Shelton: Remembering Civilized Healthcare | View to the West
by Peter Shelton
May 30, 2007 | 430 views | 0 0 comments | 5 5 recommendations | email to a friend | print

Little Cloe was about 10. She got a lot of ear infections as a child, and she caught a doozey that August while we were in France.

We had swapped houses for the month with a French family who wanted see the American Southwest. We found each other through a house-exchange agency in Vermont. It was a brilliant system: we not only had the use of their house in an ancient village near the Mediterranean, we had the keys to their car, and, as it turned out, gracious entrée to their healthcare system as well.

The Esquirols – she was a bookkeeper; he was an electrician; their eight-year-old daughter left Barbies for our girls to play with – made sure before they left that we had their healthcare card, with their national ID number on it. When Cloe’s fever would not go away, we piled in the diesel VW Golf and drove to the doctor out in the country.

It was a big old gray house under the plane trees. The waiting room was to the right of a central hall in what had once been the parlor. The exam room was to the left. The doctor and his family lived in the rest of the house. Ellen remembers smelling something delicious cooking, onions perhaps.

When we walked in the waiting room, everyone there looked up and said, “Bonjour, m’sieurs-dames.” Every time someone new came in, we all chimed in unison, “Bonjour, m’sieurs-dames.” When the doctor poked his head in the door to call someone across the hall, we politely wished those leaving, “Au revoir, m’sieurs-dames.”

The doctor listened to Cloe’s heart and lungs, looked in her ears and throat, and prescribed antibiotics. He said that if the fever didn’t let up soon, we should call and he would stop by on his house-call rounds.

Total cost – not counting the antibiotics, which we picked up at the local pharmacy (they came in a white paper packet) – exactly nothing. Zero francs. Zero dollars.

I am remembering all this because the dysfunctional healthcare system in the U.S. is once again big news. Not since First Lady Hillary Clinton tried to make healthcare reform her personal bailiwick 15 years ago has the disgrace of it been so publicly discussed. 

There is Massachusetts, of course, which absent any federal leadership, is feeling its way toward insuring 100 percent of its citizens by 2009. Then there is Michael Moore, the Academy Award winning director of Bowling for Columbine, with his new film, Sicko, which will be premiered this week at the Cannes Film Festival.

Sicko attacks, in Moore’s acid-satire way, big drug companies, the federal bureaucracy, the insurance cartels, the indefensible fact that 46.6 million people in this country, “the richest nation on earth,” do not have health insurance. That is up from 31 million uninsured in 1987.

Is it coincidence the film is opening in France? I don’t know. It certainly is apropos. The World Health Organization, in its latest ranking of healthcare systems, lists France at number one. The U.S. ranks 37th, between Costa Rica and Slovenia.

On NPR’s “Science Friday” last week, the topic was America’s healthcare mess. A woman called in with a story. She and her husband were traveling in France when he suffered a detached retina. Because they were visitors, they could not partake (as we had 20 years earlier) of the national insurance system. But, they were told, they could have the surgery done for 800 Euros, about $1,200. When the couple got home, they found that while they were away a friend had needed the exact same surgery here, at a cost of over $20,000.

Why? What’s wrong with this picture? Just about every piece of the puzzle is bloated beyond reason, said author and Harvard surgeon, Dr. Atul Gawande, who was a guest on the show. Everything except the medical treatment itself: we do have the skilled doctors, the machines, the high-tech facilities for superb care. It’s just that they are not universally available; they are there, on-demand, for the rich. 

Universal coverage is un-American, anti-marketplace, anti-innovation, anti-profit. It’s socialism, for Chrissake! Or so say defenders of the U.S. system. Many of whom also happen to be down on France for whatever reasons, down on its social safety net, its high taxes, its unforgivable refusal to “get on board with our wonderfully conceived and brilliantly executed war in Iraq.”

That last is from Bill Maher in an essay for a couple of weeks ago. France bashing has always been a happy pastime of the conservative right. It was even taken up during the campaign by France’s new president, Nicolas Sarkozy, who seemed to be saying that France was “broken” and needed fixing.

But, as Maher wrote, how broken can a place be that has the best healthcare in the world, that is not dependant on Mideast oil, that has the lowest poverty rate and the lowest income-inequality rate among industrialized nations, that generates the smallest carbon footprint on the planet? And, French people are not fat.

“I don’t want to be French,” Maher wrote. “I just want to take what’s best from the French … Can’t we just admit we could learn something from them?”

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