euro extra from patients, and they state that this will build up a fund so that people that need help with claims against doctors (and who would never have been able to afford litigation in the past) can be helped with aid from the government. Whether this works or not is yet to be seen, although I feel they could have made more economies in changing the way in which drugs are doled out.

Dentistry.

Dentistry in expensive both in the UK and in France, and only the rich get their dental payments reimbursed in full, by being able to afford the more expensive insurances. Here again, the poor are penalised. The actual dentistry that I have had in France has been first rate, although it has cost me a lot of money that I could ill afford.

Opticians.

Here, stupidity reigns. The government will only reimburse a small amount of optical costs if the initial eye test was carried out at a hospital. What this does is push poor people who cannot afford to bear the cost of eye tests themselves into hospital queues, and the last time that I made an appointment with an eye specialist at hospital for tests into an inherited eye problem, the wait for an appointment was a year. The opticians are being overworked by having to do eye tests for glasses that could otherwise have been performed in the high street opticians.

Emergency.

In France they have a very good team of emergency workers in the field of medicine. Many in rural areas cannot get to towns for their appointments, and here the ambulance service is split into two areas, one with equipped ambulances, and one as a taxi service. The qualifications of the men and women that work in these areas are high, and the treatment that you receive is first rate.

Just as in the UK, we have an emergency number to dial (16) and recently, they have introduced yet another for people that do not speak French.

Examinations in general.

One of the marvelous things about France is the availability of machinery to perform the examinations that are important, such as mammography, radiology, etc. Women have an invitation every two years, after the age of 45 for a mammogram, and X ray examination, and many other examinations that keep an eye on people's health are much easier to come by than they are in the UK. What France seems to do in the way of health care is to find what things are likely to give you problems in your life, taking into account family factors, and your general lifestyle, and here they excel. Keeping people fit, rather than letting them get to an emergency state is much more the norm here than in the UK. You are given results and told facts about what you can do to improve the lifestyle that you live. In the UK, although I believe this has now changed, I felt that discussing my case with a GP was difficult at the best of times, and that my notes were almost hidden from me, and never discussed. Here, I feel that a certain amount of personal responsibility for my body and how it progresses through life is not only permitted but encouraged.


OVERALL IMPRESSIONS

I believe that the health care services here in France are better equipped than the UK, with many resources relatively easy to access when the need arises. New changes are making the treatment of patients a little elitist, and this worries me. Over prescribing is rife. You are made aware of more things than I believe you are in the UK. For example blood tests tell you what your readings are and what the national normal reading is, and you can easily relate to what things are wrong, and do something about them, as they are not veiled in secrecy.

I think that the penalties imposed on the poor are wrong, and wish that there were some way that this could be corrected. I like the fact that I do not have to fight my way through a reception desk to talk to my doctor. Doctors are more accessible, and do talk to patients, although home visits is another area where cuts have been made, thus making people in rural areas more vulnerable.

The health system has it strengths and its' weaknesses, and to me, the experience has taught me that at the end of the day, my body is my responsibility. If I doubt a treatment, I ask questions and get answers. I only get one chance at this life, and I honestly believe that in many ways, both the British National Health and the French health care have their faults, and that the way in which either can work for a patient is for that patient to take an active interest in the whys and the wherefores of the treatment they are offered, and to listen to the advice of professionals and to question when the answers you are given baffle you, because it is only by understanding your own health needs that any health care system can work at its' best for you and your future.

Summary: A system is only as good as your use of it.