The French way of cancer treatment; it’s entirely humane

I’m still switching to climate writing, and have two strong piece in the works. One details the inevitable death of South Florida (yep), and the other, the coming ice age in Europe (yep). For the first, think “salt water.” For the second, think “Atlantic Gulf Stream.”

But I couldn’t resist taking time off to post this. Anya Schiffrin is the daughter of the late writer André Schiffrin and the wife of Nobel-prize-winning economist Joseph Stiglitz. She’s also quite the writer and editor herself. A few weeks ago, she wrote an article for Reuters about her father’s struggle with cancer last year, and about the relative cancer care he received in the U.S. and in France. (Her father was born in France, but he and his family fled the Vichy government for the United States during World War II.)

What Anya Schiffrin found was that there was no comparison at all. All of the indignities you take for granted in the U.S., the French take away. To read this account, the French system for human health care is … well, humane.

So I consider this piece a must-read. It’s clear and stunning.

It’s not just that single-payer done-right is a terrific system. You have no idea how terrific it is, done the way the French do it. You have to read it all to get that. Every paragraph, it’s one more thing done right. Wait-time for chemo treatments? Eight hours at Sloan Kettering, a big-deal hospital. And only ninety minutes in a French hospital, the one down the street. And there’s much more like that.

Anya Schiffrin

Anya Schiffrin

Before you read, a word or two of clarification:

▪ “Single payer” refers to a system where the government is the insurance company, while the health care providers can be either public or private, as they choose. Medicare and Medicaid are “single payer” systems. (Schiffrin says the French system is most like Medicaid in structure.)

▪ “Nationalized medicine” refers to a system where the government is the health care provider itself, and doctors and hospitals are government-controlled. The British health system is nationalized medicine. The closest we have in the U.S.to a nationalized medical system is the VA.

▪ Under “single payer” it’s critical that the government regulate cost. They do that in France, and most other countries with good health care. We try hard not to do that in the U.S. (because, jobs, or profits, or something to do with CEO compensation). If we actually regulated cost — for example, by letting Medicare use its size to negotiate drug prices — you’d pay cost + a small profit for your medicine, not cost + a CEO salary bump.

That said, here’s Anya Schiffrin (some paragraphing mine):

When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

I humored him — though my sister and I didn’t want him to go. We felt he should stay in New York City, in the apartment where we grew up. I could visit him daily there, bringing takeout from his favorite Chinese restaurant and helping my mother.

I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care. Not better cancer specialists. How could a public hospital in Paris possibly improve on Sloan Kettering’s cancer treatment? …

But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions.

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. …

Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

And in France?

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting.

Total time at the Paris hospital each week: 90 minutes.

There were other surprises. At the hospital, the doctors all came to see Schiffrin’s father, in a group. That meant they would talk to each other about his care and nutrition. If they kept him extra long, he got breakfast and lunch, on them. He got replacement drugs when the original drugs stopped working — drugs that his U.S. insurance wouldn’t pay for. Even his taxi home was taken care of. 

The list of differences is amazing. You really do have to read this piece. And then there’s this:

In 2011, France’s expenditure on health per capita was $4,086, compared to $8,608 in the United States, according to the World Health Organization. Spending as a percentage of gross domestic product was 11.6 percent in France while in the United States it was a far higher 17.9 percent.

That’s half the per-capita cost, but you knew that, right? The end of the essay is quite touching, by the way. It’s about time spent with billing departments vs. time spent with her father.

The ACA is as close as you’ll get to a good thing from triangulating, profit-protecting Democrat. Ready for another to take his place? If you’re not, the time is now to clear space for a real progressive in 2016 — literally now. The longer the good ones don’t plan to enter, the less likely they’ll come in later, even if a slot opens up.

But you knew that too, right?

GP

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Gaius Publius is a professional writer living on the West Coast of the United States. Click here for more. Follow him on Twitter @Gaius_Publius and Facebook.

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  • caphillprof

    I think you underestimate la Hillary.

  • Badgerite

    I think there are several areas of common life where you do not expect your fellow citizens to be looking to make a whopping ‘Wolf of Wall Street’ profit. One of them is healthcare.

  • Silver_Witch

    100% agree Ronbo

  • Badgerite

    Too be fair, dealing with dying people on a daily basis, as a profession has to have its emotional costs. I once met a woman who was an physical therapist who had 5 patients of hers die in one day. (Nothing she did, of course. She was just the physical therapist.) She quit the profession after that because she found it too emotionally draining.

  • ronbo

    I entirely agree. If we are going to have the 1%’s policies regardless of Rep or Dem, then let’s embolden the Dems by making the Repubs responsible. It might move the Dems to the left of 1980’s Republican policy.

  • ronbo

    Leadership needs to, at least, lead in the direction of of those who elected them. It’s why our economy has bush-ed further towards Wallstreet and the banksters.

  • ronbo

    So very true. I had insurance (crappy BC/BS) for seven (7!) years who subsequently refused to pay for my hernia surgery saying that it was “pre-existing”. I offered to close the account and pay the hospital directly the co-pay I WOULD have paid BC/BS. They accepted.

    I was legally robbed by BC/BS for thousands and thousands of dollars. BC/BS automatically refused me and it paid off for them in spades. Insurance companies ONLY insure their profits.

  • Julien Pierre

    My father died of the same cancer, pancreatic stage four, in the summer of 2010 , in France. He was treated at a different hospital, hôpital Beaujon. He lived in a suburb where there was no hospital care for this cancer nearby. He had a nurse coming at home for the first month, but his condition worsened to the point where he had to spend his final month in the hospital, in a cramped room, in a run-down building that was over 100 years old and didn’t even have air conditioning despite the heat 35°C heat in august. I spent the last days and nights with him there. He only survived 60 days from the day the cancer was confirmed. It is a horrible cancer and I don’t think there is any good way to treat it, but I wish he had been spared this awful ending. He never got the chance to be moved from the hospital to palliative care.

    While the French system is better in many ways than what we have here in the US, it is not by any means perfect.

  • Julien Pierre

    I am very happy with Kaiser in the SF bay area . The HIV specialist is top notch. I can see a doctor within hours and just did a couple days ago. I wish the hospital was closer, but that’s my fault for moving somewhere in the hills.

  • docsterx

    One general tip on billing problems. This often works with larger corporate entities (hospitals, urgicares, laboratories, imaging centers, etc.) ALWAYS push them, repeatedly, to negotiate the bill down. Some of them will be willing to talk and lower the fees. Often patients are unable to pay the full amount. The billing agency wants to get some money. They don’t want the payer to declare bankruptcy. They don’t want to have to turn the case over to collections. In both of those cases, they lose. Many people will call and complain about the bill once to the billing office and then try to pay. They often won;t call back and try to negotiate a reduction in fees. It doesn’t always work and it can be time consuming but sometimes you can get your bill cut by a reasonable amount.

    One of the local imaging center groups will cut their fees by 50% if you are a self-pay patient and you emphasize that you’ll be paying out of pocket for their services. They don’t advertise this fact, but patients who call and explain their circumstances can get their bills cut in half. Some large lab corporations offer similar savings. If you let them know in advance that you are a self-pay patient, they will sometimes (if you meet their criteria) charge you less for your lab tests. Some will also work with you if you still have to meet your insurance deductible. They may reduce fees until your deductible is met. Ask about possible savings like these up front and look in to negotiating.

  • pappyvet

    I’ve had some experience with a loved one dying in our system here. The care was matter of fact at best. I will not go into the worst.

  • http://AMERICAblog.com/ John Aravosis

    My cataract surgery was $15k an eye here in the US, which insurance knocked down to $5k an eye, which was stil absurd. And I’ve had similar laser surgery, which cost me a couple grand here, and around $150 in France.

  • http://AMERICAblog.com/ John Aravosis

    I was going to say I’ll check it out, but I likely won’t as I can’t open that link and save the video – Comedy Central automatically turns on their vidoes after a few minutes of pause, so I can’t save it and watch it later. Oh well :)

  • arcadesproject

    I don’t know what French Doctors drive around in but I did see a documentary about the English system. I remember a neurologist who had a London townhouse and a brace of Audis. (But Cameron and the conservatives, and a quiescent British Public, are in the in the process of destroying the National Health Service.

  • Ford Prefect

    Ha! That’s one way to get around that problem, eh?

  • Silver_Witch

    You go Ford!!! Maybe if they find a problem during the prenatal they will check your eyes to be sure you can see you are a boy <giggle.

  • Ford Prefect

    LOL!

    “Yes, I’m calling to make an appointment for my free pre-natal exam.”

    “But you’re a man.”

    “So what? You make me pay for it and it’s just about the only thing you cover, so I’m going to get what I paid for. I would have preferred an eye exam, but Kaiser prefers I go blind, so this is all that’s left.”

  • Silver_Witch

    I have been very concerned for those who are above the poverty line, without insurance through their employer and how the ACA would work. Thankfully I am working and my employer has a good plan (not a great plan, but a good plan).

    I hear you and hope for better days with One Payor or something coming soon. Hang in their Ford and you could practice the behavior that would make you need Pre Natal Care – even if you can get Natal…you can enjoy the practice.

  • Ford Prefect

    I’ve been with KP on and off since 1990. The farther back I go, the better it was. The problem is their entire business model is a for-profit one (even though they don’t have to pay any taxes) that mandates ever higher costs for ever fewer services. That is how Richard Kaiser explained it to Richard Nixon in 1972. You can only squeeze so much blood from a turnip, so after that, they’re just inflicting pain on their “customers.”

    Anyhoo, my new plan is compliant with Obamacare Bronze, since that’s all I can afford and barely so at that. My previous plan was reasonable. The service was fine for little stuff and the front line staff are generally very pleasant. Now, the last thing I want to do is use it, even though I’m paying through the nose for it. I get free pre-natal exams, but no vision and as an aging male, that does not make me happy. In fact, it really covers nothing and the “full cost” that I now have to pay for everything is absurd. They wanted $300-plus-plus (whatever that means) for an eye exam, so I did it at Costco for $50.

    Whatever it is, it ain’t healthcare. It’s just theft, since I can’t not have it without violating the law. The only way I get my “money’s worth” is if I get really sick and run up bills well in excess of $13,000. Needless to say, I’d rather bitch about the theft than get sick, so there is no positive spin on all this.

  • Silver_Witch

    Perhaps it is different. I am in So Cal – that might make the difference too.

    I hope SanFran keeps their icky Kaiser there – I am waiting to join when I get old enough to get it through medicare.

  • http://www.rebeccamorn.com/mind BeccaM

    Not true for your husband perhaps, but like I said, I have several friends in the SF Bay Area and they’ve expressed to me personally increasing discontent with the price and quality of Kaiser services.

    You mention below that your husband isn’t actually a direct Kaiser subscriber, but enrolled through Medicare. That might make a difference.

  • Silver_Witch

    I have only had ONE doctor that actually acted as if I were a human in all of the years and all of the doctors I have seen. And because of my mental illness – I am often treated as an animal that can not possible know what is wrong with me or what is good for me.

  • Silver_Witch

    I would vote for him as an Independent…the Dems would never let him run…they are not progressive or liberal…

    I WILL not hold my nose and vote for Clinton, I would rather see a Republican in the WH so they can be responsible for the failures than another 4 or 8 years of obstruction, hatred and evil…honestly….I have just about given up on the whole process and would gladly move to France or Canada except for the stupid weather and that silly language thing.

  • Silver_Witch

    Oh Gosh Ford, my experience is totally the opposite…my husband has it as his Medicare choice and his co-pay is $20, ER is expensive ($60), but the Urgent Care is available here almost all the time so ER visits are rare.

    So sorry your experience is so awful…you should complain to the Advocate at your facility.

  • Silver_Witch

    Not true BeccaM….my husband has Kaiser and I love them. They truly care for him, they treat him like a human. If he doesn’t go to the doctor for a while (he is a bit stubborn with his treatment plan) they call and bug him to come in for blood work or other necessaries. They are wonderful and easily refer him to a specialist.

    In fact, they take better care of him both here and on the East Coast than I the care I got from my “premium” coverage through my employer on the East Coast – here I am in a general HMO and it is okay coverage – just hope nothing bad ever happens.

  • docsterx

    Sometimes we all get so caught up in making sure that the procedure goes just right we forget that there’s a PERSON ATTACHED to that procedure.

  • http://www.americablog.com/ Naja pallida

    I’m not sure it really matters, at least as far as health care is concerned. The ACA has effectively made health care a hot potato issue that no President and no Congress is going to want to seriously touch back on again for at least another decade. So even if there is a second President Clinton, and that’s a big if, it’s unlikely health care reform will even be a significant part of her platform, except in rhetoric.

  • Mike_in_the_Tundra

    The U.S.A’s medical system is not for the convenience of patients. Fifteen years ago, I did battle with cancer. It was a vicious battle, but I eventually won. However, I wish I could have back all the time I spent waiting. The oncologist’s staff always called to remind me of appointments, and that was fine. They also asked me to arrive fifteen minutes before the scheduled time. That was in case the doctor was ready for me earlier than I was scheduled. What that actually did was increase my waiting time from 30 minutes to 45 minutes.

    I sometimes think they forgot they were working with human beings. My veins just couldn’t handle all the medications, so it was decided that I needed a PIC line. A PIC line is a port in the upper arm that has a tube leading to a large vein in the chest. First a doctor must make a incision or hole in the arm. Then someone else comes in to insert the tube. Then they take the patient to radiology to check the tubes placement. Then they take the patient back to the surgical suite. The tube guy looks at the x-ray and moves the tube and sends the patient back to radiology. This goes on and on until the placement is correct. Every time I had to wait 15 or more minutes for the tube guy and radiology. I was still there when the next shift came on duty. The new nurse was more alert. I’m certain he saw my husband waiting with me and realized we were brothers. He was quite chatty as he studied my chart. He asked if I had anything to eat since I arrived. When I said no, he practically shouted, “You’re a diabetic.” I told him I was aware of that. He rushed out and got me some juice to drink immediately. He also ordered a lunch and pre-lunch insulin. I sort of felt he was the first to realize I was human.

    I guess I should have told the nurse that my husband always had juice boxes, candy, and glucose with him.

  • docsterx

    Thanks, Gaius. Good article and post. I wouldn’t have seen Anya’s blog otherwise.

    There are a lot of problems with US healthcare. Some are addressed in this article and post. There are others, some that most people don’t realize or consider. The insight that Anya gives from her point of view is really perceptive, but there are almost as many problems from the physician’s (or nurse’s) point of view.

    Having group rounds like that would be great. But it would be almost impossible to coordinate when you have a group of physicians in private practice. Those little touches, like providing a meal, assuring transportation are great and I’m sure that they’re much appreciated by the patient and his family. In the US, things tend to be more time- and cost-centered. “Keeping the patient in the bed long enough to give him lunch will make us lose revenue from another patient who could be using the room for his chemo. And there would be the cost of lunch, the employee time to cook and serve it, etc. Nope, get him out get the bed changed and get the next patient in so we can bill for him.” A large percentage of hospitals are now owned by for-profit corporations. They want to turn the room and get the next patient in to maximize revenue. Sadly, many doctors’ practices have been bought by hospitals or urgent care businesses and the same applies there. One of my colleagues told me that he absolutely has to see 4 patients per hour just to keep his practice running. To turn a profit, he has to see 5-6 patients per hour. And then, after office hours, he usually needs to stay an additional 2 hours to get caught up with charts, other paperwork, try to return phone calls and do whatever else he couldn’t fit into his regular day. Then get to the hospital, either before or after office hours to check on his inpatients there. And, he is also on the ER’s call schedule. He may get called to the ER to see a patient who may need emergency surgery. If that happens during office hours, his patients in the office get upset. And there are other problems,

    Payments from insurers may take months to be received. Or they may be denied, which entails a battle between the service provider and insurance company that can take additional months. Sometimes the payment from the insurance company is less than the actual cost of the visit. And, if at some point in the future, the insurance company decides that it wants to subsequently deny payment for a previously paid claim, it will. Just withholding that amount from future payments. All of this often entails that the practice hire one or more billers (or pay to use a billing service.) So the biller’s salary and benefits are now part of the office expenses, Meantime, rent, salaries, insurance premiums, etc. at the practice all need to be paid. 

The cost of medical education is huge. Tuition isn’t the only major cost. A single textbook can easily cost $175 and more than one text is needed per semester. Plus the medical equipment: stethoscope, ophthalmoscope/otoscope and others. When I graduated from medical school, I owed close to $160,000 in loans. Medical education in most foreign countries is paid for by the government. An Indian colleague told me that his costs for his entire medical education in India, came to a grand total of $8 for the entire period. Additionally, MDs and DOs need to complete required medical examinations, continuing medical education courses, must take reexams to maintain certification, pay for licensing fees, professional fees, etc. Malpractice insurance rates have caused some physicians to retire, move practices elsewhere, seek alternate careers, etc.

There are huge costs for prescription drugs. John has written about his trips to France where he gets needed medications at about 1/3 the cost that the same medication might cost in the US. This often holds true for medical devices (like pacemakers, artificial joints, etc.) Some prescriptions can cost about $3000/month for a single medication. Costs for antiretroviral medications are often >$10,000/month depending on the drugs prescribed.

Hospital-generated costs that get passed on to patients. Executive salaries (one of the local medical centers has 23 executive vice-president positions. The salary for each is over $100,000. The medical center recently laid off nurses, tried to break a union, is leaving vacant positions unfilled, etc. in an effort to cut costs. Yet they desperately need all of those vice presidents.) Plus there are other costs that get passed on to patients, either directly or indirectly (maintenance of the physical plant, and others costs.)

Excessive paperwork required by insurance companies, government, hospitals, pharmacies that causes loss of time and need to hire trained clerical personnel to deal with the endless paperwork and computer input. Outlay for computer systems, servers, electronic medical records software and other record keeping necessities.

Limiting preventive services is a problem, as well. Many health plans don’t pay for, or limit access for preventive services. Things like weight reduction programs that include diet and nutrition counseling may not be covered. Smoking cessation programs, including medications to help stop smoking may not be covered. Some plans don’t cover all vaccinations that might be necessary. In the short run, this saves the insurance companies money, but may be catastrophically expensive in the long run. Not to mention just making primary care services available. Not just in major metropolitan areas, but throughout the country. In some areas there’s an excessive wait to get to see a PCP. That causes more patients to use an ER, increasing wait times there and increasing costs for primary care services. In more rural communities there may only be one, or no, primary care providers available. And, if there is a local hospital, its ER may be the only close source or care.

    There are several others that are also liabilities to providing humane health care. The above are just a few. Single payer may be a better way to approach health care, but it would require a tremendous change in the way the US delivers health care and would probably be difficult to implement. The ACA is a step, a small step, in the right direction. But I think we may need seven-league boots to improve US health care.

  • Hue-Man

    “I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care.”

    Americans assume that every other country has their system of superior health-care for the rich and ER meatball care for everybody else. In Canada, for example, by law there is NO alternate care system for medically-necessary services (although attempts have been made to circumvent the system – most considered illegal – with concierge family practices, specialized surgery clinics, private MRIs, etc.). This leads to quotes like this reporter as he sat in his doctor’s office: “It turned out I was seated opposite Nadir Mohamed, the president and CEO of Rogers Communications.” http://thewalrus.ca/nadir-and-me/?ref=2012.06-essay-nadir-and-me

    The per capita health care data are even more shocking when you look at government funding per capita for each country. US $4,437, France $3,130, Canada $3,104, UK $2,919. Of course, one of the countries covers only old people, military and government, and the indiigent poor… The data table is sortable. (I don’t get too hung up on what particular year as medical systems and funding change very slowly.) http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country

  • Ford Prefect

    I can attest that Kaiser sucks. High rates, high deductible and high co-pays. It’s no bargain. It’s not affordable and the co-pays (now at $60) guarantee that people won’t use their “healthcare.” Need a doctor? Well, the next appointment for your primary is available in 4 to 6 months. Have an infection? They’ll give you penicillin first and if in a week it doesn’t work, they’ll give you something a bit stronger. Just be prepared to have that infection a week longer than you should have it and eventually you’ll be fine.

    If you just have something minor, it’s really easy to get it dealt with. But something involved will invoke the bonus system they have for doctors: They get bonuses for denying patients services, on top of their $20k-30k monthly salary. You can’t trust them and you have to be willing to do battle with them to get what you need. The problem is, you pretty much have to be a doctor to second guess a doctor, so that’s fraught with problems.

    While the French want to treat people, our system seeks to abuse them, while taking ever greater amounts of cash for the abuse rendered. Some healthcare we’ve got! I wonder how many heart attacks and strokes are directly attributable to the way our “system” works? I’m betting that number would be rather high.

  • http://www.rebeccamorn.com/mind BeccaM

    I have some friends in Kaiser and most of them say that Kaiser now isn’t the Kaiser it used to be. They’ve become really strict with pre-approvals, narrowed their prescription formularies, and enacted rules governing the only accepted treatments they’ll pay for. And getting an appointment, especially with a Kaiser specialist, can be a hair-pulling ordeal.

  • emjayay

    Well obviously it’s because the Free Market is in control of everything and always provides the very best and most efficient products in every situation. Or to put it another way, corporations are people and you aren’t.

  • emjayay

    To be fair, the doctors in India no doubt make much less than they would even in France and all the other workers at the hospital are paid almost nothing from the hospital constuction workers to the current staff.
    In the US of course if you are in a real HMO like Kaiser it’s like a mini National Health and you don’t get nickel and dimed and everything is in one place. All you do is hand over your card and a credit card for copays. Actually it’s the same if you have a not-really-an-HMO plan in NYC as it turns out, except for having to figure out what provider to use and having them all over the place. And them being confused about whether they are in your plan and billing you later after taking your card and………

  • melitagnm105

    My Uncle Connor got Mercedes-Benz SLS AMG use
    this link B­i­g­4­1­.­ℂ­o­m

  • cole3244

    another example of why i say capitalism sucks.

  • Ford Prefect

    Word:

    If you’re not, the time is now to clear space for a real progressive in 2016 — literally now. The longer the good ones don’t plan to enter, the less likely they’ll come in later, even if a slot opens up.

    And WTF is up with the French? Don’t they know that treating people like human beings violates Neo-Liberal principles? They need to triple their prices, lest people in DC start noticing we charge too much for our system… which is based on the long-held American principle that good health results from abuse and economic ruin.

  • http://www.rebeccamorn.com/mind BeccaM

    Hell, I’ve told the stories of my wife’s retina laser-reattachment surgery in India enough times, as well as our decision to have her cataract surgery done there, too.

    Two things impressed me the most: One was that the ‘super-speciality’ hospital in Bangalore immediately assigned us a concierge, as soon as they learned we were foreigners and might need help navigating the system. The other was there were never any surprises regarding how much we’d have to pay — and EVERYTHING was always included in the one bill. Not only the surgery in question, but also the intake exam, the surgery itself and any ancillary costs, the prescriptions, and the follow-up visits.

    When we asked how this could be, they said it was because they had a standard charges list, which they were required to adhere to. Plus, as we were told, when one is having medical problems, dealing with a complicated bill was the last thing a patient needed. If a blanket or a pain pill was needed, these were simply to be provided, no charge. Rather than itemize every last little thing and try to make people pay for them, the ancillary items were considered to be rolled into the overall fee for service.

    Strike what I said before: Three surprises. The third was how much incredibly cheaper it was to get quality medical care in India. The laser reattachment cost us a grand total of about $38 US. The cataract surgery was $600 an eye, but only because we went with imported lenses. It would’ve been less than half that if we’d gone with domestic — but the doctor advised us to upgrade if we could afford it.

    And before anyone suggests it’s because they do shoddy work, it’s nonsense. Upon returning home, my wife had her eyes examined by our regular ophthalmologist/optometrist, and he said he’d never seen finer work — everything looked superb.

    So yeah: Humane medical treatment isn’t limited just to France. It seems to be only here in America where we expect sick and injured people to suffer and to go broke doing it. There are times when I think we have no clue what it means to be kind or have compassion.

  • emjayay

    Love him, but he doesn’t have a chance. And this is a comment section on a health care post.

  • emjayay

    What does that have to do with health care?

  • Badgerite

    Good article. Sometimes I wish I were French. But —- You neglect to notice that Congress is the entity that passes laws. The POTUS can say, “I want this”, but that doesn’t mean that the POTUS will get this. You can’t just focus on one branch and think it will change everything. It won’t.
    However, pointing up the differences in health care systems and questioning why ours is not the best in the world seems to me a good point to make. It’s like this country has a mean streak that it just has to indulge against its own citizens. So, why is that?

  • Indigo

    It’s no longer about what We, the People, want. It’s about what Our Corporate Overlords want. Remember?

  • Indigo

    Yeah but French doctors don’t drive around in Cadillacs either. And that’s how you know the US is superior. (You saw that ad, right?)

  • TheOriginalLiz

    amazing that in some countries doctors don’t go into medicine primarily for financial gain.

  • bkmn

    Anyone in the US that proclaims the healthcare systems in Canada or the EU are inferior to the US have never been outside the country. I have seen world class physicians working in Canada, UK, France, Germany. They are all as talented as any physician here in the US. They may not be making as much money but I can guarantee that they don’t have the headaches that physicians in the US have.

  • Jim Olson

    I do not want Hillary in 2016, but if its a choice between her and any Republican, I will hold my nose and vote for her. Bernie Sanders just had an article in the Nation saying that he is prepared to run. He won’t have a chance unless he runs as a Democrat, something he acknowledges, but boy it would be interesting to see him run.

  • HKAnders

    If we actually regulated cost — for example, by letting Medicare use its size to negotiate drug prices — you’d pay cost + a small profit for your medicine, not cost + a CEO salary bump.

    More like “cost + shareholder dividends,” but… yeah.

  • caphillprof

    Even if she could win, do we really want Hillary in 2016? How about somebody at least a bit progressive!

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