A Tour Guide’s Experience with Health Care Phobia in France

I believe that, especially with a good guide, travel can be transformative and richly experiential…both a political act and a spiritual act. It forces people to grow, to deal with others who see things differently, to get out of their comfort zones, and to grapple with their own ethnocentricity and hang-ups. While people don’t generally sign up for a tour thinking they are investing in the growing pains of a broader perspective, I encourage my guides — like a loving parent who works to broaden a child’s palate — to thoughtfully set up experiences that can pry open a little wider the hometown blinders of an American traveler. Recently, one of our guides (who happens to be an American) shared this fascinating experience relating to health care in France. Here’s her report:

When I’m leading a tour in France, I always give a talk on the French tax, education, and health care systems. When speaking to a tour group — many of whom are relatively well-off, middle-aged Americans — these subjects can be a little controversial…even taboo. But I believe these issues are essential for anyone hoping to understand contemporary French society and culture.

The French pay lots of taxes for social programs. These taxes allow for “free” universal health care (not socialized medicine, but rather a quasi-private system overseen by the government — rated #1 in the world by the World Health Organization) and “free” education through the university level for all French citizens. Of course, health care and education are not free — they are paid for collectively by the entire society through taxes.

The French, in general, believe this is a good system. As is the case with other Europeans, they are not eager to pay high taxes (the French pay about 30 percent income tax, plus about 20 percent sales tax). But they have high expectations for the programs their taxes pay for, and they generally embrace the system. The French see their tax dollars at work each time they go to the doctor of their choosing and pay only a small co-pay (about $20); when they don’t have to worry whether they can afford their cancer treatment; and when they don’t have to ask, “How will I pay for higher education for my child?” No one in France is in debt because they have cancer or because they went to school to become a teacher.

When I explain this to my tour members, I let them know that I don’t think the French system is perfect, and neither do the French.  It’s expensive. There is abuse. And some people fall through the cracks. But I believe that when our tax, health care, and education expenses are added together, we Americans end up paying more for less. The French, by their communal nature, prefer the collective approach — life with more taxes and without the economic stress that we treat as normal. I graduated from the University of Washington owing $30,000, and my parents owed even more. My 30-year-old brother, who is self-employed with no insurance, fell off his bike and had to wait more than six hours to be seen in the emergency room. He was billed $7,000 for that visit. My underinsured father had quadruple bypass heart surgery and had to file for bankruptcy because he couldn’t pay his medical bills.

Rick Steves groups are filled with people of all political stripes, but nearly everyone is rational, open-minded, and willing to respect (if not agree with) the opinions of others. But on a recent tour, a few of my tour members were angered that I would “talk positively about socialism” (as they put it). One couple (I’ll call them Jane and John) said they vehemently disagreed with everything I said — not just my opinions, which I could understand, but even the facts and statistics I had cited, and the personal French accounts I’d collected. Jane insisted that no one could be happy living in a system where one is responsible for carrying the weight of their neighbor.

The next morning, when I went down to breakfast, Jane and John weren’t anywhere to be found. Finally John appeared looking like he’d seen a ghost — like he hadn’t slept all night. Turns out he hadn’t. Jane had suffered a severe medical problem the night before, but she wouldn’t let John come get me to help — she refused to see a doctor in France. I went to see Jane and convinced her to go to the hospital. When we got there, she was seen within two minutes of walking through the door, they were giving her tests within five minutes, and after ten minutes, she felt comfortable enough with the quality of care that she told me I didn’t need to stay.

I went back when it was time for Jane to be discharged. Fortunately, her condition had not caused long-term damage, and with medication she’d be able to return home to follow up with her own doctors. But John was struggling to sort things out with the discharge nurse. I translated the nurse’s explanation that she couldn’t accept their US insurance information — in fact, there was nothing to pay. John turned to me and said, “Do you know how much this overnight stay would cost in the US? This is crazy! Are you sure I don’t have to pay?” Determined to “pay their own way,” John and Jane took out their credit card. After some convincing, I persuaded the nurse to charge them a small “donation” of about $200.

I’m so thankful Jane was able to walk away from the incident. And I also hope that maybe their experience opened their minds a bit. We don’t need to embrace European social ethics. But we should be open to learning about them and respecting people who choose to design caring societies a little differently than ours.


15 Replies to “A Tour Guide’s Experience with Health Care Phobia in France”

  1. This was amusing in the most macabre way; indeed, I had no problem using a Pharmacie in Paris six weeks ago to treat sunburn. And I certainly had no qualms seeking out medical attention in London when I fell ill. I suppose with some people’s mentality, unless it’s stressfully expensive and inefficient, healthcare can’t be trusted. I mean what does the WHO know anyway? Smh….

  2. I had need of medical assistance in France. As it was evening my only option was the hospital emergency room. Within a couple of minutes of walking in the door I was being treated by 4-5 hospital staff members and was missing about a pint of blood which was on its way to the lab. As it turned out the problem was not serious and was easily treatable. About an hour later I was out the door with no bill for the hospital visit other than being told there would be a bill for the lab work which turned out to be 116 Euros. Anybody want to guess how long it would have taken or what the cost would have been in a U.S hospital.

  3. I absolutely love this post and the story! I recently spent 3 months with my husband in Europe and he had to go through a small emergency surgery in London, with a month left in our trip(we still had 3 cities to go through) we had to look for medical assistance for his wound in London, Paris and Madrid and we had nothing but helpful doctors, nurses in these three places at a very reduced o no cost at all. Only when we arrived at the states we had an issue when the wound center said to my husband.. “sorry we can only see you in a week …(for a wound that needed daily care)”

  4. this is a perfect example of why the united states is so far behind so many other developed nations when it comes to progressive social policy.

  5. We had a similar experience while on the GAS tour in Vienna a couple of years ago. My 10 yr old grandson superglued the fingers on both his hands together while trying to repair his broken sunglasses. One of those long and embarrassing for him “family stories”. This happened after 10 pm, but with the help of a sleepy but friendly and happy to help pharmacist who answered the knock on her little wooden window at the pharmacie, some wonderful advice, precise instructions and a small, inexpensive bottle of acetone, problem solved. I can just imagine what hoops we would have had to jumped through here…..I would never hesitate to use any of the health facilities in Europe.

  6. This similar thing happened to us a few years ago in Florence. We were traveling with friends and one of them (quite young) had a life long heart condition and needed to have her blood levels checked for a medication she was taking. They walked into the Florence hospital, explained what they needed. They gave her a blood test with her levels and then asked what the cost was and were told that they would not charge them. They don’t charge US citizens traveling in Italy. Our friends left their info and were sure for years they would get a bill and never did. I am glad to hear about France. We are traveling in December with some friends quite a bit older than us and they have never been out of the country, and I had thought to make some inquires about the medical care there just in case.

  7. That $200 is probably what the guy needed to pay to hang onto his world view. How sad. I hope I’m not this close-minded when I’m old. When does old start? I want to ward this kind of I-know-everything-thinking off by being aware.

    One of my college friends married a French man who unfortunately developed a brain tumor. He had a long, horrible death which couldn’t be prevented, but I can’t begin to tell you how grateful my friend was that he was experiencing French health care. She said the doctors and the health care system did everything possible for him and for her and her family as he went through it. She was sooo grateful. She just had to raise her kids and deal with the trauma of losing her husband, without bankruptcy and medical bills she could never even hope to pay on top of that. Raising her kids and becoming a widow has been more than enough challenge.

  8. another me too post

    mine was in prague
    middle of the night, instant service, an incredibly smart dr who spoke 6 languages and was working on learning 2 more

    exam, ekg, blood work. $200

  9. We have a similar story, but needed hospital care and lots of tests. After 3 days in the hospital (private room), multiple doctors and tests the total bill was $550 euros. They kept apologizing for having to charge us. We thought it was the best care ever. After returning to the US we followed up and the cost for the same tests without hospital stay was over $5,000 with insurance. Do we have the best system, no is the answer. By the way, for meals in the hospital a waiter comes in and takes your order. They handle the food like a fine dining restaurant. I tell everyone, if you get sick, go to the airport and fly someplace else.

  10. Several years ago on a trip to France my husband fell jogging across the street in Lyon. Hit his head on the fender of a Volkswagen and began spewing blood everywhere. A French woman also crossing the street directed us to the pharmacy where the pharmacist gave him first aid and called a taxi to take him to the emergency room. Husband got his head stitched and the bill was about the equivalency of $25.00 as I remember. There is something to be said for the French system. As others have said, health care in the States can be a bankrupting proposition.

  11. I broke off a temp front tooth my first day in Paris trying to eat a hard roll. My guide found a Dentist for me at 7PM and went with me and waited while it was repaired and it only cost me $100. Where do you find dentists that work at night in the states?

  12. Annual U.S. health care costs are freighted by an excess of nearly $190 billion in administrative costs, $150 billion in unnecessary extra tests and $75 billion in fraud. Of course we can thank our legal system for the unnecessary tests because doctors want to protect themselves from suits. The administrative load is largely created by insurance companies. And if you ever wonder why it’s so hard to understand the part of the Medicare system that uses private insurance companies for so-called “advantage plans” just look to your congress and the deals it has fabricated for the benefit of the intensely lobbying insurance industry. Of course our own life styles complicate matters also. It would be interesting to know the politics of RS’s tour takers. My guess is most are moderate. I have never been impressed by the work ethic of the Italians and the French but they do work to live not the other way around and that’s not a bad idea.

  13. The unbelievable thing in our country is that we are a wealthy nation. We encourage education in science, engineering and have medical tests and equipment that can help our people. The same with medications. But they are sitting there unavailable for many. This is shameful. It doesn’t matter what the politics are, this is just plain humanity. Why would anyone not want to help their fellow man. Not to mention if money is an issue, we are paying a fortune for illnesses that could have been taken care of provented before they become a burden on society.

  14. We had a similar experience when we had a medical emergency while we were on a family biking trip in Italy. After a day of riding, we traveled from our hotel to a near-by village for dinner where we explained that our son could have no shell fish because of a allergy. While none of us ate shell fish, we suspect that the cooking utensils may have been used to dish up or stir shell fish. The consequence was that our son had a reaction and went into anaphlylactic shock. Luckily, we had the epi pen with us but due to the emergency situation, the medical emergency team was called and arrived within minutes of the time we had to use the epi pen. The team included 1 physician, 1 nurse and 1 EMT. They examined our son, gave him IV and observed him until the fluid had been administered. They not only did not ask for payment, they would not accept payment and were so gracious. We were so impressed, very touched and very lucky!!

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