Disclaimer! This story was previously published on my Medium page in Feburary 2019. Since it is one of my favorite things I’ve written, I decided to publish it here. This is not a current situation. Hope you enjoy.
I generally try to bring fun, uplifting content to my blog about navigating life as a 20-something in another country, learning a language, travel, etc. This post is not that. This post is, however, concerned with the things that you get to learn about while living in a foreign country, such as what really happens when you get sick.
Fortunately, prior to my hospitalization, I had a pretty good understanding of the inner workings of the French healthcare system.
I wrote a thesis (actually, kind of two) related to the French healthcare system. The first was on the treatment and coverage of transgender patients within the French healthcare system as part of my study abroad experience, where I worked for an organization serving trans sex workers in Paris. You can read a little more about this experience here.
The second was my undergraduate thesis for my French major, in which I explored the French government’s attitude towards race and the country’s racial and ethnic disparities in healthcare. This attitude is admittedly complex and can really only be described as one of “colorblindness” as the French government, in short, doesn’t really like to talk about race.
This podcast from NPR explains the situation very well.
However, despite equal and excellent health coverage for all inhabitants, provider bias and individual microaggressions contribute to degraded health status among people of color.
Sidenote: if you happen upon this blog, speak French, and are interested in being probably the only person outside of my thesis committee to read my research, shoot me a message.
Back to what happened.
I had a pretty commonplace orthopedic surgery in the US in December. I came back to France in January, the incision looked infected. I called my doctor in the US, went to the doctor here, took one week of antibiotics, thought everything was fine. Three weeks later, the incision wasn’t fully healed and it began to hurt more, so I went to the doctor in France who referred me to get radiology and blood work to see what was going on. I went to the ER because I couldn’t get in anywhere else within a 3 day period. This was already a large change for me as in the US I would never, ever, ever go to the ER for some blood work, but in France, things like urgent care don’t really exist. I got to the ER, they ran some tests, found out that yes, indeed, I did have an infection, and later that night, I was admitted for surgery. Not exactly how I planned the day going.
My hospitalization lasted 5 nights, under the care of wonderful nurses and doctors.
I had a private room, I got cassoulet (weird, but ok, France), and I had bread with every meal. Instead of those weird big cups with the bendy plastic straw, my water was served to me in a carafe. After more conclusive tests came back, I learned that I had a bacterial infection in the bone, or osteomyelitis.
Throughout my hospitalization, I had been speaking with the social worker, because as a foreign student in France, I benefit from Protection Maladie Universelle which covers 70–80% of my healthcare costs. This means visits to the doctor and hospitals, as well as prescriptions, are covered. However, I did not have my insurance card yet from the government, and only had a social security number, so I was worried that I would not yet be eligible for these benefits. She assured me that I would not have to front the costs of my stay, and that with a number, I was still registered in the system.
During my stay, I purchased supplemental insurance for about $40 a month that will allow me to hopefully have the visit covered at 100%, save for the two nights I spent there before my supplemental insurance took effect. The social worker told me I can expect to pay around 600€ for this, but I don’t know as I still haven’t received the bill and she said she will try to work with my insurance to get it covered, as she knows I’m a student. Additionally, this supplemental insurance will cover up to 100% of many of my other related healthcare costs while I continue to live here.
When it came time to leave the hospital, I planned on taking a taxi home with my dad, who had flown out from the US to help me. The nurse was shocked at this proposition and told me that no, I could take an ambulance, that was covered within my rights as well. The ambulance came, drove me to my house, put me on a chair, and two EMTs walked me up to my 4th-floor medieval apartment. I received a bill for 66€, of which I only pay 23€ as again, my insurance as a student pays the bulk of the costs. In the US, ambulance costs range dramatically, and there’s no way of predicting the cost, leaving people with bills that cost thousands of dollars. Here, costs are reimbursed by social security and are quite predictable.
For follow up care, as I was still not quite mobile and living in a picturesque attic which doesn’t lend itself too well to moving on crutches, I was given a prescription for a home nurse. Each day, someone came to give me IV antibiotics, check on and clean my incisions, and take my vitals. All of this, again, is covered under both my insurance as a student as well as my supplemental insurance. I will still be on antibiotics for another month or so and will continue going back to the doctor as I heal, but my doctors and care staff have been exceedingly accessible and communicative, offering their help to me in many ways, and bearing with my French.
However, as an impassioned advocate for systems-level change in the USA’s health system, I couldn’t let it go without talking about what I learned from this experience.
If you’ve been in a room with me for more than 3 hours you’ve probably heard me mention the fact that the US pays the most of all OECD countries for healthcare but has the lowest amount of coverage. This is unacceptable. Now, having lived through a pretty major health complication in another country, I can say that although it may require a complete and total overhaul in the systems we currently possess, it’s worth it. How we solve that is for another blog, but from a patient perspective, I didn’t notice a reduction in care and those who want you to believe in the evils of “socialized medicine” are spouting nonsense.
Additionally, I believe it is incredibly important to make sure that patients who do not speak a language at a native level fully understand the steps of their care.
Better yet, it is hugely advantageous for care providers to learn a foreign language so that you can be the one that feels uncomfortable rather than put a sick and tired patient in that position. I have a university-level degree in French. Sometimes I still don’t necessarily feel like I can properly advocate for my healthcare needs in French. It is hard to ask questions on techniques when you don’t know the words for things or when you have to WordReference a random term because you never thought you would be asking about that.
Finally, I am on the mend. I have a great support system with friends and family, and I am thankful to be in a country with such a fantastic health system and doctors and nurses looking out for my health.
While it was not ideal, I learned so much from my hospitalization in France as an expat, and I hope that I can use this experience to encourage similar policy in the US.
Update: March 2020
I decided to upload this again in the hopes that it gains more traction. The current situation surrounding COVID-19 globally is stressful, but these concerns are only exacerbated by the fact that many Americans do not have health insurance, and a stay in the ICU could result in a lifetime of debt.
I believe that healthcare is a human right and that no one should be stuck with the decision of crippling debt or treatment. Emergencies happen. Cancer happens. Pandemics happen. People should not worry that receiving care will financially ruin them.