As an immediate response to MinistryOfTruth's call for people to post personal health care horror stories, and as this has been requested privately by several kossacks, here's the story of my son's dealings with the French national (socialised) health care system after he was diagnosed with a brain tumor almost 5 years ago.
This is my son today, enjoying life and activities despite being partly hemiplegic:
(Note, I first wrote this almost 3 years ago, and have reposted it (and updated) a couple of times already in the past few years. Given what I read every day here on dKos about your health care system, this should probably be posted every single day... like all Europeans (and anyone from a civilised country), I just can't comprehend how awful healthcare in the US is - or rather, I understand it too well, but the shock never wears out.)
My (then 4 years old) son was diagnosed 5 years ago with a brain tumor. He underwent surgery, then chemiotherapy for a year and a half. In 2006, he appeared to have been cured, but the tumor reappeared in September that year, and he underwent radiotherapy for several weeks the following winter. Since that, his tumor has not reappeared in the quarterly (now semestrial) check ups.
As a consequence of the initial surgery on the tumor, which was in a very bad location, he is handicapped and has only very partial use of his right arm (as the picture shows, he makes the best of it)
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He was first diagnosed by our regular pediatrician, a private sector doctor.
an added note here: you can go to whichever doctor you care to. Doctors can belong to two different categories in the system: those that charge the regulated rates for a visit, and those that charge whatever they care to. Whichever doctor you go to, you get the regulated rate taken care of by the system (except for a co-pay of, currently, 1 euro per visit). So if you want to go to the fancy fashionable doctor and pay more for the privilege, you can. and if you just want to pay the least, you go to a "category 1 doctor" - there are plenty in all cities. Specialists are usually more expensive than generalists, but work under the same system. With current systems, if you have the national health card, you don't even need to advance the funds - the doctor is paid directly by the national healthcare system (which we call "Sécu" - shorthand for Sécurité Sociale, which covers healthcare, pensions and unemployment benefits; the healthcare bit is called "assurance maladie" - as in "insurance" - the single payer kind).
In our case, the doctor is a private sector one, so he charges about double the standard rate; a good part of the difference is covered by our private insurance, which comes on top of the basic coverage, and is provided by my job
The doctor sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know. He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.
Again, to repeat: a doctor had required the (sophisticated and expensive) exams: they were done immediately, the same day, at no cost to us, and with no bureaucrat, public or private, having a say whether they were justified or not.
Surgery - an act that the doctor that performed it (one of the world's top specialists in his field) told us he would not have done it five years before - actually took place the next week, because emergency cases came up in the meantime, and our son's surgery was not deemed as critical. After the surgery and a few days of recovery at the hospital (first in the sterile area, then in a normal area, in each case in a private room), we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.
Again: world class treatment was provided immediately, not subject to any "death panel" of any kind, and at no cost to us. In this case, treatment was provided in a public hospital, but if the best solution had been in a private clinic (or even, in some cases, if the only solution was to ship my son to a foreign specialist, something which happens in rare instances), then my son would have been taken there at no cost to us, everything been covered by the "Sécu"
Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.
Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, psychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.
No rationing here: altogether, probably 10 specialised doctors and nurses took care of him in turns over that year.
My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) - and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).
This is probably the kind of things that gets called "unsustainable benefits" in the English language press: not only did we not pay any money, but we were actually given some to better take care of our son and compensate for the fact that one of us could no longer work as a result of this unexpected tragedy. But then, that's what socialism and national solidarity are about: you take care of sick people, no questions about cost asked. Pretty evil, huh?
During the chemiotherapy, if he had any side effects (his immune system being weakened, any normal children's disease basically required him to be hospitalised to be given full anti-biotic treatment), we'd call up the hospital and just come around. Either of us could spend the night with him as needed. We never spent a dime when we did so. Again, had we needed it, ambulance transport would have been provided free of charge.
After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size because of his hemiplegy and the need to help his arm and leg grow as normally as possible). Among other things, they manufacture leg and arm braces (both for daytime and night time) and other specialised equipment for him and provide it free of charge to us. This has now been going on for 3 years and pretty much the same team has been taking care of him throughout.
Check up exams now take place every 6 months (it was every 3 months just after the radiotherapy), with all the appropriate exams (including a MRI), and we've never had to wait for the appointments. Again, no cost for us, no funds to be fronted.
Note: given that these are not time-sensitive exams, they are not done at the hospital (they keep their machine as available as possible for emergencies), but in a private practice in town. I have no idea how much an exam costs, but the price would likely be regulated
When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the "socialist" French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that's where the best hope was, the costs of that would have been covered fully by "Sécu." Our doctors are part of an international network of brain tupor specialists, and they know all the facilities in the world for these kinds of tumors - and being research specialists as well as medical practitioners, they publish papers and share all information on the most promising treatments and protocols, and have access to the same from colleagues from Europe and the US.
Since our son has been in first grade (he is now in third grade), he has the right to special help for handicapped children at school, thanks to a fairly recent national law, and he now benefits from part time help - a person who is around about 20 hours per week to help him do his work and catch up when he is absent for his therapy. This is paid by the city of Paris and the ministry of education.
Oh, and as he is officially handicapped, we discovered that we actually benefit from an additional tax break (in France, income taxes you pay are roughly divided by the number of people in the family; the handicap counts as an additional person for that purpose).
So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.
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As I noted above, we do have private healthcare insurance in France. Basic healthcare is covered by social security, but only partly: except for the poor (under a certain income level), there are co-payments for most expenses like medecine and doctor visits, and doctors are also allowed to charge you more than the official tariff (and you have to pay the difference, in addition to the co-payment on the official price). Thus many people buy private (or mutual) insurance to cover that difference partly or fully. Such insurance is often provided by employers. But whenever you have "major" expenses, you switch to 100% coverage of expenses by the public system, which takes care of all associated costs, with no attention paid to income, pre-existing conditions or age - except that, if you had a private insurer, it has to pay to the public entity a portion of the costs. In my case, as I had a good insurance via my bank, this is what's happening, and thus the private sector bears a portion of "catastrophic risk." (And they have no say in what care is provided. They just pay an agreed fraction of it.)
Thus there is solidarity across the sytem.
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This is not to say that all is well in French healthcare. As in other countries, costs are barely under control, spending increases every year, and there are many ways the system could be improved for doctors, nurses and patients. But the fact remains that if you are badly ill, you will be taken care of; you will not need to give up your job (or if you do, you're helped); you will not need to sell your house; and you will certainly NEVER be denied healthcare.
It's been tough enough to deal with a sick child; I simply do not want to imagine what it would have been like if I had to beg for care or to scurry around for money in addition. It's just inconceivable. And thus, I was happy to pay taxes before, and I'm really, really happy to pay taxes now to provide that level of care for those that really need it.
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Oh, and another tidbit: as you can see from the picture, we're in Switzerland. This is not a worry: we can get care in all European countries as if we were a local, and our natinal healthcare system will pay for the costs incurred in the other country (see a detailed explanation in the Engish via the British NHS here). The only Western country we're wary to travel to, because we know care may only be forthcoming at a massive upfront cost, is the USA: all European travellers to the US need to buy additional insurance, and if you read the fine print, you'll see that there are caps that appear quite high to us but don't cover a lot more than emergency care plus immediate repatriation to a "normal" system back in Europe.
At various points in time, I've thought about coming to work in the US, but ongoing care for my son is likely to be the biggest obstacle. I don't worry too much about the cost of a relapse (because we'd go back home to France, where all would be covered), but I have no idea if I'd be able to find the kind of ongoing help are he still needs - would my employer be able to cover that? would I need ot pay for it separately?